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Allogeneic haematopoietic stem cell transplantation in utero has been successfully used for the prenatal treatment of severe combined immunodefiency syndrome. However, this treatment has not been successful in the therapy of other conditions in which the fetus is immunologically competent. The main obstacles to success are lack of competitive advantage of donor versus host stem cells, preventing stable engraftment and graft rejection. Several strategies are being explored to overcome these problems, and some of them have been successful in animal studies. Prenatal gene therapy, using ex-vivo transduced autologous haematopoietic cells or direct gene targeting in utero, is another potential approach in the treatment of immunocompetent fetal recipients. Although this has been shown to be feasible in animal models, safety concerns regarding transduction of fetal germ cells or maternal cells should be addressed in preclinical experiments prior to initiation of clinical trials.

Worldwide estimates of the prevalence of female genital mutilation (FGM) indicate that well over 100 million women in more than 26 countries have undergone this procedure. Illegal in most western countries, FGM is primarily practiced in sub-Saharan Africa. Many women with FGM have migrated to Western countries where they constitute a significant proportion of the population. These women have special medical and psychological problems during pregnancy, and do not readily volunteer that they have undergone the procedure. Most physicians and other health professionals in Western countries have little knowledge of FGM and its management. There has been concern over reports of increased maternal and fetal mortality during childbirth among women with FGM. Little data is available on maternal expectations and wishes concerning antenatal, intrapartum, and postpartum care.

Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity, and causes an estimated 125,000 deaths worldwide each year. The use of surgical compression sutures has gained interest as a means of avoiding hysterectomy when uterotonic drugs fail to control massive bleeding. The goal is to compress the uterine vascular sinus without occluding the uterine arteries or uterine cavity. The B-Lynch suture has been most widely used but, in 2002, Hayman et al. proposed a simpler approach that is more easily and more rapidly applied. In addition, it precludes the need to do a lower-segment hysterotomy when PPH follows vaginal delivery. There is, however, concern about occlusion of the uterine cavity and blood entrapment because the uterus is transfixed from front to back when placing the suture.