Key clinical point: Offspring who were exposed in utero to any subtype of hypertensive disorders during pregnancy (HDP) were at an increased risk for higher blood pressure (BP) than those with no exposure.

Major finding: In utero exposure vs no exposure to HDP was associated with higher systolic BP (mean difference 2.46 mm Hg; 95% CI 1.88-3.03 mm Hg) in offspring. Higher systolic BP was also observed in offspring exposed vs not exposed in utero to HDP subtypes, including pregnancy-associated hypertension, preeclampsia, gestational hypertension, and chronic hypertension.

Study details: Findings are from a systematic review and meta-analysis of 24 cohort studies including 3839 offspring who were exposed to HDP in utero and 57,977 offspring from normotensive mothers.

Disclosures: This study was partly supported by Sichuan Science and Technology Program, China. The authors declared no conflicts of interest.

Source: Yu H et al. Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2022 (Sep 12). Doi: 10.1111/jch.14577

Key clinical point: Offspring who were exposed in utero to any subtype of hypertensive disorders during pregnancy (HDP) were at an increased risk for higher blood pressure (BP) than those with no exposure.

Major finding: In utero exposure vs no exposure to HDP was associated with higher systolic BP (mean difference 2.46 mm Hg; 95% CI 1.88-3.03 mm Hg) in offspring. Higher systolic BP was also observed in offspring exposed vs not exposed in utero to HDP subtypes, including pregnancy-associated hypertension, preeclampsia, gestational hypertension, and chronic hypertension.

Study details: Findings are from a systematic review and meta-analysis of 24 cohort studies including 3839 offspring who were exposed to HDP in utero and 57,977 offspring from normotensive mothers.

Disclosures: This study was partly supported by Sichuan Science and Technology Program, China. The authors declared no conflicts of interest.

Source: Yu H et al. Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2022 (Sep 12). Doi: 10.1111/jch.14577

Key clinical point: Offspring who were exposed in utero to any subtype of hypertensive disorders during pregnancy (HDP) were at an increased risk for higher blood pressure (BP) than those with no exposure.

Major finding: In utero exposure vs no exposure to HDP was associated with higher systolic BP (mean difference 2.46 mm Hg; 95% CI 1.88-3.03 mm Hg) in offspring. Higher systolic BP was also observed in offspring exposed vs not exposed in utero to HDP subtypes, including pregnancy-associated hypertension, preeclampsia, gestational hypertension, and chronic hypertension.

Study details: Findings are from a systematic review and meta-analysis of 24 cohort studies including 3839 offspring who were exposed to HDP in utero and 57,977 offspring from normotensive mothers.

Disclosures: This study was partly supported by Sichuan Science and Technology Program, China. The authors declared no conflicts of interest.

Source: Yu H et al. Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2022 (Sep 12). Doi: 10.1111/jch.14577

Key clinical point: The risk for brachial plexus strain, injury, or tear can be minimized with prompt identification of shoulder dystocia (SD) accompanied by cessation of axial fetal head traction, while accurate obstetrical maneuvers can avoid permanent obstetric brachial palsy (OBP) or cerebral morbidity.

Major finding: SD was mostly unilateral anterior, with only 0.9% of cases diagnosed as the more difficult bilateral SD and 2% as recurrent SD. The majority (87.4%) of SD cases were managed by McRobert’s maneuver; the other management procedures included Barnum’s procedure (7.9%), Wood’s maneuver (3.9%), and Menticoglou procedure (0.4%). Only 7.5% of newborns were diagnosed with transient form of Duchenne Erb obstetrics brachioparesis (OBP), none with permanent OBP, and only 1 with cerebral morbidity.

