Obstetrics

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

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

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

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

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

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

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879

Key clinical point: The presence of uterine fibroids in early pregnancy is significantly and independently associated with higher odds of developing preeclampsia in the middle and late trimesters.

Major finding: Pregnant women with vs without uterine fibroids in early pregnancy had a 3-fold higher risk for preeclampsia (adjusted odds ratio 3.02; P = .019).

Study details: This case-control study included 121 pregnant women diagnosed with preeclampsia and 578 age-matched pregnant women without preeclampsia.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Gong L et al. Uterine fibroids are associated with increased risk of pre-eclampsia: A case-control study. Front Cardiovasc Med. 2022;9:1011311 (Oct 18). Doi: 10.3389/fcvm.2022.1011311

Key clinical point: The presence of uterine fibroids in early pregnancy is significantly and independently associated with higher odds of developing preeclampsia in the middle and late trimesters.

Major finding: Pregnant women with vs without uterine fibroids in early pregnancy had a 3-fold higher risk for preeclampsia (adjusted odds ratio 3.02; P = .019).

Study details: This case-control study included 121 pregnant women diagnosed with preeclampsia and 578 age-matched pregnant women without preeclampsia.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Gong L et al. Uterine fibroids are associated with increased risk of pre-eclampsia: A case-control study. Front Cardiovasc Med. 2022;9:1011311 (Oct 18). Doi: 10.3389/fcvm.2022.1011311

Key clinical point: The presence of uterine fibroids in early pregnancy is significantly and independently associated with higher odds of developing preeclampsia in the middle and late trimesters.

Major finding: Pregnant women with vs without uterine fibroids in early pregnancy had a 3-fold higher risk for preeclampsia (adjusted odds ratio 3.02; P = .019).

Study details: This case-control study included 121 pregnant women diagnosed with preeclampsia and 578 age-matched pregnant women without preeclampsia.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Gong L et al. Uterine fibroids are associated with increased risk of pre-eclampsia: A case-control study. Front Cardiovasc Med. 2022;9:1011311 (Oct 18). Doi: 10.3389/fcvm.2022.1011311

Key clinical point: Vaginal breech delivery (VBD) performed under experienced supervision does not significantly increase the risk for negative short-term perinatal outcomes.

Major finding: VBD, elective caesarean section (CS), and emergency CS did not result in any significant difference in the proportion of neonates with a 5-min Apgar score of <3, umbilical arterial pH of <7.00, or the need for admission to the neonatal intensive care unit (all P > .05).

Study details: This single-center, retrospective study included 804 singleton pregnant women with a fetus in breech position at delivery who underwent VBD (n = 433), emergency CS (n = 214), or elective CS (n = 157).

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

Source: Fruscalzo A et al. Short-term neonatal outcomes in vaginal breech delivery: Results of a retrospective single-centre study. Eur J Obstet Gynecol Reprod Biol. 2022;279:122-129 (Oct 28). Doi: 10.1016/j.ejogrb.2022.10.022

Key clinical point: Vaginal breech delivery (VBD) performed under experienced supervision does not significantly increase the risk for negative short-term perinatal outcomes.

Major finding: VBD, elective caesarean section (CS), and emergency CS did not result in any significant difference in the proportion of neonates with a 5-min Apgar score of <3, umbilical arterial pH of <7.00, or the need for admission to the neonatal intensive care unit (all P > .05).

Study details: This single-center, retrospective study included 804 singleton pregnant women with a fetus in breech position at delivery who underwent VBD (n = 433), emergency CS (n = 214), or elective CS (n = 157).

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

Source: Fruscalzo A et al. Short-term neonatal outcomes in vaginal breech delivery: Results of a retrospective single-centre study. Eur J Obstet Gynecol Reprod Biol. 2022;279:122-129 (Oct 28). Doi: 10.1016/j.ejogrb.2022.10.022

Key clinical point: Vaginal breech delivery (VBD) performed under experienced supervision does not significantly increase the risk for negative short-term perinatal outcomes.

Major finding: VBD, elective caesarean section (CS), and emergency CS did not result in any significant difference in the proportion of neonates with a 5-min Apgar score of <3, umbilical arterial pH of <7.00, or the need for admission to the neonatal intensive care unit (all P > .05).

Study details: This single-center, retrospective study included 804 singleton pregnant women with a fetus in breech position at delivery who underwent VBD (n = 433), emergency CS (n = 214), or elective CS (n = 157).

