Obstetric Medicine, Ahead of Print. The presence of non-cirrhotic portal hypertension in pregnancy poses a challenging clinical scenario as it predisposes women to several life-threatening complications such as variceal haemorrhage, splenic artery aneurysm, pulmonary hypertension and bacterial peritonitis. The haemodynamic changes in pregnancy along with the demands of a growing fetus may worsen the severity of pre-existing non-cirrhotic portal hypertension. In this case series, we discuss four cases of non-cirrhotic portal hypertension in pregnancy in a low to middle income setting and review ..read more

Obstetric Medicine, Ahead of Print. Through their personal experience of having intrahepatic cholestasis of pregnancy (ICP), this paper covers the development of current understanding of ICP. It summarises how research and clinical practice was developed through clinicians and followed by the inception of an ICP research group in the 1990s. This group's work has led to a better understanding of the mechanisms behind ICP, the risk threshold for stillbirth, and a genomic understanding of the condition. It focuses on how collaborative work between the author and researchers led to the formation o ..read more

Obstetric Medicine, Ahead of Print. ObjectivesTo determine the levels of angiogenic biomarkers: vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor 1 (sVEGFR1 or sFlt-1), platelet count, and the VEGF/platelet ratio in preeclampsia.MethodsForty-four cases of preeclampsia and 44 controls were recruited.ResultsThe serum VEGF, sVEGFR1, and VEGF/platelet ratio were significantly higher and platelet counts lower in preeclampsia in comparison to controls (VEGF: median = 178 vs. 97 pg/mL, p < 0.0001, sVEGFR1: 1634 vs. 627 pg/mL, p < 0.0001, VEGF/platele ..read more

Obstetric Medicine, Ahead of Print. BackgroundThere are limited data regarding intermittently scanned continuous glucose monitoring (isCGM) in pregnancy for women with Type 2 diabetes. We have tested the acceptability and feasibility of an isCGM method using Libre device.MethodIn a hospital-based service improvement project, 23 pregnant women (March 2022-April 2023), with Type 2 diabetes got isCGM for monitoring from 20 weeks until delivery. Women completed a structured and validated questionnaire assessing satisfaction, equipment issue, relationship with diabetes team. ResultsTwo-thirds of th ..read more

Obstetric Medicine, Ahead of Print. Transient osteoporosis of the hip is an uncommon bone marrow oedema syndrome of unknown pathophysiology affecting previously healthy pregnant women and young to middle-aged men. The disorder is characterised by hip pain, reduced mobility, and the risk of fracture, which is significantly higher in pregnant than in non-pregnant individuals. Diagnosis is by magnetic resonance imaging. Other than a single case-control study, published literature is limited to case series and case reports, with no evidence to guide management, risk of fracture, mode of delivery ..read more

Obstetric Medicine, Ahead of Print. ObjectivesTo compare gestational weight gain (GWG) during pregnancy and obesity-related maternal morbidity between three months of the first year of the COVID-19 pandemic and three months of the previous year.MethodsA retrospective comparative study was conducted in a tertiary university-affiliated hospital. GWG, obesity rates and pregnancy complications were compared between the time periods.ResultsAmong women with class I obesity, GWG was higher during the pandemic (n = 1071) than the previous year (n = 1194): 11.16 vs. 8.69 kg, p = 0.04. Women during the ..read more

Obstetric Medicine, Ahead of Print. AimTo investigate the effect of aspirin on obstetric outcomes in women with pre-gestational diabetes mellitus (PGDM).MethodRetrospective audit of pregnant women with PGDM from two centres in South-Western Sydney was conducted. Women were categorised into the aspirin group (prescribed aspirin before 16 weeks, gestation) and non-aspirin group (not prescribed aspirin or prescribed aspirin at or after 16 weeks, gestation). The outcomes examined were pre-eclampsia, pre-term delivery and birthweight percentile.ResultsOf 494 women, 52 (10.5%) were in the aspirin gr ..read more

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Obstetric Medicine, Ahead of Print. Abnormalities of liver function are common during pregnancy. This retrospective study examined the incidence, aetiology and adequacy of investigation of pregnant women with markedly elevated aspartate aminotransferase and/or alanine transaminase levels (more than 10-fold of the upper limit of normal) over a ten-year period at a tertiary referral maternity hospital in Brisbane, Australia. Three hundred and twenty-three women were found to have markedly elevated liver enzymes, representing 0.56% of pregnancies with known delivery outcomes. Two hundred and sixt ..read more

Obstetric Medicine, Ahead of Print. IntroductionIn 2021, the steering committee members of British Society of Haematology Obstetric Haematology Special Interest Group noted difficulties in opening research studies. This led to the development of a survey to further evaluate this issue.MethodAn electronic survey was distributed to all members of the British Society of Haematology Obstetric Haematology Special Interest Group and to relevant specialty leads of the National Institute for Health and Care Research Clinical Research Network for further dissemination within these networks.ResultsRespo ..read more