Maternal Health

Preeclampsia is often recognised by high blood pressure and protein in the urine, but its effects can reach much further. When the placenta does not function well, the fetus may need to adjust its circulation to protect vital organs. These changes can be subtle before they become visible as poor growth, reduced fluid, or abnormal Doppler findings. That is why interest is growing in venous and cardiovascular markers that look beyond the usual arteries. Two measurements attract

Shoulder dystocia is rare, sudden, and unforgiving. A birth that appears to be progressing normally can become an obstetric emergency within seconds, with the anterior shoulder impacted behind the pubic symphysis or, less often, the posterior shoulder obstructed at the sacral promontory. The McRoberts manoeuvre is usually the first response. It is simple, quick, non-invasive, and widely taught. Yet recent reappraisal has raised an important question: how much of its reputatio

A baby’s first protection from infection can begin before the first breath. During pregnancy, antibodies made by the mother can cross the placenta and help shield the newborn in the fragile early weeks of life. Maternal vaccines use this natural pathway, turning routine antenatal care into one of the earliest and most powerful tools for child survival. This matters because newborns do not enter the world with fully developed immune systems. Many routine childhood vaccines sta

Pregnancy changes the immune system, heart, and lungs in ways that can make some infections more severe. A mild fever or cough may pass quickly for one person, yet the same infection during pregnancy can raise the risk of complications such as pneumonia, preterm birth, low birth weight, or serious illness in a newborn. That is why vaccination is part of routine antenatal care, not an optional extra. The aim is simple: protect the pregnant person during a vulnerable period and

Prelabour caesarean delivery removes the fetus from the hormonal and mechanical signals of labour. For late-preterm newborns, that missing transition can matter. The lungs must shift within minutes from fluid-filled fetal organs to air-breathing organs capable of gas exchange. When this switch is delayed, respiratory support may be needed. A late-preterm lamb model offers a useful way to study this problem. Lambs have long been used in perinatal physiology because their cardi

A perineal tear can happen in any vaginal birth, but certain vulval skin conditions may change how the tissue stretches, heals, and responds under pressure. For expectant mothers with lichen sclerosus, the question is practical and deeply personal: does this condition make birth tears more likely, and what can be done before labour begins? Vulvar lichen sclerosus is a long-term inflammatory skin condition that affects the vulva and, sometimes, the skin around the anus. It is

A heterotopic cornual pregnancy in the setting of a monochorionic diamniotic twin gestation is one of the most demanding scenarios in early pregnancy care. It combines an ectopic implantation at a highly vascular uterine site with the need to protect an ongoing intrauterine twin pregnancy. The clinical window is narrow, the haemorrhage risk is real, and management requires coordinated decision-making between reproductive medicine, maternal foetal medicine, anaesthesia, radiol

Cervical cerclage can be pregnancy preserving, but its benefit is not uniform. Two patients may receive the same procedure at a similar gestational age and have very different outcomes. That is the clinical tension behind nomogram-based prediction: can routinely available patient data help estimate who is most likely to benefit from cerclage, and under which indication? A 10-year retrospective observational study on nomogram models addresses this question by examining cerclag

Preterm birth often appears as a late pregnancy event, but the biology behind it may begin much earlier. One signal attracting attention is placental growth factor, or PlGF, a protein produced by the placenta that supports healthy blood vessel development. A prospective cohort study examining first-trimester PlGF suggests that low levels may help identify pregnancies at higher risk of preterm birth, especially when the pathway involves placental dysfunction. The finding matte

PPROM creates a clinical tension that every obstetric unit knows well: prolong pregnancy to reduce prematurity, but do not miss infection while waiting. That balance looks different at 28 weeks than it does at 35 weeks, yet the microbiological risk does not simply disappear once a pregnancy reaches the late preterm window. The study comparing early and late preterm cases adds an important message for practice. Early cases carry the heavier burden of neonatal morbidity, largel

A person can survive childbirth and still die within hours because a health system was not ready for heavy bleeding. That is the hard truth behind postpartum haemorrhage, and it is why global action cannot wait. Severe bleeding after birth remains one of the leading causes of maternal death worldwide. The World Health Organization estimates that around 14 million women experience postpartum haemorrhage each year, and about 70,000 die from it. Many of these deaths occur in low

A mother can survive childbirth and still be lost within hours if postpartum haemorrhage is not recognised and treated fast enough. That is the urgency behind one of the most preventable causes of maternal death worldwide. Postpartum haemorrhage, often called PPH, is severe bleeding after birth. It is commonly defined as blood loss of 500 ml or more after vaginal birth, 1,000 ml or more after caesarean birth, or any blood loss that causes signs of shock. The danger is not onl

A pregnant woman should not need three separate journeys through the health system to protect her baby from three preventable infections. In Somalia, where many families already face insecurity, displacement, long travel distances and fragile health services, that burden can be too high. That is why the World Health Organization’s call for a unified antenatal platform in Somalia matters. The idea is simple but powerful: use antenatal care as one common entry point to prevent

A classification system should make clinical thinking clearer. If it does not separate how a problem was detected from the conditions under which treatment was performed, it can blur the very details that guide care. That is the central issue in many descriptions of cervical cerclage. Traditional categories such as history-indicated, ultrasound-indicated, and emergency or rescue cerclage are familiar and useful. They are also imperfect. They mix different ideas: risk history,

Pain after a caesarean birth is not a small inconvenience. It can affect how comfortably a new mother moves, feeds her baby, sleeps, coughs, laughs, and even feels during the first few days of recovery. Medicines remain the mainstay of post-caesarean pain relief, and for good reason. They work, they are familiar to clinicians, and they can be adjusted based on pain levels and breastfeeding needs. Still, many mothers ask a very reasonable question: can non-drug methods help to

Pregnancy is already a state of controlled inflammation, vascular adaptation, and haemostatic change. When vascular events occur, that balance can shift quickly, sometimes before clinical deterioration becomes obvious. A retrospective cohort study examining inflammatory indices in pregnancies complicated by vascular events adds to a growing body of evidence that routine blood count data may help identify patients at higher risk of adverse outcomes. The study’s central message

Predicting the likelihood of operative birth is not a substitute for clinical judgement. Used well, it can give obstetric teams a clearer view of risk before labour becomes urgent. That is the promise of a nationwide prediction model for cesarean delivery in Japan, particularly when the model is tested not only on past data, but also across time. Japan has a distinctive obstetric care system, with care delivered across university hospitals, perinatal centres, community hospit

When a fetus appears smaller than expected near term, induction of labour is often recommended to reduce the risk of stillbirth and other complications. Yet one question quickly follows: will induction increase the chance of a cesarean birth? For suspected fetal growth restriction at term, the answer is not simple. Many pregnancies progress to vaginal birth after induction. Some require cesarean during labour because the fetus does not tolerate contractions, the cervix change

A fetus does not move through the pelvis like a fixed object. Labour is dynamic, and small changes in contractions, maternal position, pelvic shape, fetal flexion, and clinical management can affect how the head rotates before birth. That is why the question of whether oxytocin should be continued or stopped during active labour deserves careful attention. Oxytocin is often used to induce or augment labour when contractions are not strong or frequent enough. In many units, cl

Twin pregnancies with painless cervical dilatation present one of the hardest decisions in obstetric care. The cervix is already opening, the membranes may be exposed, and the risks of extreme preterm birth are high. In this setting, clinicians may either place an emergency cerclage soon after assessment or delay the procedure briefly while they evaluate contractions, infection, membrane status, and maternal stability. A multicentre retrospective cohort study comparing immedi