Tara Haelle

January 20, 2017

LAS VEGAS — Perhaps the largest trial ever conducted to test the effectiveness of magnesium in the prevention of postpartum eclampsia will be among the research featured here at the Society for Maternal–Fetal Medicine (SMFM) 2017 Annual Pregnancy Meeting.

"That trial has the potential to change practice and save people from the misery of being on this medication afterward," said Joanne Stone, MD, director of the Maternal Fetal Medicine Mount Sinai Health System in New York City, who is poster chair for the meeting. A study of this size — 11,020 patients from nine centers — is hard to do because it requires so many patients with severe pre-eclampsia, she told Medscape Medical News.

Another big draw will be a study on the use of whole-exome sequencing to examine the genetic anomalies related to fetal abnormalities. "It's really helpful because it can give patients answers," Dr Stone explained.

Two other major studies also have the potential to significantly change clinical practice: one on the use of universal cervical-length screening to decrease preterm birth rates and the other on the use of low-dose aspirin to reduce the risk for pre-eclampsia in women at risk, said Brian Iriye, MD, a maternal–fetal medicine subspecialist at the High Risk Pregnancy Center in Las Vegas, who is local arrangements chair for the meeting.

Both studies focus on risk reduction, as do so many others that will be presented. The irony is not lost on Dr Iriye that they will be presented in a town notorious for risk-taking. He said he is excited to see the meeting return to his home after 2 decades at other locations. The last time The Pregnancy Meeting was in Las Vegas, the SMFM was asked cordially never to return; the betting handle — the amount wagered — was down 12% while they were there, he reported.

Our whole life is not gambling. It's getting the safe play, and it's all about the science.

"We don't gamble," Dr Iriye laughed. "Our whole life is not gambling. It's getting the safe play, and it's all about the science."

And the science featured at the meeting will cover everything from the management of infectious diseases — particularly relevant with the looming threat of Zika — to the most cutting-edge advances in genetics.

"We're always excited about the meeting. We think it's become the premier meeting for research regarding pregnancy," said Robert Silver, MD, chief of the division of maternal–fetal medicine at the University of Utah Health Sciences Center in Salt Lake City, who is meeting program chair.

This year's meeting received a record number of research submissions, with 2130 abstracts, which is a significant increase over the previous record of 1749 abstracts, he pointed out.

"We were able to accept fewer than half of those submitted, and what was selected is of very high quality," Dr Silver told Medscape Medical News. The meeting will feature 115 oral presentations, 875 posters, 12 postgraduate courses, and 12 luncheon round tables, with discussions covering Zika, genetics, cytomegalovirus, skeletal dysplasia, and other topics currently relevant in maternal-fetal medicine. And 20 scientific forums will cover topics such as infection, global health, fetal surgery, placenta accreta, obesity, and genetics.

One workshop generating a great deal of excitement is a large genetics workshop that will be held over 2 days and will involve 60 experts from across the United States.

"They're getting the best minds in genetics and going over all the testing being performed, how to perform it, cost-effectiveness, screening vs diagnostic tests, counseling, how often people need rigorous counseling, and more," Dr Iriye said.

Keeping with the theme of genetics research that runs through the meeting, Dennis Lo, PhD, one of the pioneers in testing for cell-free fetal DNA, will be a special guest, speaking at several sessions, Dr Silver said.

Still, the sheer volume and quality of research remains the biggest draw for Aaron Caughey, MD, PhD, chair of the Department of Obstetrics and Gynecology and associate dean for women's health research and policy at Oregon Health & Science University School of Medicine in Portland, who will be attending the meeting.

"I think this is one of the best meetings of the year for research in pregnancy," Dr Caughey told Medscape Medical News. "We encourage some of the best science from the world to be presented at this meeting."

Approximately 75 abstracts will be presented by researchers from the Oregon Health & Science University — the most from any single institution — including a study from Amy Valent, DO, and her colleagues, which looks at the postoperative use of prophylactic oral antibiotics to reduce surgical-site infections in obese women who undergo cesarean delivery.

"About a third of the patients we take care of are obese, and this could be a change in practice, where we can reduce infections in patients," Dr Caughey pointed out.

Another abstract comes from Rachel Pilliod, MD, and her colleagues, which examines the effect on fetal and neonatal mortality of the push to reduce the number of deliveries before 39 weeks.

As usual, this year's meeting will include a 5 km run to raise money for the Pregnancy Foundation and an update on research funded by the organization, but a new feature will be local outreach, Dr Iriye explained.

"This is the first time the society has done local outreach. We're going to bring in five doctors to talk to about 150 students at a medical magnet high school," he reported. In addition, 40 seniors who are particularly interested in medicine will be paired with doctors who will take them through the poster sessions and discuss the research.

Dr Stone, Dr Iriye, and Dr Silver have disclosed no relevant financial relationships. Dr Caughey is on the scientific advisory boards for Mindchild and Celmatix.


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