Despite awareness of obstetricians to the constant increase in the number of caesarean sections in recent years, certain dogmas concerning uterine scar still persist in our practices and influence clinical decisions. Fear of a uterine scar rupture, a major obstetric complication, is always in mind. As for bi-uterine scar, it was considered, until recently in Belgium, as a full and definitive indication against an attempted vaginal delivery. However, several previous clinical studies clearly showed that, under certain conditions, vaginal birth after two caesarean sections was usually successful with very good results in terms of maternal and fetal morbidities. Even if such a clinical situation is not common, this article aims to sensitize obstetricians to the lack of objective clinical arguments to reject a vaginal delivery in a patient having a previous history of two caesarean sections. Such a patient must be motivated and followed up within a specific framework. Moreover, this type of delivery should receive optimal monitoring.
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Childs Nerv Syst
January 2025
Department of Neurological Surgery, Children's Hospital, Goiânia, Brazil.
Background: Myelomeningocele (MMC) is the most common type of congenital spinal malformation, typically requiring surgical intervention. While prenatal repair is increasingly favored, postnatal repair remains the standard in many settings. This study aims to evaluate the antibiotics prescribed to neonates with MMC and their correlation with central nervous system (CNS) infection rates following postnatal surgical repair.
View Article and Find Full Text PDFNEJM Evid
February 2025
from the Fellowship Program in Maternal-Fetal Medicine and the Sections of Infectious Diseases and Global Health and Gastroenterology, Hepatology, and Nutrition at the University of Chicago Medical Center.
AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 26-year-old woman who developed acute hepatocellular liver injury following a cesarean delivery for fetal distress.
View Article and Find Full Text PDFInt J Gynaecol Obstet
January 2025
Obstetrics and Gynaecology Department, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Objective: To evaluate the ability of the fullPIERS model to predict adverse maternal outcomes in patients diagnosed as early-onset pre-eclampsia at Charlotte Maxeke Johannesburg Academic Hospital, South Africa.
Methods: Retrospective record review and analysis of 134 patients admitted with early-onset pre-eclampsia. Demographic data, symptoms, and investigation results relevant to the fullPIERS calculator present on admission were collected.
BMC Pregnancy Childbirth
January 2025
Hochschule für Gesundheitsfachberufe in Eberswalde, Schicklerstraße 20, 16225, Eberswalde, Germany.
The benefits and risks of delivery should always be considered before initiating preinduction cervical ripening and labor induction. Understanding the benefits and potential complications is crucial for healthcare professionals to make informed decisions and provide optimal care. The research was conducted retrospectively between January 2019 and July 2022.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Cheng-Hsin General Hospital, Taipei, Taiwan.
Background: Obesity and excessive gestational weight gain (GWG) have been linked to an increased risk of cesarean section. However, existing literature primarily focuses on weight gain during individual trimesters, lacking a comprehensive assessment of GWG trajectories across all three trimesters. This study aimed to investigate the impact of pre-pregnancy BMI and changes in GWG trajectories from the first to the third trimester on cesarean section in women with confirmed gestational diabetes mellitus (GDM).
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