The March issue contains three Systematic Reviews on strategies for prevention of preterm birth and an Editorial discussing which strategies work in a particular subset of women with mid-trimester short cervix, and 12 Original Articles including a number that focus on prediction of small-for-gestational-age neonates.

Prevention of preterm birth
The March issue of UOG contains three systematic reviews on different strategies for preventing preterm birth: 
1) Romero et al. provide an updated meta-analysis of individual patient data from six randomized controlled trials comparing vaginal progesterone with placebo or no treatment in women with a twin pregnancy and short cervix (≤ 25 mm). They found that administration of vaginal progesterone significantly reduces the risk of preterm birth occurring < 30 to < 35 weeks’ gestation and risks of neonatal death and morbidity. 2) Saccone et al. evaluated the findings from three large randomized controlled trials comparing vaginal progesterone against intramuscular 17α-hydroxyprogesterone caproate injections for prevention of recurrent preterm birth in singleton pregnancies with previous preterm birth. Started at 16 weeks’ gestation, daily vaginal progesterone was found to be a reasonable, if not better, intervention for preventing preterm birth in this subset of women. 3) Berghella et al. evaluated the effect of knowledge of cervical length in preventing preterm birth in singleton pregnancies with threatened preterm labor. From individual patient data of three randomized controlled trials, they found a significant association between knowledge of cervical length and reduced preterm birth.

Supplementary to the systematic reviews is an Editorial by Vintzileos and Visser which summarizes the different intervention strategies for preterm birth, including progestogens, cerclage and cervical pessary, and reviews evidence regarding their effectiveness in women with a short cervix on mid-trimester ultrasound.

View the accompanying press release and videoclip for the article by Romero et al. View the accompanying Journal Club slides for the article by Berghella et al. This month’s Journal Club slides were compiled by Dr Shireen Meher.

Screening and prediction of the small-for-gestational-age neonate
In this issue of UOG is a selection of studies reporting on the prediction of a small-for-gestational-age (SGA) fetus.Crovetto et al. evaluate first-trimester screening, combining maternal characteristics and biophysical and biochemical markers, to predict delivery of a SGA neonate, and compare this with its ability to predict fetal growth restriction (FGR). Triunfo et al. investigate whether longitudinal assessment of uterine artery Doppler and circulating angiogenic factors improves the prediction of SGA achieved by cross-sectional assessment. A second study by Triunfo et al.explores the predictive capacity of fetoplacental Doppler at 37 weeks’ gestation in identifying SGA neonates, FGR and adverse perinatal outcome among low-risk singleton pregnancies. Reboul et al. compare third-trimester ultrasound screening methods to predict SGA, and evaluate the impact of the ultrasound–delivery interval on screening performance. 

Coming up in the next issue of UOG…
• A randomized controlled trial evaluating the impact of low-dose aspirin, administered from the first trimester, on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks. Preview the accepted article here. 
• A systematic review and meta-analysis by Scala et al., assessing perinatal and long-term outcome in fetuses with isolated unilateral ventriculomegaly. Preview the accepted article here. This article has been chosen for Journal Club, so look out for the accompanying downloadable slides next month.
• A selection of articles on fetal growth, including international estimated fetal weight standards of the INTERGROWTH-21st Project. Preview the accepted article here.

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