Society for Maternal-Fetal Medicine, Jan. 23-28

The Society for Maternal-Fetal Medicine's 36th Annual Meeting: The Pregnancy Meeting

The annual meeting of the Society for Maternal-Fetal Medicine was held from Jan. 23 to 28 in Las Vegas and attracted more than 2,000 participants from around the world, including obstetricians/gynecologists and other clinical practitioners who specialize in maternal-fetal medicine. The conference highlighted recent advances in maternal-fetal medicine, with presentations and abstracts focusing on reducing high-risk pregnancy complications through pregnancy assessment and management.

In one study, Michal Elovitz, M.D., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues found that specific bacteria in the cervicovaginal space are highly associated with spontaneous preterm birth.

"This is the first study that has had the sufficient sample size and racial diversity to confirm an association between the microbial communities and spontaneous preterm birth," Elovitz said. "Specific bacteria are associated with either an increased risk for or are protective against spontaneous preterm birth. One could assume that, by now, with our ability to identify which bacteria are associated with preterm birth, we could use this knowledge to stratify which women are at risk for this adverse outcome. Then we could target bacteria as a therapy to prevent premature birth."

In another study, Josianne Pare, M.D., of the University of Sherbrooke in Canada, and colleagues found that glucose supplementation significantly reduces the total length of labor without increasing the rate of complications in induced, nulliparous women.

"This study was a single center prospective double-blind randomized-controlled trial comparing the use of parenteral intravenous dextrose 5 percent with normal saline to normal saline in induced, nulliparous women. A total of 193 patients (96 in the dextrose with normal saline [NS+D] group and 97 in the normal saline group [NS]) were analyzed in the study," Pare said. "The median total duration of labor was 76 minutes shorter in the NS+D group than in the NS group (499 versus 423 minutes; P = 0.024). There was no difference in the rate of cesarean section, instrumented delivery, APGAR score, or arterial cord pH."

Based on these findings, Pare recommends that glucose should be used as the default solute during labor, given the safety and low cost of this intervention.

Lisa Levine, M.D., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues evaluated whether or not early changes in cardiac function among women with and without preeclampsia could be detected.

"We know that women with a history of preeclampsia are at a high risk for cardiovascular disease later in life and it is important to try to identify who, among the women with preeclampsia, will be the ones to develop disease at a later point," Levine said. "We therefore performed echocardiograms when women were diagnosed with preeclampsia during pregnancy and then again six weeks after giving birth."

The investigators found that women with preeclampsia had notable differences in cardiac function at the time of diagnosis of preeclampsia and at six weeks after delivery, compared to women without preeclampsia.

"This has huge implications for clinical care because if we can identify those women who are at greatest risk for cardiovascular disease in the future, we could help provide early interventions to decrease the long-term risk," Levine said.

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