Halting the Canadian STRIDER randomised controlled trial of sildenafil for severe, early-onset fetal growth restriction: ethical, methodological, and pragmatic considerations.

Objectives: To determine the efficacy and safety of sildenafil citrate to improve outcomes in pregnancies complicated by early-onset, dismal prognosis, fetal growth restriction (FGR). Eligibility: women ≥ 18 years, singleton, 18 + 0-27 + 6 weeks' gestation, estimated fetal weight < 700 g, low PLFG, and ≥ 1 of (i) abdominal circumference < 10th percentile for gestational age (GA); or (ii) reduced growth velocity and either abnormal uterine artery Doppler or prior early-onset FGR with adverse outcome. Ineligibility criteria included: planned termination or reversed umbilical artery end-diastolic flow.

PIERS proteinuria: relationship with adverse maternal and perinatal outcome.

Objective: To examine the ability of three different proteinuria assessment methods (urinary dipstick, spot urine protein:creatinine ratio [Pr/Cr], and 24-hour urine collection) to predict adverse pregnancy outcomes.

Methods: We performed a prospective multicentre cohort study, PIERS (Preeclampsia Integrated Estimate of RiSk), in seven academic tertiary maternity centres practising expectant management of preeclampsia remote from term in Canada, New Zealand, and Australia. Eligible women were those admitted with preeclampsia who had at least one antenatal proteinuria assessment by urinary dipstick, spot urine Pr/Cr ratio, and/or 24-hour urine collection.

Acceptance of a rapid herpes test in labour: survey of attitudes of patients and health care providers.

Objective: To determine the acceptability to pregnant women and their health care providers of a rapid test for genital herpes simplex virus (HSV) in labour.

Methods: A cross-sectional survey was conducted with outpatient pregnant women and their health care providers (obstetricians, family physicians and midwives) at BC Women's Hospital and Health Centre.

Results: Of pregnant women approached, 207 (92%) completed the survey; 90% reported no history of genital herpes.

The evaluation of the fetal fibronectin test for prediction of preterm delivery in symptomatic patients.

Objective: This study was conducted to evaluate the usefulness of testing for fetal fibronectin (fFN) to rule out the diagnosis of preterm labour in symptomatic patients in a Canadian setting.

Methods: This was a prospective, blinded clinical evaluation of fFN testing in women presenting with threatened preterm labour at between 24 and 34 weeks' gestation at two Canadian tertiary care centres.

Results: Of the 149 women tested, 32 had a positive fFN test.