Study details: This retrospective study analyzed the data of 45,687 singleton deliveries (vaginal deliveries, 78.9%; cesarean sections, 21.1%). Overall, 0.7% of vaginally delivered neonates had fetal SD.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Habek D et al. Obstetrics injuries during shoulder dystocia in a tertiary perinatal center. Eur J Obstet Gynecol Reprod Biol. 2022;278:33-37 (Sep 10). Doi: 10.1016/j.ejogrb.2022.09.009

Key clinical point: The risk for brachial plexus strain, injury, or tear can be minimized with prompt identification of shoulder dystocia (SD) accompanied by cessation of axial fetal head traction, while accurate obstetrical maneuvers can avoid permanent obstetric brachial palsy (OBP) or cerebral morbidity.

Major finding: SD was mostly unilateral anterior, with only 0.9% of cases diagnosed as the more difficult bilateral SD and 2% as recurrent SD. The majority (87.4%) of SD cases were managed by McRobert’s maneuver; the other management procedures included Barnum’s procedure (7.9%), Wood’s maneuver (3.9%), and Menticoglou procedure (0.4%). Only 7.5% of newborns were diagnosed with transient form of Duchenne Erb obstetrics brachioparesis (OBP), none with permanent OBP, and only 1 with cerebral morbidity.

Study details: This retrospective study analyzed the data of 45,687 singleton deliveries (vaginal deliveries, 78.9%; cesarean sections, 21.1%). Overall, 0.7% of vaginally delivered neonates had fetal SD.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Habek D et al. Obstetrics injuries during shoulder dystocia in a tertiary perinatal center. Eur J Obstet Gynecol Reprod Biol. 2022;278:33-37 (Sep 10). Doi: 10.1016/j.ejogrb.2022.09.009

Key clinical point: The risk for brachial plexus strain, injury, or tear can be minimized with prompt identification of shoulder dystocia (SD) accompanied by cessation of axial fetal head traction, while accurate obstetrical maneuvers can avoid permanent obstetric brachial palsy (OBP) or cerebral morbidity.

Major finding: SD was mostly unilateral anterior, with only 0.9% of cases diagnosed as the more difficult bilateral SD and 2% as recurrent SD. The majority (87.4%) of SD cases were managed by McRobert’s maneuver; the other management procedures included Barnum’s procedure (7.9%), Wood’s maneuver (3.9%), and Menticoglou procedure (0.4%). Only 7.5% of newborns were diagnosed with transient form of Duchenne Erb obstetrics brachioparesis (OBP), none with permanent OBP, and only 1 with cerebral morbidity.

Study details: This retrospective study analyzed the data of 45,687 singleton deliveries (vaginal deliveries, 78.9%; cesarean sections, 21.1%). Overall, 0.7% of vaginally delivered neonates had fetal SD.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Habek D et al. Obstetrics injuries during shoulder dystocia in a tertiary perinatal center. Eur J Obstet Gynecol Reprod Biol. 2022;278:33-37 (Sep 10). Doi: 10.1016/j.ejogrb.2022.09.009

Key clinical point: Preventive B-Lynch suture seemed safe and effective in preventing excessive maternal hemorrhage in patients at a high risk for postpartum hemorrhage.

Major finding: Overall, 92% of patients who underwent the B-Lynch suture procedure showed no apparent postoperative bleeding within 2 hours after the cesarean section (CS), with 24 patients requiring intraoperative or postoperative blood transfusion, none requiring hysterectomy, and only 1 patient with a twin pregnancy requiring additional treatment because of secondary postpartum hemorrhage 5 days after the CS. Adverse events seemed unrelated to the procedure.

Study details: Findings are from a retrospective study including 663 patients who underwent CS, of which 38 patients underwent the preventive B-Lynch suture procedure before excessive blood loss occurred during CS.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Kuwabara M et al. Effectiveness of preventive B-Lynch sutures in patients at a high risk of postpartum hemorrhage. J Obstet Gynaecol Res. 2022 (Sep 11). Doi: 10.1111/jog.15415

Key clinical point: Preventive B-Lynch suture seemed safe and effective in preventing excessive maternal hemorrhage in patients at a high risk for postpartum hemorrhage.

