Women's experiences of tests and procedures carried out at a preterm birth surveillance clinic

Background Preterm birth is a major cause of neonatal mortality and morbidity, with practices varying between specialist services. Aim To explore the experiences and views of pregnant women at high-risk of preterm birth who were undergoing tests requiring a speculum examination and procedures at a preterm birth surveillance clinic. Methods Women attending for preterm surveillance at a specialist clinic were asked to complete a questionnaire. Findings A total of 102 participants completed the questionnaire. Overall, 97% (n=99) of women found the speculum examination acceptable and 88% (n=90) stated they would be happy to have the examination again if required. This was comparable to 95% (n=97) of women who stated they found the transvaginal ultrasound examination acceptable. Conclusions Our findings suggest that women at risk of preterm birth find speculum examinations and transvaginal ultrasound scans for cervical length measurement acceptable. </jats:sec

Successful pregnancy following mid-trimester evacuation through a transabdominal cervical cerclage

Preterm birth remains a major challenge in modern obstetrics and is increasing, even among low-risk primiparous women. Very few interventions have made a positive impact on outcome although cervical cerclage appears to benefit some women. Transabdominal cervical cerclage can be highly successful and should be considered in women with previous failed transvaginal cerclage, but requires operative abdominal delivery as it cannot be removed. The authors report the first case they are aware of, where a spontaneous abortion occurred with a transabdominal cerclage in situ and a mid-trimester dilation and evacuation was performed through the cerclage at 18 weeks gestation, instead of a hysterotomy. A subsequent pregnancy was successful and it was the first to go full term

Clinical Application of Quantitative Foetal Fibronectin for the Prediction of Preterm Birth in Symptomatic Women

Aim: To evaluate the clinical application of the new Hologic quantitative foetal fibronectin (qfFN) bedside test for the prediction of spontaneous preterm birth (sPTB) in patients with symptoms suggestive of spontaneous threatened preterm labour (sPTL). Methods: A prospective observational study with 154 pregnant women presenting signs and symptoms of sPTL was conducted. These women were subjected to a qfFN test between 22 and 35 weeks of gestation For each cut-off threshold, the ability to predict sPTB at within 14 days of conducting the test and 200 ng/mL produced a 50.0% PPVthus, qfFN added enhanced discrimination between high- and low-risk patients. The overall rate of sPTB (< 37) was 13.3% (16/120), which increased progressively with increasing levels of fFN, with rates of 9.8% (8/81), 11.5% (3/26), 14.2% (1/7), 50% (3/6) within the 4 categories (fFN 0-9, 10-49, 50-200, 200+) respectively. Conclusions: The use of the qfFN testing in symptomatic patients allowed for more accurate identification of women at risk of sPTB and thus more directed management. (C) 2017 S. Karger AG, BaselUniv Melbourne, Royal Womens Hosp, Dept Perinatal Med, Parkville, Vic, AustraliaUniv Melbourne, Royal Womens Hosp, Dept Obstet & Gynaecol, Parkville, Vic, AustraliaMonash Univ, Dept Obstet & Gynaecol, Clayton, Vic, AustraliaMonash Ultrasound Women, Clayton, Vic, AustraliaUniv Fed Sao Paulo, Paulista Sch Med, Dept Obstet, Sao Paulo, BrazilUniv Fed Sao Paulo, Paulista Sch Med, Dept Obstet, Sao Paulo, BrazilWeb of Scienc

Acupuncture versus antidepressants in the management of postpartum depression : a systematic review

Background: Antidepressants for postnatal depression may not be acceptable to women and so many may seek alternative therapies. Aim: To evaluate the effectiveness and safety of acupuncture for postnatal depression compared with antidepressant treatment. Methods: A literature search was conducted in English, Chinese, Japanese and Korean databases. Details of the trials were extracted and analysed. Findings Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis.Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements. Conclusions: Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option

Assessing the contribution of urban green spaces in green infrastructure strategy planning for urban ecosystem conditions and services

Maintaining ecosystem services is a key adaption option towards sustainable cities and adaptive societies in securing citizens’ health and wellbeing. This research investigates the contribution of using urban green space components as the basic units in green infrastructure strategy planning for urban ecosystem conditions and services. A total of 9 types of urban green spaces are selected and delineated from the high-resolution data. A combination of the quantification method of 6 common urban ecosystem services based on urban green spaces and the MAES framework in reference to literature data is used. A case study of Cheltenham, a typical urban town in England, is studied to present the new approach for local green infrastructure strategy development for urban ecosystem conditions and respective services in improving the resilience of a city in facing global climate change. Results show that changing the composition and spatial arrangement of urban green space components, synergy or tradeoff of various services can be stimulated easily. The small scale of urban green space components allows local detail planning and potential integrated planning among other urban settlements