Pessary or cerclage (PC study) to prevent recurrent preterm birth: a non-inferiority, randomised controlled trial.

Background: Previous spontaneous preterm birth (sPTB) is a strong risk indicator for recurrent preterm birth (PTB). Cervical cerclage is an accepted intervention to prevent recurrent PTB in high risk patients. Cervical pessary might be a less invasive alternative.

Caesarean scar pregnancy complicated by partial rupture in the second trimester: A case report.

This case report examines caesarean scar pregnancy, a rare but significant complication associated with increasing global caesarean rates. It explores diagnostic challenges, therapeutic interventions, and the importance of a multidisciplinary approach. This report details the case of a patient at 13 + 4 weeks of amenorrhea presenting with severe abdominal pain, diagnosed with caesarean scar pregnancy and scar dehiscence causing major haemorrhage.

What proportion of couples with a history of recurrent pregnancy loss and with a balanced rearrangement in one parent can potentially be identified through cell-free DNA genotyping?

Background: Balanced chromosome aberrations are reported in about 1:30 couples with recurrent pregnancy loss (RPL). Karyotyping of both parents is necessary to identify these aberrations. Genome-wide non-invasive prenatal testing (NIPT) in case of recurrent pregnancy loss could be a more efficient way to identify couples at increased risk for carrying a balanced chromosome rearrangement.

Levothyroxine in euthyroid thyroid peroxidase antibody positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.

Background: Women positive for thyroid peroxidase antibodies (TPO-Ab) have a higher risk of recurrent pregnancy loss. Evidence on whether levothyroxine treatment improves pregnancy outcomes in women who are TPO-Ab positive women with recurrent pregnancy loss is scarce. The aim of this study was to determine if levothyroxine increases live birth rates in women who were TPO-Ab positive with recurrent pregnancy loss and normal thyroid function.

Cervical cancer in 2 women with a Mirena(R)-pitfalls in the assessment of irregular bleeding: a case series.

Introduction: The levonorgestrel-releasing intra-uterine device (Mirena(R)) is an effective, long term form of contraception that leads to a significant reduction of menstrual bleeding among majority of women. However, irregular bleeding is quite common in initial Mirena(R) users and may thereby mask underlying cervical pathology.

Case Presentation: Two women with cervical cancer and a Mirena(R) initially presented with irregular bleeding, posing a diagnostic pitfall which resulted in doctor and patient delay.

Dutch community midwives' views on preconception care.

Objective: to explore the opinions of midwives on the desirability of preconception care for all couples contemplating pregnancy, their willingness to introduce preconception care to midwifery practice and, if it were to be implemented, the necessary conditions, including knowledge, postgraduate education and referral possibilities for successful implementation in the community.

Participants: all community midwives (n = 129) working in 49 midwifery practices that refer their high-risk clients to the Erasmus University Medical Centre, Rotterdam (the Netherlands).

Setting: Rotterdam and its immediate surrounding communities.

Preconception care: preliminary estimates of costs and effects of smoking cessation and folic acid supplementation.

Objective: To assess costs and effectiveness of preconception counseling for all women planning pregnancy in The Netherlands with regard to folic acid supplementation and smoking cessation counseling.

Study Design: Costs and effects were estimated based on 200,000 women approached yearly and uptake rates of 50% and 75%. Effectiveness and potential savings were based on hospital costs of neural tube defects, low birth weight, very low birth weight and perinatal death attributable to maternal smoking.

Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss.

Background: Physical, emotional, and social functioning are impaired in obesity. It is unknown whether and, if so, to what extent and in which domain obese subjects who lose weight may catch up to normal-weight levels. Our objective was to compare the health-related quality-of-life (HRQL) of obese subjects with that of a normal-weight reference group before and 1 year after a weight loss program that centered around laparoscopic and open gastric banding.

The past and present practices and continuing controversies of preconception care.

Preconception care, a long-established concept for primary prevention of maternal and perinatal morbidity and mortality through detection and reduction of modifiable risks, has been widely propagated for the last decades. This article provides an overview of the various goals and practices described in the literature in different parts of the world, including issues and controversies pertaining to the provision and implementation of preconception care in different health care settings.

Preconception nutritional intake and lifestyle factors: first results of an explorative study.

Objective: To describe nutritional intake and lifestyle factors in women planning pregnancy.

Study Design: A semi-quantitative, 1-month food frequency questionnaire and a questionnaire on health practices and personal views were filled out at home and verified by telephone interview.

Results: One hundred and one women agreed to participate and data of 69 women were eligible for evaluation.

Validation of the dutch short form of the state scale of the Spielberger State-Trait Anxiety Inventory: considerations for usage in screening outcomes.

Objective: To validate the six-item short form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI) for usage in screening outcomes in a Dutch population receiving preconception counseling.

Methods: Men and women completed the 20-item full form of the STAI before (n = 310) and after preconception counseling (n = 147). Prorated scores of the six-item form were compared to the full form using Pearson's correlation coefficients and paired t tests.

Variation of serum and urine cotinine in passive and active smokers and applicability in preconceptional smoking cessation counseling.

This study assessed the applicability of serum and urine cotinine as a biochemical marker of self-reported smoking habits for use in a preconceptional smoking cessation program. The variation of serum and urine cotinine over the course of the day was investigated in a sample of 21 smokers and 8 passive smokers who reported their smoking habits and exposure to smoke daily in a questionnaire for 10 consecutive days. Blood and urine samples were collected on two sampling days, 1 week apart.

Preconception care: a screening tool for health assessment and risk detection.

Background: Identification of risk factors for adverse pregnancy outcome is a main component of preconception care, but requires adequate time and knowledge. This study compares self-administered questionnaires to history taking by a physician to evaluate the reliability of such a screening tool for prepregnancy risk detection.

Methods: One hundred ninety-three women from the outpatient clinic of Obstetrics and Gynecology of the University Medical Center Nijmegen, The Netherlands, were included in a study on preconception care.

Preconception counseling improves folate status of women planning pregnancy.

Objective: To assess whether counseling women planning pregnancy to start or continue folic acid supplementation improves folate status.

Methods: Women and their partners reported folic acid supplement intake in a preconceptional health questionnaire, and the women were categorized as reported "users" or "nonusers" of supplements before counseling. The use of periconceptional folic acid was addressed at a subsequent preconceptional consultation.