Major finding: Overall, 92% of patients who underwent the B-Lynch suture procedure showed no apparent postoperative bleeding within 2 hours after the cesarean section (CS), with 24 patients requiring intraoperative or postoperative blood transfusion, none requiring hysterectomy, and only 1 patient with a twin pregnancy requiring additional treatment because of secondary postpartum hemorrhage 5 days after the CS. Adverse events seemed unrelated to the procedure.

Study details: Findings are from a retrospective study including 663 patients who underwent CS, of which 38 patients underwent the preventive B-Lynch suture procedure before excessive blood loss occurred during CS.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Kuwabara M et al. Effectiveness of preventive B-Lynch sutures in patients at a high risk of postpartum hemorrhage. J Obstet Gynaecol Res. 2022 (Sep 11). Doi: 10.1111/jog.15415

Key clinical point: Preventive B-Lynch suture seemed safe and effective in preventing excessive maternal hemorrhage in patients at a high risk for postpartum hemorrhage.

Major finding: Overall, 92% of patients who underwent the B-Lynch suture procedure showed no apparent postoperative bleeding within 2 hours after the cesarean section (CS), with 24 patients requiring intraoperative or postoperative blood transfusion, none requiring hysterectomy, and only 1 patient with a twin pregnancy requiring additional treatment because of secondary postpartum hemorrhage 5 days after the CS. Adverse events seemed unrelated to the procedure.

Study details: Findings are from a retrospective study including 663 patients who underwent CS, of which 38 patients underwent the preventive B-Lynch suture procedure before excessive blood loss occurred during CS.

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Kuwabara M et al. Effectiveness of preventive B-Lynch sutures in patients at a high risk of postpartum hemorrhage. J Obstet Gynaecol Res. 2022 (Sep 11). Doi: 10.1111/jog.15415

Key clinical point: Birth injuries are rare with breech vaginal delivery (VD); however, severe birth injury incidence is nearly 2-times higher with breech VD compared with cephalic VD, with brachial plexus palsy (BPP) being more common with breech vs cephalic VD.

Major finding: The incidence of severe birth injury with breech VD, cephalic VD, and cesarean section with breech presentation were 0.76/100, 0.31/100, and 0.059/100 live births, respectively. BPP occurred more frequently with breech VD (0.6% of live births) than with cephalic VD (0.3% of live births).

Study details: The data come from a retrospective study including 650,528 neonates who were delivered by breech VD (0.7%), breech cesarean section (2.6%), or cephalic VD (96.7%).

Disclosures: This study was partly funded by competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, Finland. The authors declared no conflicts of interest.

Source: Kekki M et al. Birth injury in breech delivery: A nationwide population-based cohort study in Finland. Arch Gynecol Obstet. 2022 (Sep 8). Doi: 10.1007/s00404-022-06772-1

Key clinical point: Birth injuries are rare with breech vaginal delivery (VD); however, severe birth injury incidence is nearly 2-times higher with breech VD compared with cephalic VD, with brachial plexus palsy (BPP) being more common with breech vs cephalic VD.

Major finding: The incidence of severe birth injury with breech VD, cephalic VD, and cesarean section with breech presentation were 0.76/100, 0.31/100, and 0.059/100 live births, respectively. BPP occurred more frequently with breech VD (0.6% of live births) than with cephalic VD (0.3% of live births).

Study details: The data come from a retrospective study including 650,528 neonates who were delivered by breech VD (0.7%), breech cesarean section (2.6%), or cephalic VD (96.7%).

Disclosures: This study was partly funded by competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, Finland. The authors declared no conflicts of interest.

Source: Kekki M et al. Birth injury in breech delivery: A nationwide population-based cohort study in Finland. Arch Gynecol Obstet. 2022 (Sep 8). Doi: 10.1007/s00404-022-06772-1

Key clinical point: Birth injuries are rare with breech vaginal delivery (VD); however, severe birth injury incidence is nearly 2-times higher with breech VD compared with cephalic VD, with brachial plexus palsy (BPP) being more common with breech vs cephalic VD.

