Genes, genomes, and developmental process.

The view advanced by Madole & Harden falls back on the dogma of a gene as a DNA sequence that codes for a fixed product with an invariant function regardless of temporal and spatial contexts. This outdated perspective entrenches the metaphor of genes as static units of information and glosses over developmental complexities.

Application of a Physiologically Based Pharmacokinetic Model to Predict Cefazolin and Cefuroxime Disposition in Obese Pregnant Women Undergoing Caesarean Section.

Intravenous (IV) cefuroxime and cefazolin are used prophylactically in caesarean sections (CS). Currently, there are concerns regarding sub-optimal dosing in obese pregnant women compared to lean pregnant women prior to CS. The current study used a physiologically based pharmacokinetic (PBPK) approach to predict cefazolin and cefuroxime pharmacokinetics in obese pregnant women at the time of CS as well as the duration that these drug concentrations remain above a target concentration (2, 4 or 8 µg/mL or µg/g) in plasma or adipose tissue.

Pre-conceptual counselling in cardiology patients: still work to do and still missed opportunities. A comparison between 2015 and 2019 in women with cardiac disease attending combined obstetric cardiology clinics. Should the European Guidelines change anything?

Women with underlying cardiac conditions have an increased risk of adverse pregnancy outcomes. Counselling reproductive age women with heart disease is important to assist them in deciding whether to pursue pregnancy, to ensure their best cardiovascular status prior to pregnancy, and that they understand the risks of pregnancy for them and baby. This also provides an opportunity to explore management strategies to reduce risks.

Samba II PCR testing for COVID-19 in pregnant women: a retrospective cohort study and literature review.

Background: Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage.

Prophylactic perioperative cefuroxime levels in plasma and adipose tissue at the time of caesarean section (C-LACE): a protocol for a pilot experimental, prospective study with non-probability sampling to determine interpatient variability.

Background: The aim of the C-LACE study is to measure cefuroxime concentration in plasma and adipose tissue of non-obese and obese pregnant women undergoing caesarean section.

Methods: This study plans to compare maternal cefuroxime concentrations (plasma and adipose tissue), at the time of skin incision and time of skin closure during a caesarean section from non-obese (body mass index BMI < 30 kg/m) and obese (BMI ≥ 30 kg/m) pregnant women. The incidence of post-surgical site infection will also be measured.

An abnormal cerebroplacental ratio (CPR) is predictive of early childhood delayed neurodevelopment in the setting of fetal growth restriction.

Background: Fetal growth restriction accounts for a significant proportion of perinatal morbidity and death. The cerebroplacental ratio is gaining much interest as a useful tool in differentiating the "at-risk" fetus in both fetal growth restriction and appropriate-for-gestational-age pregnancies. The Prospective Observational Trial to Optimize Pediatric Health in Fetal Growth Restriction group has demonstrated previously that the presence of this "brain-sparing" effect is associated significantly with adverse perinatal outcomes in the fetal growth restriction cohort.

Maternal rates of lipolysis and glucose production in late pregnancy are independently related to foetal weight.

Objective: Associations between maternal glucose levels and increased foetal growth are well established, and independent relationships with maternal weight, weight gain and insulin resistance are also observed. The relative roles of lipolysis and glucose production in the determination of these observations remain unclear.

Design: We examined, through detailed physiological studies, the relationship between maternal late gestational energy substrate production (glucose and glycerol), maternal weight and weight gain, and estimated foetal size in the third trimester.

The SafeBoosC II randomized trial: treatment guided by near-infrared spectroscopy reduces cerebral hypoxia without changing early biomarkers of brain injury.

Background: The SafeBoosC phase II multicentre randomized clinical trial investigated the benefits and harms of monitoring cerebral oxygenation by near-infrared spectroscopy (NIRS) combined with an evidence-based treatment guideline vs. no NIRS data and treatment as usual in the control group during the first 72 h of life. The trial demonstrated a significant reduction in the burden of cerebral hypoxia in the experimental group.

Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial: cranial ultrasound and magnetic resonance imaging assessments.

Background: Abnormal cerebral perfusion during the first days of life in preterm infants is associated with higher grades of intraventricular hemorrhages and lower developmental score. In SafeBoosC II, we obtained a significant reduction of cerebral hypoxia by monitoring cerebral oxygenation in combination with a treatment guideline. Here, we describe (i) difference in brain injury between groups, (ii) feasibility of serial cranial ultrasound (cUS) and magnetic resonance imaging (MRI), (iii) local and central cUS assessment.

A model to predict vaginal delivery in nulliparous women based on maternal characteristics and intrapartum ultrasound.

Objective: Accurate prediction of whether a nulliparous woman will have a vaginal delivery would be a major advance in obstetrics. The objective of the study was to develop such a model based on maternal characteristics and the results of intrapartum ultrasound.

Study Design: One hundred twenty-two nulliparous women in the first stage of labor were included in a prospective observational 2-centre study.

Prediction of delivery mode by ultrasound-assessed fetal position in nulliparous women with prolonged first stage of labor.

Objectives: To ascertain if fetal head position on transabdominal ultrasound is associated with delivery by Cesarean section in nulliparous women with a prolonged first stage of labor.

Methods: This was a prospective observational study performed at Stavanger University Hospital, Norway, and Addenbrooke's Hospital, Cambridge, UK, between January 2012 and April 2013. Nulliparous pregnant women with a singleton cephalic presentation at term and prolonged labor had fetal head position assessed by ultrasound.

