Mode of delivery after a previous cesarean birth, and associated maternal and neonatal morbidity.

Background: The mode of delivery for women with a previous cesarean delivery remains contentious. We conducted a study comparing maternal and infant outcomes after attempted vaginal birth after cesarean delivery versus elective repeat cesarean delivery.

Methods: We used data from the Discharge Abstract Database that includes all hospital deliveries in Canada (excluding Quebec).

Perinatal outcomes in multifetal pregnancy following fetal reduction.

Background: There is currently insufficient evidence regarding the prognosis of multifetal pregnancy following elective fetal reduction to twin or singleton pregnancy. We compared perinatal outcomes in pregnancies with and without fetal reduction.

Methods: We used data on all stillbirths and live births in British Columbia, Canada, from 2009 to 2013.

Once more unto the breech: planned vaginal delivery compared with planned cesarean delivery.

This article provides a knowledge-based assessment of planned cesarean delivery compared with planned vaginal delivery for breech presentation at term gestation. The most critical evidence on this issue is the intention-to-treat analysis from the Term Breech Trial, which showed that planned cesarean delivery reduced composite perinatal death and serious neonatal morbidity. Although there was no difference in composite death or neurodevelopmental delay at 2 years of age, this finding was based on only 44% of randomized patients and was not an analysis by intention to treat.

Delivery of breech presentation at term gestation in Canada, 2003-2011.

Objective: To examine neonatal mortality and morbidity rates by mode of delivery among women with breech presentation at term gestation.

Methods: We carried out a population-based cohort study examining neonatal outcomes among term, nonanomalous singletons in breech presentation among all hospital deliveries in Canada (excluding Quebec) between 2003 and 2011. Mode of delivery was categorized into vaginal delivery, cesarean delivery in labor, and cesarean delivery without labor.

SOGC Clinical Practice Guidelines: Obesity in pregnancy. No. 239, February 2010.

Objective: To review the evidence and provide recommendations for the counselling and management of obese parturients.

Outcomes: OUTCOMES evaluated include the impact of maternal obesity on the provision of antenatal and intrapartum care, maternal morbidity and mortality, and perinatal morbidity and mortality.

Evidence: Literature was retrieved through searches of Statistics Canada, Medline, and The Cochrane Library on the impact of obesity in pregnancy on antepartum and intrapartum care, maternal morbidity and mortality, obstetrical anaesthesia, and perinatal morbidity and mortality.

SOGC CLINICAL PRACTICE GUIDELINE: guidelines for the management of vasa previa.

Objectives: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa.

Outcomes: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality.

Evidence: Published literature on randomized trials prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e.

SOGC clinical practice guideline: Vaginal delivery of breech presentation: no. 226, June 2009.

Objectives: To review the physiology of breech birth; to discern the risks and benefits of a trial of labour versus planned Caesarean section; and to recommend to obstetricians, family physicians, midwives, obstetrical nurses, anaesthesiologists, pediatricians, and other health care providers selection criteria, intrapartum management parameters, and delivery techniques for a trial of vaginal breech birth.

Options: Trial of labour in an appropriate setting or delivery by pre-emptive Caesarean section for women with a singleton breech fetus at term.

Outcomes: Reduced perinatal mortality, short-term neonatal morbidity, longterm infant morbidity, and short- and long-term maternal morbidity and mortality.

Prenatal diagnosis of partial trisomy 1q and monosomy X in a fetus with a congenital lung lesion and hydrops fetalis.

We report on the prenatal diagnosis of partial trisomy 1q and monosomy X in a fetus with a congenital lung lesion and hydrops. The finding of hydrops in a fetus with a small lung lesion, congenital cystic adenomatoid malformation (CCAM) volume to head circumference ratio (CVR) 0.78, prompted cytogenetic analysis of amniotic fluid, revealing an unbalanced translocation between chromosomes X and 1 [46,X,der(X)t(X;1)(p11.