Major finding: The incidence of severe birth injury with breech VD, cephalic VD, and cesarean section with breech presentation were 0.76/100, 0.31/100, and 0.059/100 live births, respectively. BPP occurred more frequently with breech VD (0.6% of live births) than with cephalic VD (0.3% of live births).

Study details: The data come from a retrospective study including 650,528 neonates who were delivered by breech VD (0.7%), breech cesarean section (2.6%), or cephalic VD (96.7%).

Disclosures: This study was partly funded by competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, Finland. The authors declared no conflicts of interest.

Source: Kekki M et al. Birth injury in breech delivery: A nationwide population-based cohort study in Finland. Arch Gynecol Obstet. 2022 (Sep 8). Doi: 10.1007/s00404-022-06772-1

Key clinical point: A majority of women with preterm preeclampsia showed persistent cardiovascular morbidity at 6 months postpartum, which may have significant implications to long-term cardiovascular health.

Major finding: At 6 months postpartum, diastolic dysfunction, increased total vascular resistance (TVR), and persistent left ventricular remodeling were observed in 61%, 75%, and 41% of women, respectively, with 46% of women with no pre-existing hypertension having de novo hypertension and only 5% of women having a completely normal echocardiogram. A significant association was observed between prolonged preeclampsia duration and increased TVR at 6 months (P = .02).

Study details: Findings are from a sub-study of PICk-UP trial involving 44 postnatal women with preterm preeclampsia who delivered before 37 weeks.

Disclosures: This study was funded by the Medical Research Council, UK. The authors declared no competing financial interests.

Source: Ormesher L et al. Postnatal cardiovascular morbidity following preterm pre-eclampsia: An observational study. Pregnancy Hypertens. 2022;30:68-81 (Aug 17). Doi: 10.1016/j.preghy.2022.08.007

Key clinical point: A majority of women with preterm preeclampsia showed persistent cardiovascular morbidity at 6 months postpartum, which may have significant implications to long-term cardiovascular health.

Major finding: At 6 months postpartum, diastolic dysfunction, increased total vascular resistance (TVR), and persistent left ventricular remodeling were observed in 61%, 75%, and 41% of women, respectively, with 46% of women with no pre-existing hypertension having de novo hypertension and only 5% of women having a completely normal echocardiogram. A significant association was observed between prolonged preeclampsia duration and increased TVR at 6 months (P = .02).

Study details: Findings are from a sub-study of PICk-UP trial involving 44 postnatal women with preterm preeclampsia who delivered before 37 weeks.

Disclosures: This study was funded by the Medical Research Council, UK. The authors declared no competing financial interests.

Source: Ormesher L et al. Postnatal cardiovascular morbidity following preterm pre-eclampsia: An observational study. Pregnancy Hypertens. 2022;30:68-81 (Aug 17). Doi: 10.1016/j.preghy.2022.08.007

Key clinical point: A majority of women with preterm preeclampsia showed persistent cardiovascular morbidity at 6 months postpartum, which may have significant implications to long-term cardiovascular health.

Major finding: At 6 months postpartum, diastolic dysfunction, increased total vascular resistance (TVR), and persistent left ventricular remodeling were observed in 61%, 75%, and 41% of women, respectively, with 46% of women with no pre-existing hypertension having de novo hypertension and only 5% of women having a completely normal echocardiogram. A significant association was observed between prolonged preeclampsia duration and increased TVR at 6 months (P = .02).

Study details: Findings are from a sub-study of PICk-UP trial involving 44 postnatal women with preterm preeclampsia who delivered before 37 weeks.

Disclosures: This study was funded by the Medical Research Council, UK. The authors declared no competing financial interests.

Source: Ormesher L et al. Postnatal cardiovascular morbidity following preterm pre-eclampsia: An observational study. Pregnancy Hypertens. 2022;30:68-81 (Aug 17). Doi: 10.1016/j.preghy.2022.08.007

Key clinical point: The incidence of acute high-risk chest pain (AHRCP) diseases during pregnancy and puerperium has increased consistently over a decade, with advanced maternal age being a significant risk factor.