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

Source: Fruscalzo A et al. Short-term neonatal outcomes in vaginal breech delivery: Results of a retrospective single-centre study. Eur J Obstet Gynecol Reprod Biol. 2022;279:122-129 (Oct 28). Doi: 10.1016/j.ejogrb.2022.10.022

Key clinical point: Intraoperative cell salvage (ICS) is an effective and safe method for blood loss recovery in patients with a high risk for postpartum hemorrhage (PPH) during cesarean section.

Major finding: Patients who underwent ICS vs received allogeneic red blood cell (RBC) transfusion had significantly higher blood cell count, hemoglobin levels, hematocrit, and fibrinogen levels, and shorter prothrombin time, thrombin time, and activated partial thromboplastin time (all P < .05). ICS treatment did not cause any adverse events.

Study details: This prospective randomized controlled study included 130 patients with a high risk for PPH who underwent elective or emergency cesarean section and were randomly assigned (1:1) to undergo ICS (n = 65) or receive allogeneic RBC transfusion (control; n = 65) if the hemoglobin level was <80 g/L during surgery.

Disclosures: This study was sponsored by the Beijing Science and Technology Commission Research Fund, China. The authors declared no conflicts of interest.

Source: Lei B et al. Intraoperative cell salvage as an effective intervention for postpartum hemorrhage—Evidence from a prospective randomized controlled trial. Front Immunol. 2022;13:953334 (Oct 10). Doi: 10.3389/fimmu.2022.953334

Key clinical point: Intraoperative cell salvage (ICS) is an effective and safe method for blood loss recovery in patients with a high risk for postpartum hemorrhage (PPH) during cesarean section.

Major finding: Patients who underwent ICS vs received allogeneic red blood cell (RBC) transfusion had significantly higher blood cell count, hemoglobin levels, hematocrit, and fibrinogen levels, and shorter prothrombin time, thrombin time, and activated partial thromboplastin time (all P < .05). ICS treatment did not cause any adverse events.

Study details: This prospective randomized controlled study included 130 patients with a high risk for PPH who underwent elective or emergency cesarean section and were randomly assigned (1:1) to undergo ICS (n = 65) or receive allogeneic RBC transfusion (control; n = 65) if the hemoglobin level was <80 g/L during surgery.

Disclosures: This study was sponsored by the Beijing Science and Technology Commission Research Fund, China. The authors declared no conflicts of interest.

Source: Lei B et al. Intraoperative cell salvage as an effective intervention for postpartum hemorrhage—Evidence from a prospective randomized controlled trial. Front Immunol. 2022;13:953334 (Oct 10). Doi: 10.3389/fimmu.2022.953334

Key clinical point: Intraoperative cell salvage (ICS) is an effective and safe method for blood loss recovery in patients with a high risk for postpartum hemorrhage (PPH) during cesarean section.

Major finding: Patients who underwent ICS vs received allogeneic red blood cell (RBC) transfusion had significantly higher blood cell count, hemoglobin levels, hematocrit, and fibrinogen levels, and shorter prothrombin time, thrombin time, and activated partial thromboplastin time (all P < .05). ICS treatment did not cause any adverse events.

Study details: This prospective randomized controlled study included 130 patients with a high risk for PPH who underwent elective or emergency cesarean section and were randomly assigned (1:1) to undergo ICS (n = 65) or receive allogeneic RBC transfusion (control; n = 65) if the hemoglobin level was <80 g/L during surgery.

Disclosures: This study was sponsored by the Beijing Science and Technology Commission Research Fund, China. The authors declared no conflicts of interest.

Source: Lei B et al. Intraoperative cell salvage as an effective intervention for postpartum hemorrhage—Evidence from a prospective randomized controlled trial. Front Immunol. 2022;13:953334 (Oct 10). Doi: 10.3389/fimmu.2022.953334

Key clinical point: A dose of 1 g intravenous tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis during cesarean delivery.

Major finding: A dose of 1 g tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis as evidenced by smaller mean increases in D-dimer levels at 120 minutes (38% vs 93%; P = .003) and plasmin-antiplasmin levels at 30 minutes (−2% vs 56%; P = .009) after the initiation of infusion but with more frequent nonserious adverse events, such as nausea and vomiting, whereas 0.5 g tranexamic acid did not lead to significant hyperfibrinolysis inhibition.

Study details: The data come from the phase 4 TRACES trial including 151 women who experienced postpartum hemorrhage during cesarean delivery and were randomly assigned to receive tranexamic acid (0.5 or 1 g) or placebo.

Disclosures: This study was supported by the French Ministry of Health and the French National Drug Safety Agency. The authors declared no conflicts of interest.

