Trial of labor is safe when the first twin is in vertex presentation (October 2013)

The Twin Birth Study showed that planned cesarean delivery does not significantly improve neonatal outcome as compared with planned vaginal delivery when the first twin is in vertex presentation. In this trial, over 1000 women at 32 to 38 weeks of gestation with twin pregnancy and the first twin in vertex presentation were randomly assigned to planned cesarean or planned vaginal delivery at term. No significant difference in the composite outcome (fetal or neonatal death or serious neonatal morbidity) was observed between groups, thus supporting a trial of labor in vertex-presenting twin pregnancy.

World Health Organization recommendations for HIV treatment (August 2013)

In 2013, the World Health Organization (WHO) updated its guidelines on the prevention and treatment of HIV in resource limited settings to recommend initiation of antiretroviral therapy (ART) for HIV-infected patients with CD4 cell counts ≤500 cells/microL . These guidelines also recommend initiation of a combination antiretroviral regimen for all pregnant women with HIV infection, regardless of CD4 cell count, to continue at least throughout the period of mother-to-child transmission risk, which includes the breastfeeding period. For all HIV-infected individuals in resource-limited settings, efavirenz-tenofovir-emtricitabine is the WHO preferred first-line regimen

Safety of fluconazole during pregnancy (September 2013)

Case reports have noted an association between prolonged fluconazole use in pregnant women and craniofacial and other abnormalities in their newborns. However, several studies that focused on low-dose, short-course therapy with fluconazole did not detect an increased risk of congenital malformations among the offspring of women who took fluconazole during pregnancy. In the largest of these studies, first trimester use of fluconazole (most commonly a single dose of 150 mg) in 7352 pregnancies was not associated with an increased risk of birth defects overall . However, a small but statistically-significant increased risk of tetralogy of Fallot was observed (0.10 percent versus 0.03 percent in unexposed pregnancies). Although these data are reassuring, an increased risk of specific anomalies (in addition to tetralogy of Fallot) cannot be definitively excluded.

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