Screening for Trisomies by cfDNA Testing of Maternal Blood in Twin Pregnancy: Update of the Fetal Medicine Foundation Results and Meta-analysis (Abstracted from Ultrasound Obstet Gynecol 2019;53:734–742) Cell-free DNA (cfDNA) analysis of maternal blood is useful and effective when screening for trisomies 21, 18, and 13 in singleton pregnancies. However, in twin pregnancies, data on cfDNA tests are much more limited: in a previous literature review and meta-analysis, there were only 5 prospective studies.

Cerclage for Women With Twin Pregnancies: A Systematic Review and Meta-analysis (Abstracted from Am J Obstet Gynecol 2019;220(6):543–557) The use of assisted-reproductive technique has led to an increase in the twin birth rate over the last 30 years, and these pregnancies are at an increased risk for preterm birth (PTB). Reportedly, approximately 50% of twin pregnancies deliver at <37 weeks of gestation and 14% are delivered at <33 weeks.

Investigating Fetal Growth Restriction and Perinatal Risks in Appropriate for Gestational Age Infants: Using Cohort and Within-Sibling Analyses (Abstracted from BJOG 2019;126(7):842–850) Fetal growth restriction, defined as fetal growth below expectations, is statistically measured by a cutoff of birthweight for gestational age. Small-for-gestational-age (SGA) birth, however, is not always linked with fetal growth restriction: SGA infants may have reached their growth potential and just be small, while larger, non-SGA infants sometimes fail to reach their growth potential.

Induction of Labor at 39 Weeks of Gestation Versus Expectant Management for Low-Risk Nulliparous Women: A Cost-Effectiveness Analysis (Abstracted from Am J Obstest Gynecol 2019;220(6):590.e1–590.e10) Inducing labor is commonly used to initiate labor before the spontaneous onset of labor for many indications. One of the major concerns about elective induction of labor (performed when there is no medical indication) is that it will increase risk of cesarean delivery.

Prophylactic Antibiotics in the Prevention of Infection After Operative Vaginal Delivery (ANODE): A Multicenter Randomized Controlled Trial (Abstracted from Lancet 2019;393:2395–2403) Sepsis causes 11% of maternal deaths globally; in 2016, an estimated 19,500 women died because of pregnancy-related infections. The risk factors for maternal sepsis are easily recognized, including cesarean delivery and operative vaginal birth (forceps or vacuum extraction).

Screening for HIV Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force (Abstracted from JAMA 2019;321(23):2349–2360) Human immunodeficiency virus (HIV) can be transmitted from mother to child (MTCT) during pregnancy and the postpartum period. The number of perinatal HIV infections in the United States declined from 1985 to 2001 after routine prenatal screening was implemented across the country, along with the use of effective therapies for preventing MTCT.

Development of Nationwide Recommendations to Support Prenatal Counseling in Extreme Prematurity (Abstracted from Pediatrics 2019;143(6):e20183253) Guidelines on management of extreme prematurity differ regarding the lowest limits of gestation for which active support can or should be offered the recommendations for the role of parents in the decision making. In addition, the use of gestational age (GA) as a cutoff has been debated because other factors also determine prenatal outcome.

Role of Interventional Radiology in Pregnancy Complicated by Placenta Accreta Spectrum Disorder: Systematic Review and Meta-analysis (Abstracted from Ultrasound Obstet Gynecol 2019;53:743–751) The increase in cesarean sections performed in the last 20 years has also led to a large increase in the incidence of placenta accreta spectrum (PAS) disorders. Prenatal diagnosis of a PAS disorder, by ultrasound or magnetic resonance imaging, has been shown to improve maternal outcome by letting providers plan surgical treatment for these disorders.

Short-term Health-Related Quality of Life After Hysterectomy Compared With Myomectomy for Symptomatic Leiomyomas (Abstracted from Obstet Gynecol 2019;134:261–269) One or more leiomyomas will be detected by abdominal or pelvic imaging by age 50 years in 70% of white women and more than 80% of African American women. Most leiomyomas are asymptomatic, but 25% to 30% of affected women will experience pelvic pain, heavy or prolonged menstrual bleeding, bulk symptoms (ie, pelvic pressure or genitourinary symptoms), and/or reproductive dysfunction.

Delayed Recognition of Lower Urinary Tract Injuries Following Hysterectomy for Benign Indications: A NSQIP-Based Study (Abstracted from Am J Obstet Gynecol 2019;221:132.e1–132.e13) The occurrence of lower urinary tract (LUT) injury at the time of hysterectomy for benign indications is rare. Reported rates range from 0.3% to 1.3%.