Source: Ducloy-Bouthors AS et al for the TRACES working group. Tranexamic acid dose-response relationship for antifibrinolysis in postpartum haemorrhage during caesarean delivery: TRACES, a double-blind, placebo-controlled, multicentre, dose-ranging biomarker study. Br J Anaesth. 2022;129(6):937-945 (Oct 12). Doi: 10.1016/j.bja.2022.08.033

Key clinical point: A dose of 1 g intravenous tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis during cesarean delivery.

Major finding: A dose of 1 g tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis as evidenced by smaller mean increases in D-dimer levels at 120 minutes (38% vs 93%; P = .003) and plasmin-antiplasmin levels at 30 minutes (−2% vs 56%; P = .009) after the initiation of infusion but with more frequent nonserious adverse events, such as nausea and vomiting, whereas 0.5 g tranexamic acid did not lead to significant hyperfibrinolysis inhibition.

Study details: The data come from the phase 4 TRACES trial including 151 women who experienced postpartum hemorrhage during cesarean delivery and were randomly assigned to receive tranexamic acid (0.5 or 1 g) or placebo.

Disclosures: This study was supported by the French Ministry of Health and the French National Drug Safety Agency. The authors declared no conflicts of interest.

Source: Ducloy-Bouthors AS et al for the TRACES working group. Tranexamic acid dose-response relationship for antifibrinolysis in postpartum haemorrhage during caesarean delivery: TRACES, a double-blind, placebo-controlled, multicentre, dose-ranging biomarker study. Br J Anaesth. 2022;129(6):937-945 (Oct 12). Doi: 10.1016/j.bja.2022.08.033

Key clinical point: A dose of 1 g intravenous tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis during cesarean delivery.

Major finding: A dose of 1 g tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis as evidenced by smaller mean increases in D-dimer levels at 120 minutes (38% vs 93%; P = .003) and plasmin-antiplasmin levels at 30 minutes (−2% vs 56%; P = .009) after the initiation of infusion but with more frequent nonserious adverse events, such as nausea and vomiting, whereas 0.5 g tranexamic acid did not lead to significant hyperfibrinolysis inhibition.

Study details: The data come from the phase 4 TRACES trial including 151 women who experienced postpartum hemorrhage during cesarean delivery and were randomly assigned to receive tranexamic acid (0.5 or 1 g) or placebo.

Disclosures: This study was supported by the French Ministry of Health and the French National Drug Safety Agency. The authors declared no conflicts of interest.

Source: Ducloy-Bouthors AS et al for the TRACES working group. Tranexamic acid dose-response relationship for antifibrinolysis in postpartum haemorrhage during caesarean delivery: TRACES, a double-blind, placebo-controlled, multicentre, dose-ranging biomarker study. Br J Anaesth. 2022;129(6):937-945 (Oct 12). Doi: 10.1016/j.bja.2022.08.033

Key clinical point: Low molecular weight heparin (LMWH), vitamin D supplementation, exercise, calcium supplementation, and aspirin reduce the risk for preeclampsia.

Major finding: LMWH (risk ratio [RR] 0.60; 95% CI 0.42-0.87), vitamin D supplementation (RR 0.65; 95% CI 0.45-0.95), exercise (RR 0.68; 95% CI 0.50-0.92), calcium supplementation (RR 0.71; 95% CI 0.62-0.82), and aspirin (RR 0.79; 95% CI 0.72-0.86) were the prophylactic strategies identified to significantly reduce the risk for preeclampsia.

Study details: Findings are from a network meta-analysis of 130 randomized controlled trials that involved 112,916 pregnant women at risk of developing preeclampsia, with preeclampsia being reported in 114 studies including 95,500 women.

Disclosures: This study was supported by the Shuangqing Talent Program Project of Guangdong Provincial People's Hospital, China, among others. The authors declared no conflicts of interest.

Source: Liu YH et al. Prophylactic strategies for preventing pre-eclampsia: A network meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2022 (Oct 22). Doi: 10.1016/j.ajog.2022.10.014

Key clinical point: Low molecular weight heparin (LMWH), vitamin D supplementation, exercise, calcium supplementation, and aspirin reduce the risk for preeclampsia.

Major finding: LMWH (risk ratio [RR] 0.60; 95% CI 0.42-0.87), vitamin D supplementation (RR 0.65; 95% CI 0.45-0.95), exercise (RR 0.68; 95% CI 0.50-0.92), calcium supplementation (RR 0.71; 95% CI 0.62-0.82), and aspirin (RR 0.79; 95% CI 0.72-0.86) were the prophylactic strategies identified to significantly reduce the risk for preeclampsia.

Study details: Findings are from a network meta-analysis of 130 randomized controlled trials that involved 112,916 pregnant women at risk of developing preeclampsia, with preeclampsia being reported in 114 studies including 95,500 women.

