Bo Jacobsson,Joe Leigh Simpson,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13863
Volume 155, Issue 1 p. 1-4
J. Frederik Frøen,Ana Bianchi,Ann-Beth Moller,Bo Jacobsson,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13847
Volume 155, Issue 1 p. 5-7
FIGO calls for strengthening of health information systems for reproductive, maternal, newborn, and child health services, co-designed with users, to ensure the timely accessibility of actionable high-quality data for all stakeholders engaged in preventing and managing preterm birth consequences. FIGO calls for strengthening of investments and capacity for implementing digital registries and the continuity of reproductive, maternal, newborn, and child health services in line with WHO recommendations, and strengthening of the science of implementation and use of registries—from local quality improvement to big data exploration.
Catalina M. Valencia,Ben W. Mol,Bo Jacobsson, on behalf of the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13857
Volume 155, Issue 1 p. 8-12
Iatrogenic preterm birth is a planned delivery that occurs before 37 weeks of gestation due to maternal and/or fetal causes. However, in some cases, such deliveries also occur with no apparent medical indication. The increasing numbers of iatrogenic preterm deliveries worldwide have led researchers to identify modifiable causes that allow the formulation of preventive strategies that could impact the overall preterm birth rate. The present document contains the FIGO (International Federation of Gynecology and Obstetrics) Working Group for Preterm Birth recommendations, aiming to reduce the rates of iatrogenic preterm birth based on four of the most common clinical scenarios and issues related to iatrogenic preterm delivery. The working group supports efforts to identify the contribution of iatrogenic preterm delivery to the overall preterm birth rate and encourages health authorities to establish preventive measures accordingly. We encourage care providers to maintain single embryo transfer policies to prevent multiple pregnancies as a substantial contributor of iatrogenic preterm birth. The working group also recommends that efforts to reduce unnecessary cesarean sections must be warranted, and mechanisms to ensure the appropriate time of delivery and strengthening of education and communication processes must be pursued.
Ben W. Mol,Bo Jacobsson,William A. Grobman,Kelle Moley,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13834
Volume 155, Issue 1 p. 13-15
FIGO (the International Federation of Gynecology and Obstetrics) supports assisted reproductive technologies (ART) to achieve pregnancy and supports their availability in all nations. However, the increased frequency of preterm birth must be taken into account. Therefore, before in vitro fertilization (IVF) is started, other approaches, including expectant management, should be considered. Single embryo transfer is the best approach to ensure a live, healthy child. However, increased risks for preterm birth are also associated with a singleton IVF pregnancy and should be discussed and contrasted with spontaneous conception. Increased preterm birth and other adverse pregnancy outcomes in singleton IVF cycles warrant investigations to elucidate and mitigate. Minimizing embryo manipulation during cell culture is recommended. Increased risk of preterm birth and other pregnancy complications in ART could reflect the underlying reasons for infertility. This information should be discussed and further explored.
Andrew Shennan,Natalie Suff,Joe Leigh Simpson,Bo Jacobsson,Ben W. Mol,William A. Grobman,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13852
Volume 155, Issue 1 p. 16-18
Women at high risk of preterm birth (either a previous spontaneous preterm birth and/or sonographic short cervix) with a singleton gestation should be offered daily vaginal progesterone or weekly 17-OHPC treatment to prevent preterm birth. Benefit is most significant in those with prior history of preterm birth and a short cervix. For women with a previous spontaneous preterm birth and a cervix ?30 mm the effectiveness of progesterone is uncertain. In asymptomatic women with no prior history of previous preterm birth, no mid-trimester loss, or no short cervical length, progesterone therapy is not recommended for the prevention of preterm birth. For those with unselected multiple pregnancies, progesterone therapy is not recommended for the prevention of preterm birth. Daily vaginal progesterone or weekly 17-OHPC treatment can be used for the prevention of preterm birth. The preparation used should be decided by the woman and her clinician. There is no evidence of neurological or developmental benefit or harm in babies whose mothers use progestogens for preterm birth prevention antenatally.
