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Trial obstetrics

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https://www.readbyqxmd.com/read/28943191/laparoscopic-myomectomy-with-temporary-bilateral-uterine-artery-occlusion-compared-with-traditional-surgery-for-uterine-fibroids-blood-loss-and-recurrence
#1
Limei Ji, Lanying Jin, Min Hu
STUDY OBJECTIVE: To compare the surgical technique of temporary bilateral uterine artery blockage with titanium clips in laparoscopic myomectomy with traditional surgery for uterine fibroids to determine efficacy, ability to control bleeding, and recurrence. DESIGN: Randomized, controlled, prospective study (Canadian Task Force classification I). SETTING: Obstetrics and gynecology department in Jinhua Municipal Central Hospital. PATIENTS: Women with symptomatic uterine myoma...
September 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28938429/effect-of-preconception-impaired-glucose-tolerance-on-pregnancy-outcomes-in-women-with-polycystic-ovary-syndrome
#2
Daimin Wei, Bo Zhang, Yuhua Shi, Lin Zhang, Shigang Zhao, Yanzhi Du, Lizhen Xu, Richard S Legro, Heping Zhang, Zi-Jiang Chen
Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Intervention(s) and Main Outcome Measure(s): This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer...
August 14, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28936111/agile-development-of-a-smartphone-app-for-perinatal-monitoring-in-a-resource-constrained-setting
#3
Boris Martinez, Rachel Hall-Clifford, Enma Coyote, Lisa Stroux, Camilo E Valderrama, Christopher Aaron, Aaron Francis, Cate Hendren, Peter Rohloff, Gari D Clifford
Technology provides the potential to empower frontline healthcare workers with low levels of training and literacy, particularly in low- and middle-income countries. An obvious platform for achieving this aim is the smartphone, a low cost, almost ubiquitous device with good supply chain infrastructure and a general cultural acceptance for its use. In particular, the smartphone offers the opportunity to provide augmented or procedural information through active audiovisual aids to illiterate or untrained users, as described in this article...
2017: Journal of Health Informatics in Developing Countries
https://www.readbyqxmd.com/read/28932882/no-episiotomy-versus-selective-lateral-mediolateral-episiotomy-epitrial-an-interim-analysis
#4
Lena Sagi-Dain, Rabia Bahous, Orna Caspin, Inna Kreinin-Bleicher, Ron Gonen, Shlomi Sagi
INTRODUCTION AND HYPOTHESIS: The objective of this trial was to evaluate whether avoiding episiotomy can decrease the risk of advanced perineal tears. MATERIAL AND METHODS: In this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into standard care (155 cases) vs. no episiotomy (154 cases) groups. The primary endpoint was the incidence of advanced (3rd- and 4th-degree) perineal tears. Secondary outcomes included perineal integrity, suturing characteristics, second-stage duration, incidence of postpartum hemorrhage, neonatal variables, and various postpartum symptoms 2 days and 2 months after delivery...
September 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28930372/efficacy-and-safety-of-blood-transfusion-in-obstetric-patients-systematic-review-of-the-literature
#5
Celso Módolo, Arnav Agarwal, Mariana Floriano Luiza Piva, Andresa Graciutti Botan, Samira Esteves Afonso Camargo, Nermeen Gawish, Norma Sueli Pinheiro Módolo, Regina El Dib
OBJECTIVES: To evaluate the efficacy of blood transfusion compared to no intervention in obstetric patients. MATERIAL AND METHODS: A systematic review was performed with Cochrane Database of Clinical Trials, PubMed, EMBASE and LILACS databases searched as of September, 2016. Two authors independently selected relevant clinical trials, assessed their methodological quality and extracted data, using the GRADE approach. RESULTS: Five studies within a total of 6,297 met the inclusion criteria, with women generally aged 20-40 years...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#6
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elisabeth Asztalos, Jon F R Barrett, J Johanna Sanchez, Alberto de Leiva, Moshe Hod, Lois Jovanovic, Erin Keely, Ruth McManus, Eileen K Hutton, Claire L Meek, Zoe A Stewart, Tim Wysocki, Robert O'Brien, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy...
