Although the efficacy of tamponade should be viewed in the light of its widespread use, our findings confirm that tamponade significantly reduces the need for interventional radiology or surgery for postpartum hemorrhage treatment.

An observational study was performed to assess the prevalence of fetal malformations and the level of preconception care in women with Type 2 diabetes. Pregnant women with Type 2 diabetes who delivered between 2002 and 2010 were recruited to the study. The fetal malformation rate of patients with Type 2 diabetes was compared with the rate in a control group; the general population. The malformation rate was 3.2 (7.2-2.2%; p < 0.0001) greater in the diabetes group. In addition, only 4% of women with Type 2 diabetes had preconception care. Despite evidence of benefits in women receiving preconception care, patients with Type 2 diabetes do not attend for preconception counselling and the malformation rate is high.

IntroductionPreeclampsia (PE) and intra-uterine growth restriction (IUGR) are two major pregnancy complications related to chronic utero-placental hypoperfusion. Three-dimensional power Doppler (3DPD) angiography has been used for the evaluation of utero-placental vascularisation and three vascular indices have been calculated: the vascularisation index (VI), flow index (FI) and vascularisation-FI (VFI). However, several technical endpoints hinder the clinical use of 3DPD as physical characteristics and machine settings may affect 3DPD indices, and so its clinical significance is not yet clear.ObjectivesThe primary objective is to better understand the clinical significance of 3DPD indices by evaluating the relationship between these indices and placental morphometry. Secondary objectives are (i) to determine the impact of machine settings and physical characteristics on 3DPD indices, and (ii) to evaluate physio-pathological placental vascularisation patterns.Methods and analysisThis is a prospective controlled study. We expect to include 112 women: 84 with normal pregnancies and 28 with PE and/or IUGR (based on our former cohort study on 3DPD indices for PE and/or IUGR prediction (unpublished data)). Within 72 h before planned or semi-urgent caesarean section, utero-placental 3DPD images with five different machine settings will be acquired. Placentas will be collected and examined after surgery and stereological indices (volume density, surface density, length density) calculated. The 3DPD indices (VI, FI and VFI) of the placenta and adjacent myometrium will be calculated. Correlation between Doppler and morphological indices will be evaluated by Pearson or Spearman tests. Agreement between 3DPD indices and morphological indices will be assessed by Bland and Altman plots. The impact of Doppler settings and maternal characteristics on 3DPD indices will be evaluated with a multivariate linear regression model.EthicsThe study and related consent forms have been approved by the French Ethics Committee (CPP, Comité de Protection des Personnes) Est III on 4 March 2014.