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Outcome of monochorionic twin pregnancy with selective fetal growth restriction at 16, 20 or 30 weeks according to new Delphi consensus definition Keywords: definition; discordance; growth restriction; monochorionic twin pregnancy; outcome EN definition discordance growth restriction monochorionic twin pregnancy outcome 821 830 10 12/03/20 20201201 NES 201201 CONTRIBUTION B What are the novel findings of this work? More specifically, a pregnancy with sFGR complicated by TTTS at 19 weeks was included in the 16-week analysis but not in the 20- or 30-week analysis, as this pregnancy would no longer be diagnosed with isolated sFGR. In 44/177 (25%) sFGR pregnancies, the smaller twin had continuous or intermittent absent or reversed end-diastolic umbilical artery flow, which was classified as sFGR Type II in 11 and Type III in 33 pregnancies, with survival rates of 55% (12/22) and 83% (55/66), respectively ( I P i = 0.006). [Extracted from the article]

Background: Labour is a period of significant physical activity. The importance of carbohydrate intake to improve outcome has been recognised in sports medicine and general surgery.Objectives: To assess the effect of oral carbohydrate supplementation on labour outcomes.Search Strategy: MEDLINE (1966-2014), Embase, the Cochrane Library and clinical trial registries.Selection Criteria: Randomised controlled trials (RCT) of women randomised to receive oral carbohydrate in labour (<6 cm dilated), versus placebo or standard care.Data Collection and Analysis: Authors were contacted to provide data. Individual patient data meta-analyses were performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).Main Results: Eight RCTs met the inclusion criteria. Six authors responded, four supplied data (n = 691). Three studies used isotonic drinks (one placebo-controlled, two compared with standard care), and one an advice booklet regarding carbohydrate intake. The mean difference in energy intake between the intervention and control groups was small [three studies, 195 kilocalories (kcal), 95% CI 118-273]. There was no difference in the risk of caesarean section (RR 1.15, 95% CI 0.83- 1.61), instrumental birth (RR 1.26, 95% CI 0.96-1.66) or syntocinon augmentation (RR 0.99, 95% CI 0.86-1.13). Length of labour was similar (mean difference -3.15 minutes, 95% CI -35.14 to 41.95). Restricting the analysis to primigravid women did not affect the result. Oral carbohydrates did not increase the risk of vomiting (RR 1.09, 95% CI 0.78-1.52) or 1-minute Apgar score <7 (RR 1.23, 95% CI 0.82-1.83).Authors' Conclusion: Oral carbohydrate supplements in small quantities did not alter labour outcome.Tweetable Abstract: Oral carbohydrate does not affect labour. But the difference between intervention and control equals 10 teaspoons sugar. [ABSTRACT FROM AUTHOR]

Objective: To develop maternal, fetal, and neonatal composite outcomes relevant to the evaluation of diet and lifestyle interventions in pregnancy by individual patient data (IPD) meta-analysis.Design: Delphi survey.Setting: The International Weight Management in Pregnancy (i-WIP) collaborative network. Sample Twenty-six researchers from the i-WIP collaborative network from 11 countries.Methods: A two-generational Delphi survey involving members of the i-WIP collaborative network (26 members in 11 countries) was undertaken to prioritise the individual outcomes for their importance in clinical care. The final components of the composite outcomes were identified using pre-specified criteria.Main Outcome Measures: Composite outcomes considered to be important for the evaluation of the effect of diet and lifestyle in pregnancy.Results: Of the 36 maternal outcomes, nine were prioritised and the following were included in the final composite: pre-eclampsia or pregnancy-induced hypertension, gestational diabetes mellitus (GDM), elective or emergency caesarean section, and preterm delivery. Of the 27 fetal and neonatal outcomes, nine were further evaluated, with the final composite consisting of intrauterine death, small for gestational age, large for gestational age, and admission to a neonatal intensive care unit (NICU).Conclusions: Our work has identified the components of maternal, fetal, and neonatal composite outcomes required for the assessment of diet and lifestyle interventions in pregnancy by IPD meta-analysis. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To evaluate the application of a pocket-sized ultrasound machine ( PUM) in a routine antenatal third-trimester scan compared with a high-specification ultrasound machine ( HSUM). Methods This was an observational cohort study of 53 unselected women who came for their routine third-trimester ultrasound scan. The first scan was performed by an experienced ultrasonographer on an HSUM for fetal growth, fetal wellbeing and placental location. A second experienced operator performed the measurements on the PUM. Both operators were blinded to the other's findings and measurement results. Results Fifty-one patients were eligible and scanned at a median gestational age of 31 + 1 (range, 27 + 2 to 36 + 0) weeks. Mean pregestational body mass index was 22.9 ± 3.1 (range, 17.6-35.7) kg/m2. In the comparison between measurements made using the PUM and HSUM, perfect agreement was found for fetal position, fetal bladder and stomach visualization (all κ 1.0) and very good agreement was found for placental position (κ 0.86). Measurements of deepest vertical pocket correlated moderately (intraclass correlation coefficient ( ICC) 0.38 (95% CI, 0.12-0.59); Bland-Altman bias, 2.43 (95% limits of agreement ( LoA), −22.65 to 27.51)). For fetal growth measurements there was very good agreement for biparietal diameter ( ICC, 0.93 (95% CI, 0.88-0.96), Bland-Altman bias, −1.06 (95% LoA, −5.07 to 2.95)), and good agreement for femur length ( ICC, 0.66 (95% CI, 0.48-0.79), Bland-Altman bias 0.56 (95% LoA, −5.97 to 7.08)) and transcerebellar diameter ( ICC, 0.65 (95% CI, 0.46-0.78), Bland-Altman bias, −0.84 (95% LoA, −7.77 to 6.09)). Conclusion A battery-driven PUM can be used in third-trimester obstetrics for routine assessment of fetal growth (biparietal diameter, transcerebellar diameter and femur length) and for assessment of fetal wellbeing. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Linked article: This is a mini commentary on K Johansson et al., pp. 461–471 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.16871 [ABSTRACT FROM AUTHOR]

The obesity epidemic affects all, including women of reproductive age. One in five women attending prenatal care in the UK is obese. Prepregnancy obesity is associated with serious short- and long-term complications for mother and child. Furthermore, gestational weight gain (GWG) of obese pregnant women generally exceeds the Institute of Medicine recommended ranges. This observation can partially be explained by an unbalanced diet and lack of daily physical activity. Despite this, few lifestyle intervention trials in obese pregnant women are available. Two out of seven intervention trials focusing on GWG, nutrition and physical activity, reached a significant decrease in GWG. Developing guidelines to promote appropriated weight gain and healthy lifestyle in overweight and obese pregnant women remains a challenge. This review aims to summarize the complications associated with maternal prepregnancy overweight and obesity and to discuss possible strategies to improve the lifestyle habits of pregnant women. [ABSTRACT FROM AUTHOR]

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Belgium has reported a proportionally high number of COVID-19-related deaths (Table S1, Figure S1)[1]. According to the classification system of Wu I et al i . for severity of COVID-19 symptoms, 37 (86.0%) patients had mild symptoms and four (9.3%) had severe symptoms, and two (4.7%) were admitted to the intensive care unit (ICU)[3]. No patients developed severe symptoms and there were therefore no ICU admissions or deaths, and no patients developed symptoms during hospitalization. [Extracted from the article]

An abstract of the conference paper "The influence of pre-pregnancy BMI and maternal weight gain in pregnancy on fetal size at 12 weeks: a cross sectional analysis," by J. Luts and colleagues is presented.