September 14, 2017: Lancet
https://www.readbyqxmd.com/read/28920404/effects-of-zearalenone-on-the-localization-and-expression-of-the-growth-hormone-receptor-gene-in-the-uteri-of-post-weaning-piglets
#7
Min Zhou, LiJie Yang, Weiren Yang, Libo Huang, Xuemei Zhou, Shuzhen Jiang, Zaibin Yang
Objective: In this study, we investigated the adverse effects of dietary zearalenone (ZEA) (0.5 to 1.5 mg•kg-1 diet) on the localization and expression of the growth hormone receptor (GHR) in the uteri of post-weaning gilts and explored another mechanism of the reproductive toxicity of ZEA on piglets. Methods: A total of forty healthy piglets (Duroc × Landrace × Large White) aged 28 d were selected for study. Piglets were transferred to single cages after 10 days' adaptation on an obstetric table...
September 18, 2017: Asian-Australasian Journal of Animal Sciences
https://www.readbyqxmd.com/read/28917612/thyroid-stimulating-hormone-anti-thyroid-antibodies-and-pregnancy-outcomes
#8
Torie C Plowden, Enrique F Schisterman, Lindsey A Sjaarda, Neil J Perkins, Robert Silver, Rose Radin, Keewan Kim, Noya Galai, Alan H DeCherney, Sunni L Mumford
BACKGROUND: Overt thyroid dysfunction has been associated with adverse obstetrical outcomes. However, less is known regarding subclinical hypothyroidism or thyroid autoimmunity and their relationship to pregnancy complications. OBJECTIVE: To examine the association between pre-pregnancy anti-thyroid antibodies and subclinical hypothyroidism and preterm delivery (PTD), gestational diabetes (GDM), and preeclampsia. STUDY DESIGN: Secondary analysis of a prospective cohort of 18-40 year old women with 1-2 prior pregnancy losses (n=1193) participating in a multi-center randomized, placebo-controlled trial of low-dose aspirin...
September 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#9
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28912958/a-nurse-delivered-mental-health-intervention-for-obstetric-fistula-patients-in-tanzania-results-of-a-pilot-randomized-controlled-trial
#10
Melissa H Watt, Mary V Mosha, Alyssa C Platt, Kathleen J Sikkema, Sarah M Wilson, Elizabeth L Turner, Gileard G Masenga
BACKGROUND: Obstetric fistula has severe psychological consequences, but no evidence-based interventions exist to improve mental health in this population. This pilot trial evaluated a psychological intervention for women receiving surgical care for obstetric fistula. METHODS: A parallel two-armed pilot RCT was conducted between 2014 and 2016. The intervention was six individual sessions, based on psychological theory and delivered by a nurse facilitator. The study was conducted at a tertiary hospital in Moshi, Tanzania...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28899619/first-do-the-experiment-do-computerised-interpretation-of-cardiotocography-and-other-widely-used-interventions-improve-newborn-outcomes
#11
REVIEW
Philip Steer
The introduction of continuous electronic fetal heart rate monitoring (EFM) in labour has coincided with a steady and remarkable fall in perinatal mortality. Whether this is cause or coincidence remains unclear because randomised trials have been underpowered. Attempts to improve the sensitivity and specificity of fetal compromise detection using fetal blood sampling and pH measurement, pulse oximetry, and fetal electrocardiogram analysis have failed to provide evidence of additional value in randomised trials...
September 9, 2017: Early Human Development
https://www.readbyqxmd.com/read/28898688/improving-non-technical-skills-teamwork-in-post-partum-haemorrhage-a-grouped-randomised-trial
#12
Pippa M Letchworth, Shane P Duffy, Dan Phillips
OBJECTIVE: To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. METHODS: Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors...
August 26, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28898687/outcomes-of-mifepristone-usage-for-cervical-ripening-and-induction-of-labour-in-full-term-pregnancy-randomized-controlled-trial
#13
Oleg R Baev, Valentina P Rumyantseva, Oleg V Tysyachnyu, Olga A Kozlova, Gennady T Sukhikh
OBJECTIVE: The most commonly used approved indications for mifepristone in obstetrics include: termination of early pregnancy, cervical dilatation prior to abortion, labour induction in case of fetal death in utero. Fewer studies have been conducted on the effect of mifepristone on cervical ripening and induction of labour in term pregnancy with a live fetus. The aim of our study was to evaluate efficacy and safety of mifepristone use for cervical ripening and induction of labour versus expectant management in full-term pregnancy...
