There is insufficient evidence to comprehensively assess the effectiveness and safety of interventions (pharmacological and non-pharmacological) for treating constipation in pregnancy, due to limited data (few studies with small sample size and no meta-analyses). Compared with bulk-forming laxatives, stimulant laxatives appear to be more effective in improvement of constipation (moderate quality evidence), but are accompanied by an increase in diarrhoea (moderate quality evidence) and abdominal discomfort (low quality evidence) and no difference in women's satisfaction (moderate quality evidence). Additionally, fibre supplementation may increase frequency of stools compared with no intervention (moderate quality evidence), although these results were of moderate risk of bias.There were no data for a comparison of other types of interventions, such as osmotic laxatives, stool softeners, lubricant laxatives and enemas and suppositories.More RCTs evaluating interventions for treating constipation in pregnancy are needed. These should cover different settings and evaluate the effectiveness of various interventions (including fibre, osmotic, and stimulant laxatives) on improvement in constipation, pain on defecation, frequency of stools and consistency of stools.

What are the novel findings of this work?This study presents the prenatal ultrasound findings and postnatal outcome of patients with left congenital diaphragmatic hernia (CDH) without liver herniation according to stomach position, demonstrating, for the first time, decreased morbidity in those without ('stomach-down' CDH) compared to those with ('stomach-up' CDH) intrathoracic stomach herniation. This is the first study to suggest stomach-down CDH as a separate entity. What are the clinical implications of this work?Our findings highlight the importance of identifying stomach-down CDH prenatally and distinguishing this entity from a congenital lung lesion and from stomach-up CDH, as contralateral lung size is insufficient for predicting postnatal outcome. This knowledge can better inform prenatal family counseling and help anticipate postnatal management.

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Generalised itching (not caused by systemic disease or skin lesions) is quite a common symptom in pregnancy. However, there is no evidence from randomised controlled trials to guide practice in terms of the effectiveness and safety of pharmacological interventions for treating this condition.Well-designed randomised controlled trials are needed in order to evaluate the effectiveness of topical and systemic pharmacological interventions as well as any adverse effects of the interventions. Such studies should consider important outcomes such as relief of itching, women's satisfaction, sleep disturbance, and adverse effects.