BJOG : an international journal of obstetrics and gynaecology
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To investigate the impact of maternal body mass index (BMI, kg/m(2)) on clinical complications, inpatient admissions, and additional short-term costs to the National Health Service (NHS) in Scotland. ⋯ Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.
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To study whether pregnancy week at delivery is an independent risk factor for shoulder dystocia. ⋯ The risk of shoulder dystocia was associated with increased birthweight, diabetes, induction of labour, use of epidural analgesia at delivery, prolonged labour, forceps-assisted and vacuum-assisted delivery, parity and period of delivery but not with post-term delivery.
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To develop a patient decision aid (PtDA) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean (VBAC) with the elicitation of patient preferences and evidence-based information. ⋯ An evidence-based PtDA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the PtDA enhances the quality of decision-making on mode of birth after caesarean section.
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Review Meta Analysis Comparative Study
Additional information from chromosomal microarray analysis (CMA) over conventional karyotyping when diagnosing chromosomal abnormalities in miscarriage: a systematic review and meta-analysis.
Approximately 50% of spontaneous miscarriages are associated with chromosome abnormalities. Identification of these karyotypic abnormalities helps to estimate recurrence risks in future pregnancies. Chromosomal microarray analysis (CMA) is transforming clinical cytogenetic practice with its ability to examine the human genome at increasingly high resolution. ⋯ Compared with karyotyping, there appears to be an increased detection rate of chromosomal abnormalities when CMA is used to analyse the products of conception; however, some of these abnormalities are VOUS, and this information should be provided when counselling women following miscarriage and when taking consent for the analysis of miscarriage products by CMA.
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Abnromalities of placentation, including placenta accreta, represent a major source of morbidity and mortality among women. Traditional management consists of peripartum hysterectomy at the time of delivery, although more conservative treatments have also been developed recently. In this review we describe the available literature describing the operative approach and considerations for management of women with placenta accreta.