Objective: To compare the rates of bleeding recurrence and other post-partum haemorrhage (PPH)-related clinical outcomes in women with PPH initially controlled by intrauterine balloon tamponade (IUBT) according to its duration.
Design: Exploratory cohort study from a randomised trial.
Setting: Eighteen hospitals in France.
Objective: To assess the association between maternal haemoglobinaemia in the immediate post-partum period and PPD symptoms 2 months after vaginal delivery.
Design: Ancillary cohort study of the TRAAP trial, a multicentre trial.
Setting: In France, 2015-2016.
Background: An enhanced consideration of blood pressure (BP) dynamics during pregnancy could improve its monitoring. Distinct BP trajectories may exist, and some have been linked to adverse fetal development. Using maternal BP measurements spanning almost the entire pregnancy, this study aimed to identify trajectories and assess their association with birth outcomes.
View Article and Find Full Text PDFBMJ Med
December 2024
Objectives: To assess the incidence of hospital admissions for covid-19 disease in pregnant women, severity of covid-19 disease, and medical treatment provided to pregnant women with moderate to severe covid-19 during the first 10 months of the pandemic.
Design: Individual patient data meta-analysis of population based cohorts in International Obstetric Survey Systems.
Setting: 10 European countries with national or regional surveillance within the International Obstetric Survey Systems (INOSS) collaboration using aligned definitions and case report forms: Belgium, France (regional), Italy, the Netherlands, Denmark, Finland, Iceland, Norway, Sweden (regional), and the UK.
Background: Placentas that are previa or low-lying are a major cause of severe postpartum hemorrhage (PPH). Tranexamic acid, by inhibiting the fibrinolytic pathway and protecting blood clots from degradation, is a promising drug for preventing blood loss after childbirth, especially in high-risk conditions. It remains unclear whether tranexamic acid would decrease the incidence of severe PPH among women with placentas that are previa or low-lying.
View Article and Find Full Text PDFBackground: Population-based data are needed to reliably assess the impact of SARS-CoV-2 infection during pregnancy.
Objectives: To estimate the population-based incidence of SARS-CoV-2 infection and its severe forms in the obstetric population, identify risk factors of severe SARS-CoV-2 infection (severe COVID-19) and describe delivery, maternal and neonatal outcomes by disease severity, using a definition of severity based on organ dysfunction.
Methods: A prospective population-based study conducted over the three first pandemic waves between March 2020 and April 2021 in 281 maternity hospitals in six French regions included all women with SARS-CoV-2 infection during pregnancy or within 7 days post-partum, whether symptomatic or not, hospitalised or not.
Background: Management and outcomes in women with placenta accreta spectrum grade 3 are rarely reported from population-based studies. The objective of this study is to describe profiles, management, and outcomes, of women with placenta accreta spectrum (PAS) grade 3 from three multiperiod studies.
Methods: This analysis used data from three multiperiod population-based cohort studies from the United Kingdom (UK) (May 2010-April 2011), France (November 2013-October 2015), and Italy (September 2014-August 2016) to compare the management and outcomes of women with grade 3 PAS.
Background: Macrosomia, classically defined by an arbitrary birthweight threshold, is associated with an increased risk of postpartum hemorrhage. However, some preliminary evidence suggests that lower birthweights may also be at increased risk. We hypothesized that birthweight, analyzed as a continuous variable, is significantly associated with the risk of severe postpartum hemorrhage, with the risk increasing not only at higher birthweights traditionally associated with macrosomia but also potentially at lower birthweights.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
April 2025
Introduction: The literature extensively documents neonatal and paediatric outcomes related to preterm delivery, but maternal health in this circumtances remains underexplored. This study aimed to identify women with antepartum severe maternal morbidity (SMM) among those delivering preterm and explore whether they delivered in hospitals with risk-appropriate maternal care facilities.
Material And Methods: Women giving birth at 22-34 weeks of gestation were identified from the French national prospective EPIPAGE-2 cohort study in 2011; terminations of pregnancy for fetal congenital malformations were excluded.
Background: Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother-infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care.
View Article and Find Full Text PDFObjective: To evaluate the prevalence and risk factors of maternal dissatisfaction 2 days after a singleton vaginal delivery at or near term.
Methods: We conducted a planned ancillary cohort study of the TRanexamic Acid for Preventing Postpartum Hemorrhage After Vaginal Delivery (TRAAP) randomized controlled trial. Maternal dissatisfaction, related to the birth and to the subsequent hospital stay, was assessed 2 days postpartum by two self-administered questions: "Are you satisfied with the care you received during your child's birth?" and "Are you satisfied with the care you have received during your hospital stay?".
Paediatr Perinat Epidemiol
May 2025
Background: Tranexamic acid is a recommended treatment for women with a clinical diagnosis of postpartum haemorrhage, but whether it can prevent bleeding is unclear. We conducted a systematic review and individual patient data (IPD) meta-analysis of randomised controlled trials to assess the effects of tranexamic acid in women giving birth.
Methods: In this systematic review and IPD meta-analysis, we searched the WHO International Clinical Trials Registry Platform from database inception to Aug 4, 2024 for randomised trials that assessed the effects of tranexamic acid in women giving birth.
Diabetes Metab
September 2024
Aims: To evaluate the impact of onset time, duration, and severity of various types of hypertensive disorders of pregnancy (HDP) on the risk of incident DM.
Methods: We used data from the ongoing French nationwide prospective cohort study CONCEPTION. We included all primiparous women in CONCEPTION who delivered between 2010 and 2018 (n = 2,816,793 women).
Acta Obstet Gynecol Scand
September 2024
BMJ Open
May 2024
Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.
Design: Systematic review and three-stage modified Delphi expert consensus.