We will discuss “Maternal and perinatal consequences of antepartum haemorrhage of unknown origin” by Bhandari and co-workers from 26 February 2014. The paper has been made free-to-view for four weeks from 17 February 2014.
Start date: 26 February 2014 (the discussion will open for 7 days)
First hosted discussion session(s) starts at Central European Time 1730
(UK time 1630; Eastern Time Zone 1130; AEDT 0400)
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All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).
The discussion points are attached below (quoted from the published manuscript)
|Scenario A patient, G3 P1+1, presented with an episode of antepartum haemorrhage at 26 week of her otherwise uncomplicated pregnancy. On examination, her genital tract was normal. Ultrasound showed a normal intrauterine pregnancy with no placenta praevia or abruption. She asked, “should I worry?”.|
Description of research
|Participants||All primigravidae delivering between 1976 and 2010 in Aberdeen Maternity Hospital (UK)|
|Events||Antepartum haemorrhage (APH) of unknown origin|
|Comparison||No antepartum haemorrhage|
|Outcomes||Preeclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death|
|Study design||Cohort study (retrospective data extraction using a prospectively collected database)|
- How did the authors define antepartum haemorrhage (APH) of unknown origin? Are there any other ways to define it?
- What are the potential biases in a historical cohort study?
- What is the odds ratio (OR)? What is the difference between OR and adjusted OR?
- How could you determine whether the different adverse outcomes associated with APH of unknown origin might be causal?
- Can you briefly summarise the results of this study? How would you advise the patient in the clinical scenario? (data S1)
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