Major finding: The incidence of AHRCP diseases during pregnancy and puerperium increased from 79.92/100,000 hospitalizations in 2008 to 114.79/100,000 hospitalizations in 2017 (P_trend < .0001), with pulmonary embolism (86.5%) occurring 10-fold and 26-fold more frequently than acute myocardial infarction (9.6%) and aortic dissection (3.3%), respectively. Maternal age over 45 years was a significant risk factor (odds ratio 4.25; 95% CI 3.80-4.75).

Study details: Findings are from an observational analysis of 41,174,101 patients hospitalized for pregnancy and puerperium, of which 40,285 were diagnosed with AHRCP diseases.

Disclosures: This study was supported by the 3-Year Action Plan for Strengthening Public Health System in Shanghai (2020–2022) and other sources. The authors declared no conflicts of interest.

Source: Wu S et al. Incidence and outcomes of acute high-risk chest pain diseases during pregnancy and puerperium. Front Cardiovasc Med. 2022;9:968964 (Aug 11). Doi: 10.3389/fcvm.2022.968964

Key clinical point: The incidence of acute high-risk chest pain (AHRCP) diseases during pregnancy and puerperium has increased consistently over a decade, with advanced maternal age being a significant risk factor.

Major finding: The incidence of AHRCP diseases during pregnancy and puerperium increased from 79.92/100,000 hospitalizations in 2008 to 114.79/100,000 hospitalizations in 2017 (P_trend < .0001), with pulmonary embolism (86.5%) occurring 10-fold and 26-fold more frequently than acute myocardial infarction (9.6%) and aortic dissection (3.3%), respectively. Maternal age over 45 years was a significant risk factor (odds ratio 4.25; 95% CI 3.80-4.75).

Study details: Findings are from an observational analysis of 41,174,101 patients hospitalized for pregnancy and puerperium, of which 40,285 were diagnosed with AHRCP diseases.

Disclosures: This study was supported by the 3-Year Action Plan for Strengthening Public Health System in Shanghai (2020–2022) and other sources. The authors declared no conflicts of interest.

Source: Wu S et al. Incidence and outcomes of acute high-risk chest pain diseases during pregnancy and puerperium. Front Cardiovasc Med. 2022;9:968964 (Aug 11). Doi: 10.3389/fcvm.2022.968964

Key clinical point: The incidence of acute high-risk chest pain (AHRCP) diseases during pregnancy and puerperium has increased consistently over a decade, with advanced maternal age being a significant risk factor.

Major finding: The incidence of AHRCP diseases during pregnancy and puerperium increased from 79.92/100,000 hospitalizations in 2008 to 114.79/100,000 hospitalizations in 2017 (P_trend < .0001), with pulmonary embolism (86.5%) occurring 10-fold and 26-fold more frequently than acute myocardial infarction (9.6%) and aortic dissection (3.3%), respectively. Maternal age over 45 years was a significant risk factor (odds ratio 4.25; 95% CI 3.80-4.75).

Study details: Findings are from an observational analysis of 41,174,101 patients hospitalized for pregnancy and puerperium, of which 40,285 were diagnosed with AHRCP diseases.

Disclosures: This study was supported by the 3-Year Action Plan for Strengthening Public Health System in Shanghai (2020–2022) and other sources. The authors declared no conflicts of interest.

Source: Wu S et al. Incidence and outcomes of acute high-risk chest pain diseases during pregnancy and puerperium. Front Cardiovasc Med. 2022;9:968964 (Aug 11). Doi: 10.3389/fcvm.2022.968964

Key clinical point: Analysis over 2 decades demonstrated trend changes in individual contribution of risk factors for postpartum hemorrhage, with perineal or vaginal tears increasing, large for gestational age neonate decreasing, and other risk factors remaining stable.

Major finding: The incidence of postpartum hemorrhage increased from 0.5% in 1988 to 0.6% in 2014. Among risk factors for postpartum hemorrhage, perineal or vaginal tear demonstrated a rising trend (P = .01), delivery of large for gestational age neonate demonstrated a declining trend (P < .001), and other risk factors, such as preeclampsia, vacuum extraction delivery, and retained placenta, remained stable during the study period.

