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(RCOG). High-risk patients were defined as a Padua score of 4, Caprini 2, and RCOG 2. Three different cutoffs were analyzed for the Caprini RAM. The primary outcome was VTE occurring during delivery or up to 1 year postpartum. We calculated the proportion of women who would have been high risk, determined the number of VTE cases within high and low risk category, as well as calculated the number needed to treat (NNT) for each RAM. We performed sensitivity analyses using different cutoffs for the RAM scores, upper limit of VTE risk, and different efficacy of anticoagulation to prevent VTE. RESULTS: A total of 6158 women were included. The overall rate of VTE was 0.05%, 95% CI (0.01-0.15). The proportion of women categorized at high risk for VTE were 62% for RCOG, 0.8% for Padua, and 94% for Caprini (Table 1). There were no differences in the rates between the high and low risk for any of the RAMs (Table 1). The observed NNT assuming 100% efficacy of thromboprophylaxis was 3838 for RCOG, not able to calculate for Padua and 1927 for Caprini (Table 2). For the best-case scenario (using upper limit of VTE rate and 100% efficacy) the NNT was 1000 for RCOG, 14 for Padua and 1000 for Caprini (Table 2). NNTs for additional scenarios are provided in Table 2. CONCLUSION: The rates of VTE in pregnancy are very low and the available RAMs do not identify most of them. The RCOG and Caprini RAMs would categorize a large proportion of women as high risk and are associated with high NNTs. The Padua RAM appears to have the lowest NNT but failed to identify all VTEs in the study.

0.36 AE0.22-fold, respectively; p¼0.0003). VE obtained from normal pregnant women also showed a down-regulation of sFlt1 expression in response to cAMP (0.56 AE0.2 fold). However, the VE from PE placenta showed an upregulation of sFlt1 (1.82 AE0.8 fold, p¼0.0001). CONCLUSION: While cAMP-mediated regulation of sFlt1 is similar in the decidua of normal vs PE placentas, there are marked differences in this regulation in the villous cells from these 2 groups of patients. The increased expression of sFlt1 induced by cAMP in VE from PE patients suggests that placentas of women with PE may have alterations in cAMP-mediated regulation of this gene, leading to an overexpression and secretion of sFlt1.

Background The Shock Index is a clinical tool to evaluate the hemodynamic status during hemorrhage. The impact of labor and pre-existing anaemia is unknown. The objective was to describe and discuss its clinical utility in this context. Methods This was a prospective cross-sectional study. The Shock Index (ratio between heart rate and systolic blood pressure) was measured in pregnant women at term, before or during labor. They were stratified according to the presence of anemia. Results The median Shock Index was significantly lower in women in labor than in those not in labor (0.72 (IQR: 0.64–0.83) vs. 0.85 (IQR: 0.80–0.94); p < 0.001). In women in labor, the Shock Index was not significantly different if anemia was present (0.72 (0.63–0.83) vs. 0.73 (0.65–0.82); p = 0.67). Conclusions Values of the Shock Index are affected by labor, which may hinder its utility in identifying hemorrhage during this period. However, the values were not altered by maternal anaemia. Therefore, an abnormal postpartum Shock Index should not be attributed to an abnormal antepartum Shock Index due to mild/moderate anemia.