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Trial obstetrics

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https://www.readbyqxmd.com/read/28547269/effect-of-intermittent-versus-continuous-bladder-catheterization-on-duration-of-the-second-stage-of-labor-among-nulliparous-women-with-an-epidural-a-randomized-controlled-trial
#1
Abeer Suleiman, Sobhiya Mruwat-Rabah, Gali Garmi, Dorit Dagilayske, Tair Zelichover, Raed Salim
INTRODUCTION AND HYPOTHESIS: Catheterization type among women laboring with epidural analgesia who develop bladder retention has been reported to affect labor duration and mode of delivery. We aimed to compare the effect of continuous bladder catheterization (CC) with that of intermittent bladder catheterization (IC) on the duration of the second stage of labor. METHODS: In a randomized trial, term nulliparous women with singleton gestation who requested epidural analgesia and were unable to void spontaneously were eligible and randomized to either CC or IC...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28541639/opportunistic-bilateral-salpingectomy-during-benign-gynecological-surgery-for-ovarian-cancer-prevention-a-survey-of-gynecologic-oncology-committee-of-japan-society-of-obstetrics-and-gynecology
#2
Mikio Mikami, Satoru Nagase, Wataru Yamagami, Kimio Ushijma, Hironori Tashiro, Hidetaka Katabuchi
OBJECTIVE: Recent evidence has supported the concept that epithelial ovarian cancer (EOC) arises from the cells of the fallopian tube or endometrium. This study investigated current practice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS) during gynecological surgery for benign disease for Ovarian Cancer Prevention. METHODS: We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accredited training institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOE-certified licensed gynecologic laparoscopist...
July 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#3
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539111/written-versus-verbal-consent-a-qualitative-study-of-stakeholder-views-of-consent-procedures-used-at-the-time-of-recruitment-into-a-peripartum-trial-conducted-in-an-emergency-setting
#4
J Lawton, N Hallowell, C Snowdon, J E Norman, K Carruthers, F C Denison
BACKGROUND: Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women's and staff views about the consent procedures used during the internal pilot of a trial (GOT-IT), where the protocol permitted staff to gain verbal consent at recruitment...
May 24, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28534014/primiparous-singleton-women-with-endometriosis-have-an-increased-risk-of-preterm-birth-meta-analyses
#5
Sun-Gyeong Kim, Hui-Gyeong Seo, Yun-Sook Kim
OBJECTIVE: The objective of this study was to assess the association between women with endometriosis and risk of preterm birth. METHODS: Two reviewers independently determined all prospective cohort study, retrospective cohort study, large population based cohort study, retrospective secondary analysis, and double blinded, multicentric, observational and cohort study, placebo-controlled, randomized clinical trial published using PubMed, Medline, Korea Education and Research Information Service, and Scopus from March 1994 through February 2016 without language restrictions comparing obstetric outcomes women with endometriosis and women without endometriosis...
May 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#6
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28522033/placenta-directed-gene-therapy-for-fetal-growth-restriction
#7
REVIEW
Tara Krishnan, Anna L David
Fetal growth restriction (FGR) is a serious pregnancy complication affecting ∼8% of all pregnancies. There is no treatment to increase fetal growth in the uterus. Gene therapy presents a promising treatment strategy for FGR, with the use of adenoviral vectors encoding for proteins such as vascular endothelial growth factor (VEGF) and insulin-like growth factor demonstrating improvements in fetal growth, placental function, and neonatal outcome in preclinical studies. Safety assessments suggest no adverse risk to the mother or fetus for VEGF maternal gene therapy; a clinical trial is in development...
May 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28520654/systematic-review-of-hydrotherapy-research-does-a-warm-bath-in-labor-promote-normal-physiologic-childbirth
#8
Jenna Shaw-Battista
Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices...
May 17, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28511455/cervical-conization-and-the-risk-of-preterm-birth-a-population-based-multicentric-trial-of-turkish-cohort
#9
Ali Galip Zebitay, Emre Sinan Güngör, Gülsah Ilhan, Orkun Çetin, Cem Dane, Canan Furtuna, Fatma Ferda Verit Atmaca, Merve Tuna
INTRODUCTION: Cold Knife Conization (CKC) is one of the most effective methods for the treatment of Cervical Intraepithelial Neoplasia (CIN). Some studies showed a relation between preterm birth and the treatment of CIN; on the other hand, other studies do not show such a relationship. AIM: The present study was conducted with the aim to investigate the pregnancy outcomes of Turkish women regarding demographic characteristics, obstetric history, removed tissue, and residual cervical length after CKC and to determine the effect of removed cervical tissue volume and height on preterm birth...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28506267/a-qualitative-study-on-acceptable-levels-of-risk-for-pregnant-women-in-clinical-research
#10
Indira S E van der Zande, Rieke van der Graaf, Martijn A Oudijk, Johannes J M van Delden
BACKGROUND: There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as a case-study...
May 15, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28499551/lessons-learned-from-a-single-institution-s-retrospective-analysis-of-emergent-cesarean-delivery-following-external-cephalic-version-with-and-without-neuraxial-anesthesia
#11
A Ainsworth, H P Sviggum, M C Tolcher, A L Weaver, M A Holman, K W Arendt
OBJECTIVES: To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. BACKGROUND: Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery...
