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Objective: To compare intramuscular oxytocin, Syntometrine® and carbetocin for prevention of postpartum haemorrhage after vaginal birth. Design: Randomised double‐blinded clinical trial. Setting: Six hospitals in England. Population: A total of 5929 normotensive women having a singleton vaginal birth. Methods: Randomisation when birth was imminent. Main outcome measures: Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. Results: Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08–1.51, P = 0.004); the difference between carbetocin and oxytocin was non‐significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65–0.91, P = 0.002). Non‐inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non‐drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42–0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. Conclusions: Non‐inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non‐drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin. IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin. [ABSTRACT FROM AUTHOR]

Objective: Parent engagement in perinatal mortality review meetings following stillbirth may benefit parents and improve patient safety. We investigated perinatal mortality review meeting practices, including the extent of parent engagement, based on self‐reports from healthcare professionals from maternity care facilities in six high‐income countries. Design: Cross‐sectional online survey. Setting: Australia, Canada, Ireland, New Zealand, UK and USA. Population: A total of 1104 healthcare professionals, comprising mainly obstetricians, gynaecologists, midwives and nurses. Methods: Data were drawn from responses to a survey covering stillbirth‐related topics. Open‐ and closed‐items that focused on 'Data quality on causes of stillbirth' were analysed. Main outcome measures: Healthcare professionals' self‐reported practices around perinatal mortality review meetings following stillbirth. Results: Most clinicians (81.0%) were aware of regular audit meetings to review stillbirth at their maternity facility, although this was true for only 35.5% of US respondents. For the 854 respondents whose facility held regular meetings, less than a third (31.1%) reported some form of parent engagement, and this was usually in the form of one‐way post‐meeting feedback. Across all six countries, only 17.1% of respondents described an explicit approach where parents provided input, received feedback and were represented at meetings. Conclusions: We found no established practice of involving parents in the perinatal mortality review process in six high‐income countries. Parent engagement may hold the key to important lessons for stillbirth prevention and care. Further understanding of approaches, barriers and enablers is warranted. Parent engagement in mortality review after stillbirth is rare, based on data from six countries. We need to understand the barriers. Parent engagement in mortality review after stillbirth is rare, based on data from six countries. We need to understand the barriers. [ABSTRACT FROM AUTHOR]

Background: Stillbirth has a profound impact on women, families, and healthcare workers. The burden is highest in low- and middle-income countries (LMICs). There is need for respectful and supportive care for women, partners, and families after bereavement.Objective: To perform a qualitative meta-summary of parents' and healthcare professionals' experiences of care after stillbirth in LMICs.Search Strategy: Search terms were formulated by identifying all synonyms, thesaurus terms, and variations for stillbirth. Databases searched were AMED, EMBASE, MEDLINE, PsychINFO, BNI, CINAHL.Selection Criteria: Qualitative, quantitative, and mixed method studies that addressed parents' or healthcare professionals' experience of care after stillbirth in LMICs.Data Collection and Analysis: Studies were screened, and data extracted in duplicate. Data were analysed using the Sandelowski meta-summary technique that calculates frequency and intensity effect sizes (FES/IES).Main Results: In all, 118 full texts were screened, and 34 studies from 17 countries were included. FES range was 15-68%. Most studies had IES 1.5-4.5. Women experience a broad range of manifestations of grief following stillbirth, which may not be recognised by healthcare workers or in their communities. Lack of recognition exacerbates negative experiences of stigmatisation, blame, devaluation, and loss of social status. Adequately developed health systems, with trained and supported staff, are best equipped to provide the support and information that women want after stillbirth.Conclusions: Basic interventions could have an immediate impact on the experiences of women and their families after stillbirth. Examples include public education to reduce stigma, promoting the respectful maternity care agenda, and investigating stillbirth appropriately.Tweetable Abstract: Reducing stigma, promoting respectful care and investigating stillbirth have a positive impact after stillbirth for women and families in LMICs. [ABSTRACT FROM AUTHOR]

The author discusses the pregnancy of women who underwent into bariatric surgery. The author mentioned the common bariatric surgery procedures for weight loss which include laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass and sleeve gastrectomy. The author also discusses the nutritional deficiencies after malabsorptive surgery, sociodemographic factors on pregnant women such as smoking, parity, and age, and the effectiveness of surgical procedures.

An introduction is presented in which the authors discuss the journal's post-publication peer review and research literacy enhancement through its club in the microblogging site, Twitter.

The article presents information about the methodology and limitations of a study which focuses on the issues related to vaginal birth after three or more caesareans. The objective of the study was to analyze the rate of success of vaginal birth and maternal morbidity. It also focuses on significant difference in maternal outcome between repeat caesarean and attempt at vaginal birth.

A response from the author of the article "#BlueJC: BJOG and Katherine Twining Network collaborate to facilitate post-publication peer review and enhance research literacy via a Twitter journal club," in the 2013 issue is presented.