Study details: Findings are from a population-based, retrospective, nested, case-control study including 285,992 pregnancies, of which 1684 were complicated by postpartum hemorrhage.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Sade S et al. Trend changes in the individual contribution of risk factors for postpartum hemorrhage over more than two decades. Matern Child Health J. 2022 (Aug 24). Doi: 10.1007/s10995-022-03461-y

Key clinical point: Analysis over 2 decades demonstrated trend changes in individual contribution of risk factors for postpartum hemorrhage, with perineal or vaginal tears increasing, large for gestational age neonate decreasing, and other risk factors remaining stable.

Major finding: The incidence of postpartum hemorrhage increased from 0.5% in 1988 to 0.6% in 2014. Among risk factors for postpartum hemorrhage, perineal or vaginal tear demonstrated a rising trend (P = .01), delivery of large for gestational age neonate demonstrated a declining trend (P < .001), and other risk factors, such as preeclampsia, vacuum extraction delivery, and retained placenta, remained stable during the study period.

Study details: Findings are from a population-based, retrospective, nested, case-control study including 285,992 pregnancies, of which 1684 were complicated by postpartum hemorrhage.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Sade S et al. Trend changes in the individual contribution of risk factors for postpartum hemorrhage over more than two decades. Matern Child Health J. 2022 (Aug 24). Doi: 10.1007/s10995-022-03461-y

Key clinical point: Analysis over 2 decades demonstrated trend changes in individual contribution of risk factors for postpartum hemorrhage, with perineal or vaginal tears increasing, large for gestational age neonate decreasing, and other risk factors remaining stable.

Major finding: The incidence of postpartum hemorrhage increased from 0.5% in 1988 to 0.6% in 2014. Among risk factors for postpartum hemorrhage, perineal or vaginal tear demonstrated a rising trend (P = .01), delivery of large for gestational age neonate demonstrated a declining trend (P < .001), and other risk factors, such as preeclampsia, vacuum extraction delivery, and retained placenta, remained stable during the study period.

Study details: Findings are from a population-based, retrospective, nested, case-control study including 285,992 pregnancies, of which 1684 were complicated by postpartum hemorrhage.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Sade S et al. Trend changes in the individual contribution of risk factors for postpartum hemorrhage over more than two decades. Matern Child Health J. 2022 (Aug 24). Doi: 10.1007/s10995-022-03461-y

Key clinical point: Cesarean delivery, preeclampsia, and uterine rupture were independently associated with a higher risk for intrauterine tamponade failure in women with deliveries complicated by postpartum hemorrhage.

Major finding: Intrauterine tamponade failure rate was 11.1%. The risk for intrauterine tamponade failure was higher in women with cesarean delivery (adjusted odds ratio [aOR] 4.2; 95% CI 2.9-6.0), preeclampsia (aOR 2.3; 95% CI 1.3-3.9), and uterine rupture (aOR 14.1; 95% CI 2.4-83.0).

Study details: Findings are from a population-based retrospective cohort study including 1761 women with deliveries complicated by postpartum hemorrhage who underwent intrauterine tamponade within 24 hours of postpartum hemorrhage to manage persistent bleeding.

Disclosures: This study did not report any source of funding. No conflicts of interest were declared.

Source: Gibier M et al. Risk factors for intrauterine tamponade failure in postpartum hemorrhage. Obstet Gynecol. 2022;140(3):439-446 (Aug 3). Doi: 10.1097/AOG.0000000000004888

Key clinical point: Cesarean delivery, preeclampsia, and uterine rupture were independently associated with a higher risk for intrauterine tamponade failure in women with deliveries complicated by postpartum hemorrhage.

Major finding: Intrauterine tamponade failure rate was 11.1%. The risk for intrauterine tamponade failure was higher in women with cesarean delivery (adjusted odds ratio [aOR] 4.2; 95% CI 2.9-6.0), preeclampsia (aOR 2.3; 95% CI 1.3-3.9), and uterine rupture (aOR 14.1; 95% CI 2.4-83.0).

