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Trial obstetrics

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https://www.readbyqxmd.com/read/28213060/prediction-of-cesarean-delivery-in-the-term-nulliparous-woman-results-from-the-prospective-multi-center-genesis-study
#1
Naomi Burke, Gerard Burke, Fionnuala Breathnach, Fionnuala Mcauliffe, John J Morrison, Michael Turner, Samina Dornan, John R Higgins, Amanda Cotter, Michael Geary, Peter Mcparland, Sean Daly, Fiona Cody, Pat Dicker, Elizabeth Tully, Fergal D Malone
BACKGROUND: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or Cesarean delivery (CD). Despite the knowledge that the rising CD rate is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important as there are higher rates of morbidity and mortality associated with unplanned CD performed in labor compared to scheduled Cesarean deliveries...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28211186/sacral-neuromodulation-compared-with-injection-of-bulking-agents-for-faecal-incontinence-following-obstetric-anal-sphincter-injury-a-randomised-controlled-trial
#2
M Rydningen, T Dehli, T Wilsgaard, A Rydning, M Kumle, R O Lindsetmo, S Norderval
AIM: The purpose of this trial was to compare the effectiveness of sacral neuromodulation (SNM) with a sub-mucosal injection of collagen (Permacol(®) ) in women with faecal incontinence following obstetric anal sphincter injury (OASIS). METHOD: This single blinded randomized controlled trial at two hospital units in Norway included women with faecal incontinence following OASIS. Eligible women who had had a successful percutaneous nerve evaluation were randomly assigned to SNM or Permacol(®) ...
February 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28202330/ethical-issues-in-cesarean-delivery
#3
REVIEW
Frank A Chervenak, Laurence B McCullough
Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28199872/fertility-and-obstetric-outcomes-after-curettage-versus-expectant-management-in-randomised-and-non-randomised-women-with-an-incomplete-evacuation-of-the-uterus-after-misoprostol-treatment-for-miscarriage
#4
M Lemmers, M A C Verschoor, K Overwater, P M Bossuyt, D Hendriks, M Hemelaar, J M Schutte, A H Adriaanse, W M Ankum, J A F Huirne, B W J Mol
OBJECTIVE: To assess fertility and obstetric outcomes in women treated with curettage or undergoing expectant management for an incomplete miscarriage after misoprostol treatment. STUDY DESIGN: Between June 2012 and July 2014, we conducted a multicentre randomised clinical trial (RCT) with a parallel cohort study for non-randomised women, treated according to their preference. In the RCT 30 women were allocated curettage and 29 expectant management. In the cohort 197 women participated; 65 underwent curettage and 132 women underwent expectant management...
January 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28194870/participation-in-clinical-trials-improves-outcomes-in-women-s-health-a-systematic-review-and-meta-analysis
#5
REVIEW
S K Nijjar, M I D'Amico, N A Wimalaweera, Nam Cooper, J Zamora, K S Khan
BACKGROUND: Previous reviews examining the effect of participation in trials on outcomes have not consistently shown benefit. Obstetrics and gynaecology is a unique disease area posing challenges for both researchers and patients. OBJECTIVES: To determine whether participation in randomised controlled trials (RCTs), compared with non-participation, has a beneficial effect on women's health. SEARCH STRATEGY: Medline, Embase, the Cochrane Library, and PsycInfo were searched up to December 2015...
February 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28188771/twin-vaginal-delivery-innovate-or-abdicate
#6
REVIEW
Sarah Rae Easter, Laura Taouk, Jay Schulkin, Julian N Robinson
Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins-particularly in the case of the noncephalic second twin. Yet the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raise concerns about the availability of providers skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to vaginal birth of twins with a focus on delivery of the noncephalic second twin...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178062/strategies-for-successful-recruitment-of-pregnant-patients-into-clinical-trials
#7
Elizabeth F Sutton, Loren E Cain, Porsha M Vallo, Leanne M Redman
Clinical research in the pregnant population allows for delivery of quality, evidence-based care in obstetrics. However, in recent years, the field of obstetrics has faced severe challenges in the recruitment of the pregnant population into clinical trials, a struggle also shared by several other medical disciplines. We candidly describe our failure to recruit a healthy population of overweight and obese pregnant women in their first trimester. We were then able to glean unsuccessful and successful recruitment approaches and improve our recruitment effort by autopsy of failed strategies and with guidance from a survey disseminated to improve our understanding of community feelings about participating in research while pregnant...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178059/less-restrictive-food-intake-during-labor-in-low-risk-singleton-pregnancies-a-systematic-review-and-meta-analysis
#8
Andrea Ciardulli, Gabriele Saccone, Hannah Anastasio, Vincenzo Berghella
OBJECTIVE: To evaluate benefits and harms of food intake during labor. DATA SOURCES: Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. METHODS OF STUDY SELECTION: We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI)...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28170094/efficacy-of-freeze-dried-amnion-graft-following-hysteroscopic-adhesiolysis-of-severe-intrauterine-adhesions
#9
Lu Gan, Hua Duan, Fu-Qing Sun, Qian Xu, Yi-Qun Tang, Sha Wang
OBJECTIVE: To evaluate the efficacy of freeze-dried amnion graft for prevention of intrauterine adhesion (IUA) reformation after hysteroscopic adhesiolysis. METHODS: A prospective randomized controlled trial was conducted among 88 women with severe IUAs who underwent hysteroscopic adhesiolysis at Beijing Obstetrics and Gynecology Hospital between July 15, 2015, and July 1, 2016. All participants had a balloon inserted into the uterine cavity for 1 week. Sterilized freeze-dried amnion graft covered the balloon portion of the Foley catheter among patients allocated to the amnion group (n=44), whereas patients in the control group (n=44) did not receive the graft...