Respiratory function parameters in ventilated newborn infants undergoing whole body hypothermia.

Aim: Whole body hypothermia (WBH) exerts proven neuroprotective effects in infants with hypoxic-ischaemic encephalopathy (HIE). Our aim was to describe how WBH could impact on respiratory function in mechanically ventilated newborn infants, by recording primary and composite indices of oxygenation and ventilation before, during and after WBH.

Methods: The medical notes of 31 mechanically ventilated full-term newborn infants who underwent WBH for HIE were retrospectively reviewed.

Pain score assessment in babies undergoing laser treatment for retinopathy of prematurity under sub-tenon anaesthesia.

Purpose: To assess the tolerability and outcomes of laser treatment for retinopathy of prematurity (ROP) under sub-tenon anaesthetic with oral or rectal sedation using a reliable, multidimensional, and internationally accepted tool for assessment of neonatal pain.

Methods: Sixty-two babies have had ROP laser treatment in our neonatal unit in the 7-year interval between 1 March 2005 and 28 February 2012; 44% (27 of the 62) were performed using sub-tenon anaesthesia. Pain scores were routinely assessed using the Neonatal Pain Agitation and Sedation Scale (N-PASS) every 10 min during laser treatment.

A novel approach to standardised recording of bleeding in a high risk neonatal population.

Background: Bleeding assessment tools have been developed in other specialties to standardise the recording of bleeding for clinical haemostatic outcomes in transfusion trials, but such tools have not been developed for routine use in neonatology.

Aim: The objective of this study was to develop, refine and evaluate a neonatal bleeding assessment tool (NeoBAT) to standardise the clinical recording of bleeding in premature and term neonates in an intensive care setting.

Methods: This prospective neonatal international multicentre study included all episodes of bleeding in infants admitted to the intensive/high dependency care nursery over a 2-4-week period.

Simple two-dimensional ultrasound technique to assess intrapartum cervical dilatation: a pilot study.

Objectives: To describe a two-dimensional (2D) ultrasound technique to measure cervical dilatation in labor, and to compare ultrasound with digital measurements.

Methods: 2D transperineal ultrasound was performed in 21 nulliparous women in labor with a singleton fetus in cephalic presentation and cervical dilatation measured before or after a digital vaginal examination. The absolute difference was calculated and Bland-Altman analysis was used to assess the mean difference between digital vaginal examination and ultrasound examination of cervical dilatation.

Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study.

Objective: To determine whether women experiencing recurrent miscarriage were more likely to have a family history of cardiovascular disease.

Design: Retrospective cohort study.

Setting: Women having a first birth in Scotland between 1992 and 2006.

Predicting antepartum stillbirth.

Stillbirth affects approximately 1 in 200 pregnancies and is one of the most common serious complications of pregnancy. Stillbirth can occur as a consequence of diverse processes, including fetal abnormality, isoimmunization, infection, maternal preeclampsia, placental abruption, maternal medical conditions, complications of labor and delivery, growth restriction, and also often occurs in the absence of an apparent cause or predisposing factor. This review summarizes a number of factors which identify women at increased risk of stillbirth, including maternal characteristics, blood tests, and biophysical tests.

Zepherina Veitch (1836-94), childbed fever and the registration of midwives.

At a time when hospital infections are rarely out of the news, it is important to reflect that the origins of midwifery as a profession owe much to the actions of a group of determined women who, in the face of much opposition from within the medical profession, strove to improve upon standards of hygiene in maternity care to reduce the high levels of maternal and infant mortality associated with some of the most prestigious hospitals in the land.

WITHDRAWN: Gonadotrophin-releasing hormone analogues for pain associated with endometriosis.

Background: Endometriosis is a common gynaecological condition that frequently presents with the symptom of pain. The precise pathogenesis (mode of development) of endometriosis is unclear but it is evident that endometriosis arises by the dissemination of endometrium to ectopic sites and the subsequent establishment of deposits of ectopic endometrium. The observation that endometriosis is rarely seen in the hypo-oestrogenic (low levels of oestrogen) post-menopausal woman led to the concept of medical treatment by induction of a pseudo-menopause using Gonadotrophin Releasing Hormone Analogues (GnRHas).

Maternal and biochemical predictors of antepartum stillbirth among nulliparous women in relation to gestational age of fetal death.

Objective: To determine whether maternal serum levels of alphafetoprotein (alpha-FP) and human chorionic gonadotrophin (hCG) at 15-21 weeks provided clinically useful prediction of stillbirth in first pregnancies.

Design: Retrospective study of record linkage of a regional serum screening laboratory to national registries of pregnancy outcome and perinatal death.

Setting: West of Scotland, 1992-2001.

Maternal uterine artery Doppler flow velocimetry and the risk of stillbirth.

Objective: We sought to relate the risk of antepartum stillbirth to uterine artery Doppler flow velocimetry at 22-24 weeks.

Methods: Data were available from 30,519 unselected women from seven units in the UK who had uterine artery Doppler performed between 22 and 24 weeks of gestation. The risk of stillbirth (n=109) was assessed using time to event and logistic regression analysis.

Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study.

Objectives: We sought to determine the association between maternal body mass index and risk of preterm delivery.

Methods: We assessed 187,290 women in Scotland and estimated adjusted odds ratios for spontaneous and elective preterm deliveries among overweight, obese, and morbidly obese women relative to normal-weight women.

Results: Among nulliparous women, the risk of requiring an elective preterm delivery increased with increasing BMI, whereas the risk of spontaneous preterm labor decreased.