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Table 19 Research gaps

From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

Basic science and physiological studies

   • Mechanisms of causation of hypertensive disorders of pregnancy and how these cause stillbirths*

   • Auto-immune pathophysiology in stillbirth causation

   • Association of periodontal disease with pre-eclampsia and pathophysiology of subsequent stillbirth*

   • Dynamics of stillbirth causation in intrahepatic cholestasis

   • Drug safety and efficacy studies:

â—¦ Anti-malarials in pregnancy

â—¦ Drugs for intrahepatic cholestasis

â—¦ Non-penicillin treatments for syphilis

â—¦ Antibiotic use in pregnancy

   • Identification of other unknown risk factors

   • Prevalence of uterine abnormalities in low-/middle-income countries

Pilot/cohort studies of interventions

   • New approaches for PIH and chronic hypertension management in community settings*

   • Management protocols for HIV and syphilis co-infection

   • Management of penicillin drug allergy in community settings

   • Diagnosis and surgical repair of uterine abnormalities in women with recurrent fetal loss

   • Intravenous immunoglobulin treatment (compared to heparin, aspirin, or other anti-coagulants) in selected populations with recurrent pregnancy loss and antiphospholipid antibodies

Well-designed large RCTs of interventions powered to detect stillbirths

   • Periodontal care studies powered to detect impact on stillbirth rates*

   • Calcium supplementation to prevent PIH and pre-eclampsia in deficient populations

   • Anti-oxidant supplementation in deficient populations

   • Management of intrahepatic cholestasis including nonstress test, amniotic fluid index, meconium screening and early delivery

   • Calcium supplementation in high-risk pregnancies*

   • Antibiotics for pPROM*

Effectiveness trials in large populations/at scale

   • Maternal anti-helminthic treatment: impact on maternal anaemia and stillbirth*

   • On-site syphilis testing and treatment

   • ITNs for Plasmodium vivax and in lower-transmission settings (Asia and Latin America)

  1. *Priority areas