February 7, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28167311/simulation-training-program-for-midwives-to-manage-postpartum-hemorrhage-a-randomized-controlled-trial
#10
Chiho Kato, Yaeko Kataoka
PURPOSE: To explore the effectiveness of a simulation training program for midwives in performance and knowledge for the management of postpartum hemorrhage (PPH). METHODS: The study design was a randomized controlled trial. Midwives working at one obstetrics ward in an urban area were randomly assigned to simulation training program or no training. This "simulation program" included pre study e-learning and simulation. Inclusion criteria were midwives who: 1) had two or three years of clinical experience, 2) worked in an obstetrics ward, and 3) had experience with birth assistance...
January 20, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28166914/role-of-anti-tubercular-treatment-for-positive-endometrial-aspirate-dna-pcr-reproductive-outcome-in-infertile-patients-in-indian-setting-a-randomized-trial
#11
A Kriplani, A Bahadur, V Kulshrestha, N Agarwal, S Singh, U B Singh
AIMS: The aim of the study was to determine the effect of anti-tubercular therapy (ATT) versus no ATT on reproductive outcome in patients with positive endometrial aspirate DNA-PCR for tuberculosis. SETTINGS AND DESIGN: Department of Obstetrics and Gynecology in collaboration with the Department of Microbiology at the All India Institute of Medical Sciences, New Delhi, India. METHODS AND MATERIALS: This prospective randomized study was conducted on 100 women in the reproductive age group with primary or secondary infertility, attending the Gynecology OPD at AIIMS...
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28164296/deinfibulation-for-preventing-or-treating-complications-in-women-living-with-type-iii-female-genital-mutilation-a%C3%A2-systematic-review-and-meta-analysis
#12
REVIEW
Babasola O Okusanya, Olabisi Oduwole, Nuria Nwachuku, Martin M Meremikwu
BACKGROUND: Deinfibulation is a surgical procedure carried out to re-open the vaginal introitus of women living with type III female genital mutilation (FGM). OBJECTIVES: To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM or women without FGM. SEARCH STRATEGY: Major databases including CENTRAL, MEDLINE, and Scopus were searched until August 2015...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28164285/antepartum-or-intrapartum-deinfibulation-for-childbirth-in-women-with-type-iii-female-genital-mutilation-a-systematic-review-and-meta-analysis
#13
Ekpereonne Esu, Atim Udo, Babasola O Okusanya, David Agamse, Martin M Meremikwu
BACKGROUND: There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). OBJECTIVES: To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. SEARCH STRATEGY: The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28163844/effect-of-entonox-on-reducing-the-need-for-pethidine-and-the-relevant-fetal-and-maternal-complications-for-painless-labor
#14
Alireza Sharifian Attar, Atefe Shirinzadeh Feizabadi, Lida Jarahi, Laya Shirinzadeh Feizabadi, Shima Sheybani
BACKGROUND: Pain relief during labour is one of the major concerns in obstetrics; severe labor pain causes fear of the next pregnancy, and interferes with the mother's family relationship. OBJECTIVE: The aim of this study was to evaluate the analgesic effects of Entonox during labor on reducing the need for pethidine (Meperidine) and fetal-maternal complications. METHODS: This double-blind randomized clinical trial was conducted on pregnant women who were candidates for vaginal delivery in Educational Hospitals of Mashhad University of Medical Sciences, Iran between January 2014 and November 2015...
