Objective To examine whether differences exist in routine first trimester maternal serum screening analyte measurements between normal pregnancies, placenta praevia and abnormally invasive placentation (AIP). Design Multidisciplinary audit.Setting Associated university teaching hospital with 9000 annual deliveries.Population Five hundred and sixteen pregnancies in total, including 344 normal controls, 17 with AIP and 155 placenta praevia cases.Methods Comparison of maternal serum free bhCG and PAPP-A MoMs distribution in pregnancies with abnormally invasive placentation, placenta praevia and normal controls, after correcting for known confounding factors between October 2005 and September 2013. Data from a previously published first trimester AIP and biochemistry study were combined with our study data and compared in the above way to complete the analysis.Main outcome measures Differences in first trimester maternal serum PAPP-A and free bhCG in AIP, placenta praevia, and normal pregnancies.Results Median free bhCG MoM in the control group was 1.04, and 1.08 (P = 0.859) in the placenta praevia group compared with 0.81 in the AIP group (P = 0.06). Median PAPP-A MoM was 1.01 in the control group and 1.05 (P = 0.83) in praevia, compared with 1.22 in AIP cases (0.16). The combined AIP dataset gave an overall PAPP-A median MoM of 1.40, and free bhCG of 0.85. Both markers showed a significantly different distribution from controls (PAPP-A P = 0.002 and free bhCG P = 0.031).Conclusions There may be differences between first trimester maternal serum biochemical markers between normal pregnancies and those complicated by abnormally invasive placentation. If upheld, this may provide useful information for the early identification of abnormally invasive placentation. More studies are required.

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Purpose of review : The Coronavirus Disease 2019 (COVID-19) pandemic has had an unprecedented impact on pregnant women, maternity services and healthcare workers. We review recent literature on the course of COVID-19 infection in pregnancy, and recommendations for treatment and service provision. Recent findings It has been increasingly recognised that pregnant women are at higher risk of severe disease associated with COVID-19 infection. Early critical care input is crucial to guide respiratory support and techniques such as prone positioning, with a low threshold for intubation in critical illness. Timing of delivery remains a highly individualised decision. Following the RECOVERY trial, the use of a course of steroids in cases of severe COVID-19 infection has been widely adopted, and emerging guidance recommends vaccination in pregnant women. Summary Rapidly emerging evidence has helped guide clinicians to identify those patients most at risk of severe disease in COVID-19 and implement early interventions to reduce morbidity and mortality.

(BJOG. 2015;122:1370–1376) This study aims to examine whether differences exist in routine first trimester maternal serum biochemical screening measurements among normal pregnancies and those complicated by placenta previa and abnormally invasive placentation (AIP). The term, AIP was suggested recently to avoid the confusion with terminology defining the various types of morbidly adherent placentae—placenta accreta, increta, and percreta.