Most Read Articles
09 Dec 2017
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.
Shilpa Kolhe, MBBS, MD, MRCOG; Shilpa Deb, MBBS, DGO, MRCOG, 01 Aug 2012

Dysmenorrhoea is a medical condition characterized by severe uterine pain during menstruation manifesting as cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs. The term dysmenorrhoea is derived from the Greek words ‘dys’ meaning difficult, painful or abnormal, ‘meno’ meaning month, and ‘rrhea’ meaning flow. It is commonly divided into primary dysmenorrhoea, where there is no coexistent pathology, and secondary dysmenorrhoea where there is an identifiable pathological condition known to contribute to painful menstruation. Symptoms of primary dysmenorrhoea begin a few hours before the start of menstruation and are often relieved during the first few days of bleeding. The initial onset of primary dysmenorrhoea is usually shortly after menarche (6–12 months), when ovulatory cycles are established. Secondary dysmenorrhoea can also occur at any time after menarche but is most commonly observed in women in their third and fourth decade of life in association with an existing condition.

02 Dec 2014
Adolescent females often experience menstrual problems, and these are usually related to mood changes. In this study, the association between dysmenorrhea and depressive symptoms, anxiety, and premenstrual syndrome was examined.
26 Feb 2017
Placement of cervical pessary in women with short cervices and singleton pregnancies does not lower the risk of having preterm births, according to the results of a meta-analysis.

Delivery by 38 weeks lowers risk of stillbirth in older pregnant women

12 Sep 2017

Delivery by 38 weeks appears to reduce the risk of stillbirth in pregnant women at least 44 years of age, according to a study.

To determine the gestational age at which the risk of foetal or neonatal death associated with delaying delivery by 1 week exceeded the risk of neonatal death associated with immediate delivery, researchers examined a total of 11,957,690 live births, 8,779 stillbirths and 8,664 neonatal deaths that occurred in the United States between 2010 and 2013. Only singleton, nonanomalous pregnancies without hypertensive disease or diabetes were included.

A generalized linear model was used to compare the rate of death associated with immediate delivery to those of expectant management, with the women grouped into six age categories.

Immediate delivery was associated with lower relative risk of neonatal death by 39 weeks across all age groups, with the exception of ≥44 years age group. The odds ratios (ORs) for death were 1.0 (95 percent CI, 0.32 to 3.10) in the <25 years age group, 0.67 (0.19 to 2.37) in the 25 to 29 years age group, 0.80 (0.21 to 2.98) in the 30 to 34 years age group, 0.67 (0.19 to 2.36) in the 35 to 39 years age group, and 0.45 (0.16 to 1.31) in the 40 to 44 years age group.

Among women aged ≥44 years and older, immediate delivery was associated with a lower relative risk of neonatal death by 38 weeks (OR, 0.35; 0.14 to 0.90).

Advanced maternal age carries a greater risk complications such as foetal congenital anomalies, maternal hypertensive disorders, gestational diabetes and pregestational diabetes. These conditions are associated with heightened stillbirth risk. [BJOG 2012;119:276–282; Am J Obstet Gynecol 2007;196:433–444]

Researchers noted that the current finding that delivery by 38 weeks gestational age may reduce the risk of stillbirth in women ≥44 years of age is important given the limited future fertility of mothers in this age group.

“Induction of labour among women 44 years or older at the time of delivery, might be useful in reducing stillbirth. However, it needs to be weighed against compromising maternal outcomes, neonatal morbidity, patient preference and healthcare costs,” researchers said.

“Quantifying and counselling women of advanced maternal age on their risk of stillbirth is important and requires a nuanced approach... Further research regarding the mechanism behind unexplained foetal death in women of advanced maternal age will help determine the most effective forms of prevention,” they added.

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Most Read Articles
09 Dec 2017
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.
Shilpa Kolhe, MBBS, MD, MRCOG; Shilpa Deb, MBBS, DGO, MRCOG, 01 Aug 2012

Dysmenorrhoea is a medical condition characterized by severe uterine pain during menstruation manifesting as cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs. The term dysmenorrhoea is derived from the Greek words ‘dys’ meaning difficult, painful or abnormal, ‘meno’ meaning month, and ‘rrhea’ meaning flow. It is commonly divided into primary dysmenorrhoea, where there is no coexistent pathology, and secondary dysmenorrhoea where there is an identifiable pathological condition known to contribute to painful menstruation. Symptoms of primary dysmenorrhoea begin a few hours before the start of menstruation and are often relieved during the first few days of bleeding. The initial onset of primary dysmenorrhoea is usually shortly after menarche (6–12 months), when ovulatory cycles are established. Secondary dysmenorrhoea can also occur at any time after menarche but is most commonly observed in women in their third and fourth decade of life in association with an existing condition.

02 Dec 2014
Adolescent females often experience menstrual problems, and these are usually related to mood changes. In this study, the association between dysmenorrhea and depressive symptoms, anxiety, and premenstrual syndrome was examined.
26 Feb 2017
Placement of cervical pessary in women with short cervices and singleton pregnancies does not lower the risk of having preterm births, according to the results of a meta-analysis.