Objectives (AOR 3.4; 95% CI, P = 0.006)

Labour induction and augmentation with Prostaglandin and Oxytocin are well established as standard practice worldwide. They are safe when used judiciously, but may be associated with maternal and neonatal morbidities. Other safer alternatives have been studied including dates consumption during late pregnancy with various outcomes. The aim of this randomised controlled trial was to investigate the effect of date fruit consumption during late pregnancy on the onset of labour and need for induction or augmentation of labour. A total of 154 nulliparous women with an uncomplicated singleton pregnancy were randomly allocated to either dates-consumer (77) or control group (77). The women in the dates-consumer group had significantly less need for augmentation of labour and longer intervention to delivery interval. There was no significant difference in the onset of spontaneous labour. Dates consumption reduces the need for labour augmentation but does not expedite the onset of labour. Impact statement • Dates fruit consumption during late pregnancy has been shown to positively affect the outcome of labour and delivery. In this study, date consumption reduced the need for labour augmentation with oxytocin but did not expedite the onset of labour. Therefore, dates consumption in late pregnancy is a safe supplement to be considered as it reduced the need for labour intervention without any adverse effect on the mother and child. This further supports the finding of earlier studies.

Direct ultrasound-guided intravascular injection of absolute alcohol is an easy and straightforward technique to occlude circulation to the acardiac twin. This vessel can be identified easily by color Doppler ultrasonography away from the main venous trunk. Selection of this target, rather than occlusion at the level of the umbilical cord, could reduce the risks of cord accidents and inadvertent intravenous injection of the ablative material.

In fetuses with single umbilical artery (SUA) the entire blood flow to the placenta is transported through only one umbilical artery, resulting in a compensatory increase of the arterial diameter. In order to establish whether umbilical vessel size could be used as an additional ultrasonographic criterion for prenatal diagnosis of SUA, we measured umbilical vein and umbilical artery diameters in 55 fetuses with SUA and in 55 with a normal three-vessel cord matched for gestational age. In all but one fetus with SUA, the diameter of the umbilical artery was greater than 50% of that of the umbilical vein, resulting in an umbilical vein to umbilical artery ratio of < or = 2. In contrast, none of the fetuses with a three-vessel cord had a ratio of < or = 2. Increasing diameter of the umbilical artery with no modification of the diameter of the vein is a characteristic prenatal ultrasonographic feature of SUA, making this observation a useful technique for the detection of this vascular anomaly in utero.

No abstract