Maternal intra-partum fever commonly complicates the process of labour. Its occurrence is often regarded as being synonymous with the presence of chorioamnionitis. This inevitably results in the administration of antibiotics to the affected mother. Review of the literature however suggests that this approach is not always appropriate. Non-infective causes of this condition that are often overlooked include the use of epidural analgesia for pain relief, normal thermal physiological changes in women not using any form of analgesia and delivery in an overheated room. Women with certain risk factors such as nulliparity and a long latent phase of labour are also more prone to developing maternal intra-partum fever. Irrespective of its aetiology, maternal intra-partum fever carries risks both for the mother and her unborn child. Putting more thought into the care of these patients will go a long way in reducing the maternal and neonatal morbidity associated with this complication.

The aim of this study was to ascertain any potential link between threatened miscarriage and obstetric outcome. Threatened miscarriage was associated independently with an increased incidence of abruption (OR 2.8, 2.0-3.7), unexplained antepartum haemorrhage (APH) (OR 2.3, 1.1-5.1) and preterm delivery (OR 2.0, 1.3-3.3). The incidence of low and very low birth weight deliveries, although significantly higher compared with the control population, was not affected independently by this early pregnancy complication on logistic regression (OR 1.3, 0.8-1.9). The early neonatal mortality rates were significantly higher in the threatened miscarriage group, which on logistic regression was due independently to preterm delivery, placental abruption and low birth weight deliveries. All forms of APH were significantly higher in term deliveries complicated by threatened miscarriage. Pregnancies presenting with threatened miscarriage should be highlighted as 'high risk' for a suboptimal obstetric outcome and a prospective observational trial followed by a randomised-controlled trial may be needed to establish whether the need exists for increased feto-maternal surveillance in this cohort of women.

This study supports the notion of expectant management in suspected fetal macrosomia in low risk primigravid women until 40 weeks gestation. Thereafter, the safest mode of delivery is controversial, with some evidence pointing to elective cesarean section as a viable alternative in these women. A prospective RCT is needed to evaluate the best management option in terms of fetal and maternal outcome in cases of suspected macrosomia after 40 weeks' gestation.

The aim of this article is to review the efficacy of a modified uterine compression suture in controlling major haemorrhage at lower segment caesarean section. This is a descriptive study of patients who had major obstetric haemorrhage where a compression suture was used to control bleeding at the two obstetrics unit in Cardiff between January 1998 and December 2003 (n = 11).

This study suggests that careful assessment and counseling of women, particularly > 40 weeks gestation or those potentially having macrosomic fetuses, especially if forceps are to be used for prolonged second stage in primigravid women, may help to identify those at significant risk of anal sphincter tears.