Safety of COVID-19 vaccines when given in pregnancy

 Read Government guidance here

Specialist mental health support for new mums available in every part of England

New and expectant mothers across the country can now access specialist mental health care in the area where they live, NHS England announced today.  Click here to read further.

Panel Urges Counseling to Prevent Perinatal Depression in High-Risk Women

The first review of evidence by the U.S. Preventive Services Task Force (USPSTF) on ways to prevent perinatal depression has led the researchers to recommend counseling for pregnant and postpartum women at increased risk for the disorder.  Click here to read further.

Study: Most Psychoactive Drugs Taken During Pregnancy Do Not Increase Risk of Autism

New research finds that a mother’s use of antidepressants and antipsychotic drugs while pregnant does not place the baby at risk for autism. Read PsychCentral article here

New NICE Diagnostics guidance [DG33] Biomarker tests to help diagnose preterm labour in women with intact membranes

New NICE Diagnostics guidance [DG33] Biomarker tests to help diagnose preterm labour in women with intact membranes


Published date: July 2018  Next review: July 2021


Evidence-based recommendations on biomarker tests to help diagnose preterm labour in women with intact membranes. The tests are Actim Partus, PartoSure and the Rapid fetal fibronectin (fFN) 10Q Cassette Kit (at thresholds other than 50 nanograms/millilitre).


For full guidance
 https://www.nice.org.uk/guidance/dg33

Some Antipsychotics Tied to Greater Risk of Gestational Diabetes

A new study finds that women who continue taking the atypical antipsychotic drugs olanzapine (Zyprexa) and quetiapine (Seroquel) during pregnancy are at an increased risk for gestational diabetes. The findings are published in the American Journal of Psychiatry. Click here to read PsychCentral article

NHS England pledges specialist mental health services for new mums in every part of the country

NHS England has confirmed that new and expectant mums will be able to access specialist perinatal mental health community services in every part of the country by April next year. Click here to view NHS England webpage

NICE - Antenatal and postnatal mental health: clinical management and service guidance

This guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year.  Click here for further details. 

Management of Infants born to Mothers who have used Opioids during Pregnancy

The incidence of infant opioid withdrawal has grown rapidly in many countries, including Canada, in the last decade, presenting significant health and early brain development concerns. Increased prenatal exposure to opioids reflects rising prescription opioid use as well as the presence of both illegal opiates and opioid-substitution therapies. Infants are at high risk for experiencing symptoms of abstinence or withdrawal that may require assessment and treatment.

This practice point focuses specifically on the effect(s) of opioid withdrawal and current management strategies in the care of infants born to mothers with opioid dependency.

Public Health England: Teenage Pregnancy Prevention Framework

Public Health England has published guidance for local teenage pregnancy prevention programmes designed to help young people avoid unplanned pregnancies and develop healthy relationships.
https://www.gov.uk/government/publications/teenage-pregnancy-prevention-framework

Group B Streptococcus (GBS) in pregnancy and newborn babies

This RCOG patient information leaflet provides advice for women who are pregnant or planning to become pregnant about Group B Streptococcus (GBS) infection in newborn babies.

Stillbirth risk is doubled if pregnant women sleep on their backs in third trimester

New research published in BJOG: An International Journal of Obstetrics and Gynaecology suggests that the risk of stillbirth is doubled if pregnant women sleep on their backs during the third trimester.

The Midlands and North of England Stillbirth Study (MiNESS) is the largest study of maternal sleep position and risk of stillbirth. It looked at 291 pregnancies that ended in stillbirth and 735 women who had a live birth.

The findings suggest women who go to sleep on their back - known as the supine position - have a 2.3 fold increase in risk of late stillbirth (after 28 weeks of gestation) compared with women who sleep on their side.

Clinical Nurse Specialist in Early Pregnancy Care

The role of the clinical nurse specialist in early pregnancy care is intended to enhance the care for women who may be concerned about a complication in early pregnancy.

This RCN document outlines the key skills and knowledge required to develop the role of this specialist nurse/midwife and should provide clear direction for commissioners and managers when creating roles to support best practice in local service provision for women and their families.

NIHR Signal Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took a placebo.

Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high risk of the condition. Aspirin did not affect other pregnancy outcomes and didn’t increase the risk of adverse effects.

This research adds to current knowledge about the range of doses that is effective and refines the definition and detection of women at high risk. The research did not compare 75mg with 150mg doses.

From the NIHR Dissemination Centre

New materials on prevention and diagnosis of FASD

The National Organisation for Foetal Alcohol Syndrome-UK (NOFAS-UK) has launched new materials designed to increase awareness about the risk of prenatal exposure to alcohol. The new materials include posters and a pre-release version of a booklet, which explains how to identify possible cases of fetal alcohol spectrum disorders (FASD).

WHO guideline on syphilis screening and treatment for pregnant women

Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management.

This guideline provides updated recommendations for syphilis screening and treatment for pregnant women based on the most recent evidence and available serologic tests for syphilis

Loss of Endometrial Sodium Glucose Cotransporter SGLT1 is Detrimental to Embryo Survival and Fetal Growth in Pregnancy

Sci Rep. 2017 Oct 3;7(1):12612. doi: 10.1038/s41598-017-11674-3.

Embryo implantation requires a hospitable uterine environment. A key metabolic change that occurs during the peri-implantation period, and throughout early pregnancy, is the rise in endometrial glycogen content. Glycogen accumulation requires prior cellular uptake of glucose. Here we show that both human and murine endometrial epithelial cells express the high affinity Na+-coupled glucose carrier SGLT1. Ussing chamber experiments revealed electrogenic glucose transport across the endometrium in wild type (Slc5a1 +/+) but not in SGLT1 deficient (Slc5a1 -/-) mice. Endometrial glycogen content, litter size and weight of offspring at birth were significantly lower in Slc5a1 -/- mice. In humans, SLC5A1 expression was upregulated upon decidualization of primary endometrial stromal cells. Endometrial SLC5A1 expression during the implantation window was attenuated in patients with recurrent pregnancy loss when compared with control subjects. Our findings reveal a novel mechanism establishing adequate endometrial glycogen stores for pregnancy. Disruption of this histiotrophic pathway leads to adverse pregnancy outcome.

UHCW Research: Durairaj RRP and Barros FSV

Postpartum depression risk, duration and recurrence

Postpartum affective disorder (AD), including postpartum depression (PPD), affects more than one in two hundred women with no history of prior psychiatric episodes, and raises the risk of later affective disorder for those women, according to a new study. Click here for news item

OP27.07: Does imaging correlate with clinical findings for morbidly adherent placenta? An audit from University Hospitals Coventry and Warwickshire

Ultrasound Obstet Gynecol, 50: 137. doi:10.1002/uog.17953

The incidence of morbidly adherent placenta is rising secondary to the increasing Caesarean rate and advancing maternal age. The Royal College of Obstetricians and Gynecologists (RCOG) recommends that women with an anterior low placenta and a Caesarean section scar at 32 completed weeks gestation undergo further imaging with either ultrasonography and/or magnetic resonance imaging (MRI) to distinguish if there is likely placenta accreta. The aim of this audit was to determine if imaging correlated with clinical findings in our unit.

UHCW Research: L.J. Ewington, E.A. Swift and P. Parthasarathy

Consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum

Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk.

These consensus guidelines from the British Association of Psychopharmacology aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.