Study details: Findings are from a population-based retrospective cohort study including 1761 women with deliveries complicated by postpartum hemorrhage who underwent intrauterine tamponade within 24 hours of postpartum hemorrhage to manage persistent bleeding.

Disclosures: This study did not report any source of funding. No conflicts of interest were declared.

Source: Gibier M et al. Risk factors for intrauterine tamponade failure in postpartum hemorrhage. Obstet Gynecol. 2022;140(3):439-446 (Aug 3). Doi: 10.1097/AOG.0000000000004888

Key clinical point: Cesarean delivery, preeclampsia, and uterine rupture were independently associated with a higher risk for intrauterine tamponade failure in women with deliveries complicated by postpartum hemorrhage.

Major finding: Intrauterine tamponade failure rate was 11.1%. The risk for intrauterine tamponade failure was higher in women with cesarean delivery (adjusted odds ratio [aOR] 4.2; 95% CI 2.9-6.0), preeclampsia (aOR 2.3; 95% CI 1.3-3.9), and uterine rupture (aOR 14.1; 95% CI 2.4-83.0).

Study details: Findings are from a population-based retrospective cohort study including 1761 women with deliveries complicated by postpartum hemorrhage who underwent intrauterine tamponade within 24 hours of postpartum hemorrhage to manage persistent bleeding.

Disclosures: This study did not report any source of funding. No conflicts of interest were declared.

Source: Gibier M et al. Risk factors for intrauterine tamponade failure in postpartum hemorrhage. Obstet Gynecol. 2022;140(3):439-446 (Aug 3). Doi: 10.1097/AOG.0000000000004888

Key clinical point: The chances of postpartum readmission for hypertension were significantly higher among patients discharged with labetalol vs nifedipine after delivery, irrespective of the severity of their hypertensive disorder of pregnancy.

Major finding: Compared with nifedipine, the chances of postpartum readmission for hypertension were higher with labetalol (adjusted odds ratio [aOR] 1.63, 95% CI 1.43-1.85), with the risk being persistent among patients with mild (aOR 1.57; 95% CI 1.29-1.93) and severe (aOR 1.63, 95% CI 1.43-1.85) hypertensive disorders.

Study details: This study evaluated 24,477 patients who were discharged with nifedipine (36.8%), labetalol (57.7%), or both medications (5.6%) after delivery.

Disclosures: This study did not report any source of funding. DJ Lyell declared receiving payment from various sources.

Source: Do SC et al. Postpartum readmission for hypertension after discharge on labetalol or nifedipine. Obstet Gynecol. 2022;140(4):591-598 (Sep 8). Doi: 10.1097/AOG.0000000000004918

Key clinical point: The chances of postpartum readmission for hypertension were significantly higher among patients discharged with labetalol vs nifedipine after delivery, irrespective of the severity of their hypertensive disorder of pregnancy.

Major finding: Compared with nifedipine, the chances of postpartum readmission for hypertension were higher with labetalol (adjusted odds ratio [aOR] 1.63, 95% CI 1.43-1.85), with the risk being persistent among patients with mild (aOR 1.57; 95% CI 1.29-1.93) and severe (aOR 1.63, 95% CI 1.43-1.85) hypertensive disorders.

Study details: This study evaluated 24,477 patients who were discharged with nifedipine (36.8%), labetalol (57.7%), or both medications (5.6%) after delivery.

Disclosures: This study did not report any source of funding. DJ Lyell declared receiving payment from various sources.

Source: Do SC et al. Postpartum readmission for hypertension after discharge on labetalol or nifedipine. Obstet Gynecol. 2022;140(4):591-598 (Sep 8). Doi: 10.1097/AOG.0000000000004918

Key clinical point: The chances of postpartum readmission for hypertension were significantly higher among patients discharged with labetalol vs nifedipine after delivery, irrespective of the severity of their hypertensive disorder of pregnancy.

