What is new in operative obstetrics?: Best articles from the past year.

This month, we focus on current research in operative obstetrics. Dr. Lupo discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message.

Change in periodontitis during pregnancy and the risk of pre-term birth and low birthweight.

Aim: Determine whether periodontitis progression during pregnancy is associated with adverse birth outcomes.

Methods: We used clinical data and birth outcomes from the Obstetrics and Periodontal Therapy Study, in which randomly selected women received periodontal treatment before 21 weeks of gestation (N=413) or after delivery (410). Birth outcomes were available for 812 women and follow-up periodontal data for 722, including 75 whose pregnancies ended <37 weeks.

Examining the safety of dental treatment in pregnant women.

Background: Although clinicians generally consider it safe to provide dental care for pregnant women, supporting clinical trial evidence is lacking. This study compares safety outcomes from a trial in which pregnant women received scaling and root planing and other dental treatments.

Methods: The authors randomly assigned 823 women with periodontitis to receive scaling and root planing, either at 13 to 21 weeks' gestation or up to three months after delivery.

Recombinant factor VIIa to successfully manage disseminated intravascular coagulation from amniotic fluid embolism.

Background: Amniotic fluid embolism (AFE) is a rare syndrome that can complicate pregnancy and labor. It often has debilitating and lethal consequences. One serious sequela of AFE is disseminated intravascular coagulation (DIC).

Treatment of periodontal disease and the risk of preterm birth.

Background: Maternal periodontal disease has been associated with an increased risk of preterm birth and low birth weight. We studied the effect of nonsurgical periodontal treatment on preterm birth.

Methods: We randomly assigned women between 13 and 17 weeks of gestation to undergo scaling and root planing either before 21 weeks (413 patients in the treatment group) or after delivery (410 patients in the control group).