April 2, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28498261/clear-cell-carcinoma-of-the-uterine-cervix-a-clinical-and-pathological-analysis-of-47-patients-without-intrauterine-diethylstilbestrol-exposure
#12
Li Yang, Aiwen Zheng, Xiang Zhang, Xianhua Fang, Wenyong Sun, Yaqing Chen
OBJECTIVES: The aim of this study was to summarize the clinical and pathological characteristics and to conduct prognosis analysis of patients who were diagnosed with clear cell carcinoma of the uterine cervix (CCCUC) and without a history of exposure to diethylstilbestrol. METHODS: We performed a retrospective review of all the patients with CCCUC who were diagnosed and treated at Zhejiang Cancer Hospital between 1998 and 2014. Charts were reviewed for clinical and pathological characteristics, and prognosis analysis was conducted...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28494909/remifentanil-as-an-alternative-to-epidural-analgesia-for-vaginal-delivery-a-meta-analysis-of-randomized-trials
#13
Myeongjong Lee, Fang Zhu, Jessica Moodie, Zhe Zhang, Davy Cheng, Janet Martin
OBJECTIVES: Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA)...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28486704/cost-effectiveness-analysis-of-lifestyle-intervention-in-obese-infertile-women
#14
A M van Oers, M A Q Mutsaerts, J M Burggraaff, W K H Kuchenbecker, D A M Perquin, C A M Koks, R van Golde, E M Kaaijk, J M Schierbeek, N F Klijn, Y M van Kasteren, J A Land, B W J Mol, A Hoek, H Groen
STUDY QUESTION: What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER: Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint...
May 9, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28483805/treating-the-dysfunctional-placenta
#15
Colin Peter Sibley
Placental dysfunction underlies major obstetric diseases such as pre-eclampsia and fetal growth restriction (FGR). Whilst there has been a little progress in prophylaxis there are still no treatments for placental dysfunction in normal obstetric practice. However, a combination of increasingly well described in vitro systems for studying the human placenta, together with the availability of more appropriate animal models of pre-eclampsia and FGR, has facilitated a recent surge in work aimed at repurposing drugs and therapies, developed for other conditions, as treatments for placental dysfunction...
May 8, 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28476693/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-chapter%C3%A2-6-fetal-neonatal-and-pediatric-risks-and-adverse-effects-of-using-oxytocin-augmentation-during-spontaneous-labor
#16
https://www.readbyqxmd.com/read/28476136/effect-of-supervised-exercise-in-groups-on-psychological-well-being-among-pregnant-women-at-risk-of-depression-the-ewe-study-study-protocol-for-a-randomized-controlled-trial
#17
Lotte Broberg, Mette Backhausen, Peter Damm, Per Bech, Ann Tabor, Hanne Kristine Hegaard
BACKGROUND: Pregnant women with depression and/or anxiety prior to pregnancy are at higher risk of preterm birth, breastfeeding problems, postpartum depression, and disruption of the mother-infant attachment. It is well documented that exercise improves psychological well-being in nonpregnant subjects with symptoms of depression. However, in only a few small studies have researchers examined the effect of exercise on symptoms of depression among pregnant women. We hypothesize that physiotherapist-supervised group exercise for pregnant women at risk of antenatal depression increases their psychological well-being...
May 5, 2017: Trials
https://www.readbyqxmd.com/read/28472976/the-effect-of-dehydroepiandrosterone-supplementation-on-ovarian-response-is-associated-with-androgen-receptor-in-diminished-ovarian-reserve-women
#18
Qiaofei Hu, Liming Hong, Mingyue Nie, Qin Wang, Ying Fang, Yinmei Dai, Yanhong Zhai, Shuyu Wang, Chenghong Yin, Xiaokui Yang
BACKGROUND: Diminished ovarian reserve(DOR) is associated with female infertility and poor response to ovarian stimulation. Our objective was to assess the effect of dehydroepiandrosterone(DHEA) on DOR women and to explore whether the improvement of ovarian response after DHEA supplementation was dependent on the expression levels of androgen receptor(AR). METHODS: A prospective cohort study was performed in the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital during August 2014 to August 2016...
May 4, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28470550/the-effect-of-type-and-volume-of-fluid-hydration-on-labor-duration-of-nulliparous-women-a-randomized-controlled-trial
#19
Gali Garmi, Sivan Zuarez-Easton, Noah Zafran, Iris Ohel, Ilanit Berkovich, Raed Salim
PURPOSE: Type and volume of fluid administered for intrapartum maintenance had been reported to differently affect labor length, delivery mode, and cord artery pH and glucose level. We aimed to compare the effect of three different fluid regimens on labor duration. METHODS: In a randomized trial, healthy nulliparous in labor were randomized into one of three intravenous fluid regimens: group 1, the reference group, lactated Ringer's solution infused at a rate of 125 mL/h; group 2, lactated Ringer's solution infused at a rate of 250 mL/h; group 3, 0...
May 3, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28466180/do-prophylactic-antibiotics-in-gynecologic-surgery-prevent-postoperative-inflammatory-complications-a-systematic-review
#20
REVIEW
Cedric Emanuel Boesch, Roderick Franziskus Pronk, Fabian Medved, Pascal Hentschel, Hans-Eberhard Schaller, Wolfgang Umek
PURPOSE: The aim of this study was to systematically review the literature on antibiotic prophylaxis in gynaecologic surgeries to prevent inflammatory complications after gynaecological operations. The study was carried out as a systematic review. METHODS: Only randomised controlled trials of women undergoing gynaecological surgery were included. The Medline and the Cochrane library databases were searched from 1966 to 2016. The trials must have investigated an antibiotic intervention to prevent an inflammatory complication after gynaecological surgery...
May 2, 2017: Archives of Gynecology and Obstetrics
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