Major finding: Compared with nifedipine, the chances of postpartum readmission for hypertension were higher with labetalol (adjusted odds ratio [aOR] 1.63, 95% CI 1.43-1.85), with the risk being persistent among patients with mild (aOR 1.57; 95% CI 1.29-1.93) and severe (aOR 1.63, 95% CI 1.43-1.85) hypertensive disorders.

Study details: This study evaluated 24,477 patients who were discharged with nifedipine (36.8%), labetalol (57.7%), or both medications (5.6%) after delivery.

Disclosures: This study did not report any source of funding. DJ Lyell declared receiving payment from various sources.

Source: Do SC et al. Postpartum readmission for hypertension after discharge on labetalol or nifedipine. Obstet Gynecol. 2022;140(4):591-598 (Sep 8). Doi: 10.1097/AOG.0000000000004918

Key clinical point: Weekly 3-hour simulation-based training of midwives and doctors on shoulder dystocia (SD) management significantly reduced the incidence of permanent brachial plexus birth injury (BPBI).

Major finding: Despite an increase in the incidence of SD cases (0.1% vs 0.3%; P < .001) and risk factors in pre-training vs post-training period, the incidence of permanent BPBI decreased significantly (0.05% vs 0.02%; P < .001), with the risk for permanent BPBI among those with SD reducing (43.5% vs 6.0%; P < .001) and the rate of successful posterior arm delivery increasing (11.3% vs 23.4%; P = .04) significantly after the implementation of systematic simulation-based training.

Study details: Findings are from a retrospective observational study including 113,785 vertex deliveries performed by a team of doctors and midwives after receiving the weekly 3-hour simulation-based training.

Disclosures: This study was funded by Helsinki University State Research Funding. No conflicts of interest were declared.

Source: Kaijomaa M et al. Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury: An observational study. BJOG. 2022 (Aug 10). Doi: 10.1111/1471-0528.17278

Key clinical point: Weekly 3-hour simulation-based training of midwives and doctors on shoulder dystocia (SD) management significantly reduced the incidence of permanent brachial plexus birth injury (BPBI).

Major finding: Despite an increase in the incidence of SD cases (0.1% vs 0.3%; P < .001) and risk factors in pre-training vs post-training period, the incidence of permanent BPBI decreased significantly (0.05% vs 0.02%; P < .001), with the risk for permanent BPBI among those with SD reducing (43.5% vs 6.0%; P < .001) and the rate of successful posterior arm delivery increasing (11.3% vs 23.4%; P = .04) significantly after the implementation of systematic simulation-based training.

Study details: Findings are from a retrospective observational study including 113,785 vertex deliveries performed by a team of doctors and midwives after receiving the weekly 3-hour simulation-based training.

Disclosures: This study was funded by Helsinki University State Research Funding. No conflicts of interest were declared.

Source: Kaijomaa M et al. Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury: An observational study. BJOG. 2022 (Aug 10). Doi: 10.1111/1471-0528.17278

Key clinical point: Weekly 3-hour simulation-based training of midwives and doctors on shoulder dystocia (SD) management significantly reduced the incidence of permanent brachial plexus birth injury (BPBI).

Major finding: Despite an increase in the incidence of SD cases (0.1% vs 0.3%; P < .001) and risk factors in pre-training vs post-training period, the incidence of permanent BPBI decreased significantly (0.05% vs 0.02%; P < .001), with the risk for permanent BPBI among those with SD reducing (43.5% vs 6.0%; P < .001) and the rate of successful posterior arm delivery increasing (11.3% vs 23.4%; P = .04) significantly after the implementation of systematic simulation-based training.

Study details: Findings are from a retrospective observational study including 113,785 vertex deliveries performed by a team of doctors and midwives after receiving the weekly 3-hour simulation-based training.

Disclosures: This study was funded by Helsinki University State Research Funding. No conflicts of interest were declared.

Source: Kaijomaa M et al. Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury: An observational study. BJOG. 2022 (Aug 10). Doi: 10.1111/1471-0528.17278