Andrew Shennan,Lisa Story,Bo Jacobsson,William A. Grobman,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13835
Volume 155, Issue 1 p. 19-22
Cervical cerclage is an intervention which when given to the right women can prevent preterm birth and second-trimester fetal losses. A history-indicated cerclage should be offered to women who have had three or more preterm deliveries and/or mid-trimester losses. An ultrasound-indicated cerclage should be offered to women with a cervical length <25 mm if they have had one or more spontaneous preterm birth and/or mid-trimester loss. In high-risk women who have not had a previous mid-trimester loss or preterm birth, an ultrasound-indicated cerclage does not have a clear benefit in women with a short cervix. However, for twins, the advantage seems more likely at shorter cervical lengths (<15 mm). In women who present with exposed membranes prolapsing through the cervical os, a rescue cerclage can be considered on an individual case basis, taking into account the high risk of infective morbidity to mother and baby. An abdominal cerclage can be offered in women who have had a failed cerclage (delivery before 28 weeks after a history or ultrasound-indicated [but not rescue] cerclage). If preterm birth has not occurred, removal is considered at 36–37 weeks in women anticipating a vaginal delivery.
William A. Grobman,Jane Norman,Bo Jacobsson,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13837
Volume 155, Issue 1 p. 23-25
A pessary is a device made of synthetic material that is placed in the vagina and has been used for prevention of preterm birth. It has been suggested that a potential mechanism of the pessary is alteration of the cervico-uterine angle to a more posterior position, which reduces cervical compression in women with a singleton pregnancy and a short cervical length. Pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. In women with a twin pregnancy—regardless of cervical length—pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. Presently there is no sufficient evidence suggesting that pessaries should be used as a standard treatment to prevent preterm birth; their use should be reserved for study populations.
Jane Norman,Andrew Shennan,Bo Jacobsson,Sarah J. Stock,the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13836
Volume 155, Issue 1 p. 26-30
For women with a singleton or a multiple pregnancy in situations where active neonatal care is appropriate, and for whom preterm birth is anticipated between 24 and 34 weeks of gestation, one course of prenatal corticosteroids should ideally be offered 18 to 72 h before preterm birth is expected to improve outcomes for the baby. However, if preterm birth is expected within 18 h, prenatal corticosteroids should still be administered. One course of corticosteroids includes two doses of betamethasone acetate/phosphate 12 mg IM 24 h apart, or two doses of dexamethasone phosphate 12 mg IM 24 h apart. In women in whom preterm birth is expected within 72 h and who have had one course of corticosteroids more than a week previously, one single additional course of prenatal corticosteroids could be given at risk of imminent delivery. Prenatal corticosteroids should not be offered routinely to women in whom late preterm birth between 34 and 36 weeks is anticipated. In addition, prenatal corticosteroids should not be given routinely before cesarean delivery at term. Neither should prenatal corticosteroids be given “just in case”. Instead, prenatal steroid administration should be reserved for women for whom preterm birth is expected within no more than 7 days, based on the woman's symptoms or an accurate predictive test.
Andrew Shennan,Natalie Suff,Bo Jacobsson, on behalf of the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13856
Volume 155, Issue 1 p. 31-33
In women at risk of early preterm imminent birth, from viability to 30 weeks of gestation, use of MgSO4 for neuroprotection of the fetus is recommended. In pregnancies below 32–34 weeks of gestation, the use of MgSO4 for neuroprotection of the fetus should be considered. MgSO4 should be administered regardless of the cause for preterm birth and the number of babies in utero. MgSO4 should be administered when early preterm birth is planned or expected within 24 h. When birth is planned, MgSO4 should commence as close as possible to 4 h before birth. If delivery is planned or expected to occur sooner than 4 h, MgSO4 should be administered, as there is still likely to be an advantage from administration within this time. The optimal regimen of MgSO4 for fetal neuroprotection is an intravenous loading dose of 4 g (administered slowly over 20–30 min), followed by a 1 g per hour maintenance dose. This regimen should continue until birth but should be stopped after 24 h if undelivered. When MgSO4 is administered, women should be monitored for clinical signs of magnesium toxicity at least every 4 h by recording pulse, blood pressure, respiratory rate, and deep tendon (for example, patellar) reflexes.