December 2016: Electronic Physician
https://www.readbyqxmd.com/read/28159465/a-comparison-of-sentinel-lymph-node-biopsy-to-lymphadenectomy-for-endometrial-cancer-staging-fires-trial-a-multicentre-prospective-cohort-study
#15
Emma C Rossi, Lynn D Kowalski, Jennifer Scalici, Leigh Cantrell, Kevin Schuler, Rabbie K Hanna, Michael Method, Melissa Ade, Anastasia Ivanova, John F Boggess
BACKGROUND: Sentinel-lymph-node mapping has been advocated as an alternative staging technique for endometrial cancer. The aim of this study was to measure the sensitivity and negative predictive value of sentinel-lymph-node mapping compared with the gold standard of complete lymphadenectomy in detecting metastatic disease for endometrial cancer. METHODS: In the FIRES multicentre, prospective, cohort study patients with clinical stage 1 endometrial cancer of all histologies and grades undergoing robotic staging were eligible for study inclusion...
January 31, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28153659/enoxaparin-for-the-prevention-of-preeclampsia-and%C3%A2-intrauterine-growth-restriction-in-women-with%C3%A2-a%C3%A2-history-%C3%A2-a%C3%A2-randomized-trial
#16
Katie M Groom, Lesley M McCowan, Laura K Mackay, Arier C Lee, Joanne M Said, Stefan C Kane, Susan P Walker, Thijs E van Mens, Natalie J Hannan, Stephen Tong, Larry W Chamley, Peter R Stone, Claire McLintock
BACKGROUND: Preeclampsia and small-for-gestational-age pregnancy are major causes of maternal and perinatal morbidity and mortality. Women with a previous pregnancy affected by these conditions are at an increased risk of recurrence in a future pregnancy. Past trials evaluating the effect of low-molecular-weight heparin for the prevention of recurrence of preeclampsia and small-for-gestational-age pregnancy have shown conflicting results with high levels of heterogeneity displayed when trials were compared...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28148278/the-pathway-to-rcts-how-many-roads-are-there-examining-the-homogeneity-of-rct-justification
#17
Jeffrey Tin Yu Chow, Kevin Lam, Abdul Naeem, Zarique Z Akanda, Francie Fengqin Si, William Hodge
BACKGROUND: Randomized controlled trials (RCTs) form the foundational background of modern medical practice. They are considered the highest quality of evidence, and their results help inform decisions concerning drug development and use, preventive therapies, and screening programs. However, the inputs that justify an RCT to be conducted have not been studied. METHODS: We reviewed the MEDLINE and EMBASE databases across six specialties (Ophthalmology, Otorhinolaryngology (ENT), General Surgery, Psychiatry, Obstetrics-Gynecology (OB-GYN), and Internal Medicine) and randomly chose 25 RCTs from each specialty except for Otorhinolaryngology (20 studies) and Internal Medicine (28 studies)...
February 2, 2017: Trials
https://www.readbyqxmd.com/read/28144462/effect-of-vocalization-of-the-holy-quran-with-and-without-translation-on-pregnancy-outcomes-a-randomized-clinical-trial
#18
Mojgan Mirghafourvand, Fahimeh Sehhati Shafaie, Sakineh Mohammad-Alizadeh-Charandabi, Batoul Jabbari
BACKGROUND: During recent decades, research in Iran in the area of the Quran and medical science has been seriously engaged in. With respect to the tendency toward spirituality and alternative medicine, we tried to find other aspects of the influence of the Quran. OBJECTIVES: This study aimed to determine the effect of vocalizations of the Holy Quran with and without translation on the consequences of pregnancy (the prevalence of preterm delivery, caesarean delivery, and neonatal anthropometric indices) in women admitted to health care centers in Urmia, Iran...
September 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28140349/reliability-of-3d-upper-limb-motion-analysis-in-children-with-obstetric-brachial-plexus-palsy
#19
Judy Mahon, Ailish Malone, Damien Kiernan, Dara Meldrum
: Kinematics, measured by 3D upper limb motion analysis (3D-ULMA), can potentially increase understanding of movement patterns by quantifying individual joint contributions. Reliability in children with obstetric brachial plexus palsy (OBPP) has not been established. OBJECTIVE: This study aimed to determine between session reliability and measurement errors of 3D-ULMA using the acromion method (AM) in children with OBPP. APPROACH: Ten participants (mean 10 years, range 7-15 years, Narakas classification I-III) completed 3D-ULMA on two occasions, mean interval of 8...
January 31, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28139951/cervical-length-measured-before-delivery-and-the-success-rate-of-vaginal-birth-after-cesarean-vbac
#20
Ron Beloosesky, Nizar Khatib, Nadir Ganem, Emad Matanis, Yuval Ginsberg, Mike Divon, Zeev Weiner
OBJECTIVE: To test the hypothesis that measuring CL close to the time of delivery is a predictor of successful vaginal birth following a cesarean. METHODS: A prospective longitudinal study included women with singleton pregnancies at 38-41 weeks, who previously underwent a cesarean, and who were interested in trial of labor. Patients who did not have a spontaneous onset of labor were induced at 41 weeks gestation. CL measurements were performed prior to labor by transvaginal ultrasound, recorded, and blinded from the caring physicians...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
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