Disclosures: This study was supported by the Shuangqing Talent Program Project of Guangdong Provincial People's Hospital, China, among others. The authors declared no conflicts of interest.

Source: Liu YH et al. Prophylactic strategies for preventing pre-eclampsia: A network meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2022 (Oct 22). Doi: 10.1016/j.ajog.2022.10.014

Key clinical point: Low molecular weight heparin (LMWH), vitamin D supplementation, exercise, calcium supplementation, and aspirin reduce the risk for preeclampsia.

Major finding: LMWH (risk ratio [RR] 0.60; 95% CI 0.42-0.87), vitamin D supplementation (RR 0.65; 95% CI 0.45-0.95), exercise (RR 0.68; 95% CI 0.50-0.92), calcium supplementation (RR 0.71; 95% CI 0.62-0.82), and aspirin (RR 0.79; 95% CI 0.72-0.86) were the prophylactic strategies identified to significantly reduce the risk for preeclampsia.

Study details: Findings are from a network meta-analysis of 130 randomized controlled trials that involved 112,916 pregnant women at risk of developing preeclampsia, with preeclampsia being reported in 114 studies including 95,500 women.

Disclosures: This study was supported by the Shuangqing Talent Program Project of Guangdong Provincial People's Hospital, China, among others. The authors declared no conflicts of interest.

Source: Liu YH et al. Prophylactic strategies for preventing pre-eclampsia: A network meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2022 (Oct 22). Doi: 10.1016/j.ajog.2022.10.014

Key clinical point: Compared with women who conceive naturally, those who conceive through assisted reproductive technology (ART) have a higher risk for cardiovascular complications, including preeclampsia/eclampsia, heart failure, and cardiac arrhythmias, during delivery admissions.

Major finding: Women who conceived through ART vs naturally had a higher risk for preeclampsia/eclampsia (adjusted odds ratio [aOR] 1.48; P < .01), heart failure (aOR 1.94; P < .01), and cardiac arrhythmias (aOR 1.39; P < .01).

Study details: This real-world population study analyzed the data of women hospitalized for deliveries (weighted n = 45,867,086), of which 108,542 had conceived through ART.

Disclosures: This study did not receive any specific funding. Some authors declared advisory board participation or consultancy for various organizations.

Source: Zahid S et al. Cardiovascular complications during delivery admissions associated with assisted reproductive technology (from a National Inpatient Sample analysis 2008 to 2019). Am J Cardiol. 2022 (Oct 23). Doi: 10.1016/j.amjcard.2022.08.037

Key clinical point: Compared with women who conceive naturally, those who conceive through assisted reproductive technology (ART) have a higher risk for cardiovascular complications, including preeclampsia/eclampsia, heart failure, and cardiac arrhythmias, during delivery admissions.

Major finding: Women who conceived through ART vs naturally had a higher risk for preeclampsia/eclampsia (adjusted odds ratio [aOR] 1.48; P < .01), heart failure (aOR 1.94; P < .01), and cardiac arrhythmias (aOR 1.39; P < .01).

Study details: This real-world population study analyzed the data of women hospitalized for deliveries (weighted n = 45,867,086), of which 108,542 had conceived through ART.

Disclosures: This study did not receive any specific funding. Some authors declared advisory board participation or consultancy for various organizations.

Source: Zahid S et al. Cardiovascular complications during delivery admissions associated with assisted reproductive technology (from a National Inpatient Sample analysis 2008 to 2019). Am J Cardiol. 2022 (Oct 23). Doi: 10.1016/j.amjcard.2022.08.037

Key clinical point: Compared with women who conceive naturally, those who conceive through assisted reproductive technology (ART) have a higher risk for cardiovascular complications, including preeclampsia/eclampsia, heart failure, and cardiac arrhythmias, during delivery admissions.

Major finding: Women who conceived through ART vs naturally had a higher risk for preeclampsia/eclampsia (adjusted odds ratio [aOR] 1.48; P < .01), heart failure (aOR 1.94; P < .01), and cardiac arrhythmias (aOR 1.39; P < .01).

Study details: This real-world population study analyzed the data of women hospitalized for deliveries (weighted n = 45,867,086), of which 108,542 had conceived through ART.

Disclosures: This study did not receive any specific funding. Some authors declared advisory board participation or consultancy for various organizations.

Source: Zahid S et al. Cardiovascular complications during delivery admissions associated with assisted reproductive technology (from a National Inpatient Sample analysis 2008 to 2019). Am J Cardiol. 2022 (Oct 23). Doi: 10.1016/j.amjcard.2022.08.037