Ana Bianchi,Bo Jacobsson,Ben W. Mol, on behalf of the FIGO Working Group for Preterm Birth
doi : 10.1002/ijgo.13841
Volume 155, Issue 1 p. 34-36
Delayed cord clamping in the first minute in preterm infants born before 34 weeks of gestation improves neonatal hematologic measures and may reduce mortality without increasing any other morbidity. In term-born babies, it also seems to improve both the short- and long-term outcomes and shows favorable scores in fine motor and social domains. However, there is insufficient evidence to show what duration of delay is best. The current evidence supports not clamping the cord before 30 seconds for preterm births. Future trials could compare different lengths of delay. Until then, a period of 30 seconds to 3 minutes seems justified for term-born babies.
Lukoye Atwoli,Abdullah H. Baqui,Thomas Benfield,Raffaella Bosurgi,Fiona Godlee,Stephen Hancocks,Richard Horton,Laurie Laybourn-Langton,Carlos Augusto Monteiro,Ian Norman,Kirsten Patrick,Nigel Praities,Marcel GM Olde Rikkert,Eric J. Rubin,Peush Sahni,Richard Smith,Nick Talley,Sue Turale,Damián Vázquez
doi : 10.1002/ijgo.13864
Volume 155, Issue 1 p. 37-39
Elizabeth M. Stringer,Ashraf Nabhan
doi : 10.1002/ijgo.13833
Volume 155, Issue 1 p. 40-42
Alexander B. Olawaiye,Joseph Cotler,Mauricio A. Cuello,Neerja Bhatla,Aikou Okamoto,Sarikapan Wilailak,Chittaranjan N. Purandare,Gerhard Lindeque,Jonathan S. Berek,Sean Kehoe
doi : 10.1002/ijgo.13880
Volume 155, Issue 1 p. 43-47
Rahul K. Gajbhiye,Mamta S. Sawant,Periyasamy Kuppusamy,Suchitra Surve,Achhelal Pasi,Ranjan K. Prusty,Smita D. Mahale,Deepak N. Modi
doi : 10.1002/ijgo.13793
Volume 155, Issue 1 p. 48-56
SARS-CoV-2 has infected a large number of pregnant women.
Yamini Sarwal,Tanvi Sarwal,Rakesh Sarwal
doi : 10.1002/ijgo.13816
Volume 155, Issue 1 p. 57-63
Despite emerging evidence on safety and efficacy, most countries do not offer COVID-19 vaccines to pregnant women even though they are at higher risk of complications from COVID-19. We performed a web search of COVID-19 vaccination policies for pregnant women under two categories: countries bearing a high burden of COVID-19 cases and countries with a high burden of maternal and under-five mortality. Of the top 20 countries affected by COVID-19, 11 allow vaccination of pregnant women, of which two have deemed it safe to vaccinate pregnant women as a high-risk group. In contrast, only five of the 20 countries with high under-five mortality and maternal mortality allow vaccination of pregnant women and none of these countries has included them as part of a high-risk group that should be vaccinated. India and Indonesia, with one-fifth of the world's population, fall under both categories but do not include pregnant women as a priority group for COVID-19 vaccination. To prevent COVID-19 from further aggravating the already heavy burden of maternal and under-five mortality, there is a strong case for including pregnant women as a high-priority group for COVID-19 vaccination. We recommend including COVID-19 vaccination in routine antenatal care in all countries, particularly India and Indonesia in view of their high dual burden.
Kirsten J. H. Das,Megan Fuerst,Ciara Brown,Jennifer Lesko
doi : 10.1002/ijgo.13805
Volume 155, Issue 1 p. 64-71
To assess how use of postpartum contraception (PPC) changed during the COVID-19 public health emergency.
Alka Dahiya,Ajit Sebastian,Anitha Thomas,Rachel George,Vinotha Thomas,Abraham Peedicayil
doi : 10.1002/ijgo.13585
Volume 155, Issue 1 p. 72-78
To determine the prevalence and study the association of ovarian, uterine, and breast cancers with endometriosis.
Gregory Shifrin,Matthias Engelhardt,Phyllis Gee,Gregor Pschadka
doi : 10.1002/ijgo.13638
Volume 155, Issue 1 p. 79-85
To examine the role and benefits of transcervical fibroid ablation (TFA) in the treatment of submucous and large uterine fibroids.
Xiaoyan Tang,Chenyan Guo,Songping Liu,Jingjing Guo,Keqin Hua,Junjun Qiu
doi : 10.1002/ijgo.13644
Volume 155, Issue 1 p. 86-94
To evaluate the prognostic performance of the revised 2018 FIGO staging system for cervical cancer.