September 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28893234/study-comparing-3%C3%A2-hour-and-24%C3%A2-hour-post-operative-removal-of-bladder-catheter-and-vaginal-pack-following-vaginal-surgery-a-randomised-controlled-trial
#14
Priya Rajan, S Soundara Raghavan, Deepak Sharma
BACKGROUND: Traditional practice after vaginal hysterectomy was to keep the vaginal pack and urinary catheter for 24 hours post operatively. But there were studies that prolonged cathterisation was associated with urinary infection. So this study was conducted to compare the post operative outcome when the urinary catheter and vaginal pack were removed after 3 hours and after 24 hours after surgery. METHODS: The study was done in the Department of Obstetrics and Gynecology, in a tertiary teaching institute of South India from September 2008 to March 2010...
September 11, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28885402/tranexamic-acid-for-the-management-of-obstetric-hemorrhage
#15
Luis D Pacheco, Gary D V Hankins, Antonio F Saad, Maged M Costantine, Giuseppe Chiossi, George R Saade
Obstetric hemorrhage remains the most common cause of maternal mortality worldwide. It is believed that increased fibrinolytic activity, secondary to release and activation of endothelial tissue plasminogen activator, is involved in its pathogenesis. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to be beneficial in trauma patients if used within 3 hours of injury. A recent large randomized controlled trial showed that TXA given to hemorrhaging women within 3 hours after delivery was associated with decreased risk of death resulting from bleeding with no increase in thromboembolic complications...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28884414/effect-of-programmed-intermittent-epidural-boluses-and-continuous-epidural-infusion-on-labor-analgesia-and-obstetric-outcomes-a-randomized-controlled-trial
#16
Leopoldo E Ferrer, David J Romero, Oscar I Vásquez, Ednna C Matute, Marc Van de Velde
PURPOSE: Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. METHODS: After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group)...
September 7, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28882116/thistle-trial-of-hands-on-interprofessional-simulation-training-for-local-emergencies-a-research-protocol-for-a-stepped-wedge-clustered-randomised-controlled-trial
#17
Erik Lenguerrand, Catherine Winter, Karen Innes, Graeme MacLennan, Dimitrios Siassakos, Pauline Lynch, Alan Cameron, Joanna Crofts, Alison McDonald, Kirsty McCormack, Mark Forrest, John Norrie, Siladitya Bhattacharya, Tim Draycott
BACKGROUND: Many adverse pregnancy outcomes in the UK could be prevented with better intrapartum care. Training for intrapartum emergencies has been widely recommended but there are conflicting data about their effectiveness. Observational studies have shown sustained local improvements in perinatal outcomes associated with the use of the PRactical Obstetric Multi-Professional Training - (PROMPT) training package. However this effect needs to be investigated in the context of randomised study design in settings other than enthusiastic early adopter single-centres...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28882096/delivering-perinatal-depression-care-in-a-rural-obstetric-setting-a-mixed-methods-study-of-feasibility-acceptability-and-effectiveness
#18
Amritha Bhat, Susan Reed, Johnny Mao, Mindy Vredevoogd, Joan Russo, Jennifer Unger, Roger Rowles, Jürgen Unützer
OBJECTIVES: Universal screening for depression during pregnancy and postpartum is recommended, yet mental health treatment and follow-up rates among screen-positive women in rural settings are low. We studied the feasibility, acceptability and effectiveness of perinatal depression treatment integrated into a rural obstetric setting. METHODS: We conducted an open treatment study of a screening and intervention program modified from the Depression Attention for Women Now (DAWN) Collaborative Care model in a rural obstetric clinic...
September 7, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28874936/factors-influencing-participation-in-clinical-trials-emergency-medicine-vs-other-specialties
#19
Anita Kurt, Hope M Kincaid, Charity Curtis, Lauren Semler, Matthew Meyers, Melanie Johnson, Beth A Careyva, Brian Stello, Timothy J Friel, Mark C Knouse, John C Smulian, Jeanne L Jacoby
INTRODUCTION: This study investigated factors that influence emergency medicine (EM) patients' decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties. METHODS: A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874243/central-regional-anaesthesia-in-patients-with-aortic-stenosis-a-systematic-review
#20
Sofia Johansson, Morten Nikolaj Lind
INTRODUCTION: Aortic stenosis is a valvular lesion that poses several haemodynamic challenges for the anaesthesiologist. The use of central regional anaesthesia is traditionally regarded as contraindicated in patients with severe aortic stenosis due to its sympatholytic effect, potentially causing loss of vascular tone and ultimately diminished cardiac output. The aim of this paper was to review current literature to find evidence for or against the use of neuroaxial blockade in patients with aortic stenosis...
September 2017: Danish Medical Journal
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