Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women.

OBJECTIVE: To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes. DESIGN: Cluster-randomised controlled trial. SETTING: Sixty-seven maternity clinics in Stockholm, Sweden. POPULATION: Women with singleton pregnancy with birth from 32 weeks' gestation. METHODS: Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population-based register. MAIN OUTCOME MEASURES: Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small-for-gestational-age and mode of delivery. RESULTS: No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8-1.2) was found between the Mindfetalness group and the Routine care group for a 5-minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57-1.87). Mindfetalness was associated with a reduction of babies born small-for-gestational-age (RR 0.95, 95% CI 0.90-1.00), babies born after gestational week 41+6 (RR 0.91, 95% CI 0.83-0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91-0.99). CONCLUSIONS: Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small-for-gestational-age. TWEETABLE ABSTRACT: Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.

Ossified intratesticular mucinous tumor.

We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 x 4.8 x 4-cm, predominantly solid, and partially cystic mass completely replaced the testis with no extension to tunica albuginea and epididymis. The multiloculated area was mostly covered by a single layer of bland mucinous epithelium with few areas of epithelial tufting, stratification, and nuclear atypia. The solid areas consisted of mature bone and fibrous stroma with cholesterol clefts, some multinucleated giant cells, moderate infiltration of lymphocytes, and foamy vacuolated macrophages. The bone showed occasional rimming of osteoblasts and rare osteoclasts. Rare foci of mature bone were found in the nonfibrosed wall and lumen cysts. The patient is alive and well 3 years after right orchiectomy with spermatic cord resection.

Unusual primary prostatic malignancies.

Atypical prostatic cancer is defined as any malignancy of prostatic origin, excluding the common acinar prostatic adenocarcinoma. These atypical prostate cancers account for less than 5 percent of all prostatic malignancies. Because atypical prostatic malignancies occur rarely, little is known about their biologic behavior. To date, no large series of patients have been reported, and specific treatment protocols have yet to be defined. Herein we describe 5 new cases of atypical prostatic cancer. By reporting the occurrence of new cases, we believe a better understanding of the natural history of these lesions will emerge.