Dana Gabrieli,Adva Cahen-Peretz,Tzvika Shimonovitz,Keren Marks-Garber,Hagai Amsalem,Yosef Kalish,Yuval Lavy,Asnat Walfisch
doi : 10.1002/ijgo.13777
Volume 155, Issue 1 p. 95-100
To explore the indirect impact of the COVID-19 pandemic on patterns of pregnancy-related venous thromboembolism (VTE) events, mediated by population mobility restrictions during lockdown periods.
Roxana Knobel,Maíra L. S. Takemoto,Marcos Nakamura-Pereira,Mariane O. Menezes,Vicente K. Borges,Leila Katz,Melania M. R. Amorim,Carla B. Andreucci
doi : 10.1002/ijgo.13811
Volume 155, Issue 1 p. 101-109
To compare risk of death due to COVID-19 among pregnant, postpartum, and non-pregnant women of reproductive age in Brazil, using the severe acute respiratory syndrome surveillance system (SARS-SS).
Elise Schapkaitz,Elena Libhaber,Haroun Rhemtula,Annika Gerber,Barry F. Jacobson,Lawrence Chauke,Harry R. Büller
doi : 10.1002/ijgo.13596
Volume 155, Issue 1 p. 110-118
To assess risk factors for venous thromboembolism (VTE) in African women in order to guide thromboprophylaxis.
Dongming Liu,Yuan Wei,Yangyu Zhao,Rong Li,Jie Yan,Jie Qiao
doi : 10.1002/ijgo.13571
Volume 155, Issue 1 p. 119-124
To investigate whether thyroid cancer survivors would have increased risks of adverse obstetric outcomes.
Bo Seong Yun,So Hyun Shim,Hee Young Cho,Seok-Jae Heo,Inkyung Jung,Haeng Jun Jeon,You Jung Han,Dong Wook Kwak,Min Hyung Kim,Hee Jin Park,Jin Hoon Chung,Dong Hyun Cha,Moon Young Kim,Hyun Mee Ryu,Sung Shin Shim,Su Young Lee
doi : 10.1002/ijgo.13602
Volume 155, Issue 1 p. 125-131
To determine the association between insufficient sleep in the prenatal period and postpartum depression (PPD), and whether changes in sleep patterns during pregnancy increase the risk of PPD.
Margeaux Oliva,Taraneh G. Nazem,Joseph A. Lee,Alan B. Copperman
doi : 10.1002/ijgo.13570
Volume 155, Issue 1 p. 132-137
To determine the relationship between patients with a low body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and in vitro fertilization (IVF) outcomes following frozen-thawed embryo transfer (FET).
Haijie Gao,Xiaohui Lu,Hui Huang,Hong Ji,Ling Zhang,Zhiying Su
doi : 10.1002/ijgo.13581
Volume 155, Issue 1 p. 138-145
In this study, we investigated the effect of thyroid-stimulating hormone (TSH) level on the outcomes of in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS).
Vincenzo Dario Mandato,Riccardo Valli,Monica Silvotti,Valentina Mastrofilippo,Giovanni Casali,Lorenzo Aguzzoli
doi : 10.1002/ijgo.13802
Volume 155, Issue 1 p. 146-155
Jennie Sourzac,Christine Germain,Eric Frison,Francois Sztark,Vanessa Conri,Marie Floccia
doi : 10.1002/ijgo.13800
Volume 155, Issue 1 p. 156-157
Rogelio Apolo Aguado Pérez,María Fernanda Linares Rodríguez,Sergio Rosales Órtiz,Karla Alejandra Sanchez Reyes,Janeth Márquez Acosta
doi : 10.1002/ijgo.13801
Volume 155, Issue 1 p. 158-159
Carrie Bell,Ibrahim Mohedas,Caroline Soyars,Kathleen H. Sienko
doi : 10.1002/ijgo.13791
Volume 155, Issue 1 p. 159-161
Debora Diniz,Ilana Ambrogi,Giselle Carino
doi : 10.1002/ijgo.13821
Volume 155, Issue 1 p. 161-162
Yeshey Dorjey
doi : 10.1002/ijgo.13799
Volume 155, Issue 1 p. 163-164
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