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https://www.readbyqxmd.com/read/29155965/is-frozen-embryo-transfer-better-for-mothers-and-babies-can-cumulative-meta-analysis-provide-a-definitive-answer
#1
Abha Maheshwari, Shilpi Pandey, Edwin Amalraj Raja, Ashalatha Shetty, Mark Hamilton, Siladitya Bhattacharya
BACKGROUND: Initial observational studies and a systematic review published 5 years ago have suggested that obstetric and perinatal outcomes are better in offspring conceived following frozen rather than fresh embryo transfers, with reduced risks of preterm birth, small for gestational age, low birth weight and pre-eclampsia. More recent primary studies are beginning to challenge some of these findings. We therefore conducted an updated systematic review and cumulative meta-analysis to examine if these results have remained consistent over time...
November 13, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/29149263/vitamin-d-and-assisted-reproductive-treatment-outcome-a-systematic-review-and-meta-analysis
#2
Justin Chu, Ioannis Gallos, Aurelio Tobias, Bee Tan, Abey Eapen, Arri Coomarasamy
STUDY QUESTION: Is serum vitamin D associated with live birth rates in women undergoing ART? SUMMARY ANSWER: Women undergoing ART who are replete in vitamin D have a higher live birth rate than women who are vitamin D deficient or insufficient. WHAT IS KNOWN ALREADY: Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation as well as obstetric complications such as pre-eclampsia and fetal growth restriction...
November 15, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29148879/a-multicenter-investigation-of-factors-influencing-women-s-participation-in-clinical-trials
#3
Samantha Myles, Cheryl Tocci, Michele Falk, Stephanie Lynch, Caroline Torres, Barbara Brown, Brandy Leopanto Firman, Marian Lake, Cynthia A Maser, Ameneh Onativia, Erin M Obermeier, Jennifer Macfarlan, Ronald Wapner, John C Smulian, Anita Kurt
OBJECTIVE: To identify factors that influence women's participation in clinical research. METHODS: We administered a survey in outpatient and inpatient populations of Obstetrics and Gynecology facilities of six institutions located in four states. The survey included questions regarding any of the participant's past experiences in clinical research and the factors that would influence their participation in clinical research. Analyses included descriptive statistics and a Principal Component Analysis...
November 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29142651/prevention-of-insulin-resistance-by-dietary-intervention-among-pregnant-mothers-a-randomized-controlled-trial
#4
Masoomeh Goodarzi-Khoigani, Seyed Saeed Mazloomy Mahmoodabad, Mohammad Hossein Baghiani Moghadam, Azadeh Nadjarzadeh, Farahnaz Mardanian, Hossein Fallahzadeh, Azam Dadkhah-Tirani
Background: Chronic insulin resistance (IR) is a basic part of the pathophysiology of gestational diabetes mellitus. Nutrition significantly impacts IR and weight loss reduces insulin levels, whereas weight gain increases the concentrations. Therefore, we surveyed the effect of nutrition intervention on IR in pregnant women and whether this effect is irrespective of weight gaining in accordance with Institute of Medicine limits. Methods: This prospective, randomized clinical trial was carried out among 150 primiparous pregnant mothers in fifteen health centers, five hospitals, and 15 private obstetrical offices in Isfahan...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#5
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29138033/randomized-trial-of-high-and-low-fidelity-simulation-to-teach-intrauterine-contraception-placement
#6
Siripanth Nippita, Miriam J Haviland, Sara F Voit, Judith Perez-Peralta, Michele R Hacker, Maureen E Paul
BACKGROUND: High fidelity simulation creates conditions that resemble real circumstances, and can help teach procedures such as intrauterine contraception placement. Its impact on skill retention has not been studied. OBJECTIVE: To evaluate novice learners' skills, attitudes, and knowledge on placement of intrauterine contraception when trained using a high-fidelity commercially available simulator compared with a low-fidelity simulator. STUDY DESIGN: We recruited senior nurse practitioner students and interns in obstetrics and gynecology and family medicine inexperienced with intrauterine contraception placement...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29137506/measuring-the-impact-of-cash-transfers-and-behavioral-nudges-on-maternity-care-in-nairobi-kenya
#7
Jessica Cohen, Claire Rothschild, Ginger Golub, George N Omondi, Margaret E Kruk, Margaret McConnell
Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29133985/effects-of-immediate-postpartum-contraceptive-counseling-on-long-acting-reversible-contraceptive-use-in-adolescents
#8
Kasemsis Kaewkiattikun
Background: Adolescent pregnancy is a global public health problem, particularly repeated pregnancy. The best strategy to lower prevalence of adolescent pregnancy and repeated pregnancy is promoting highly effective long-acting contraceptive methods along with special counseling programs. Long-acting reversible contraception (LARC) is the ideal contraceptive of choice for adolescents. It is not known whether immediate postpartum contraceptive counseling increases postpartum LARC use in adolescents...
2017: Adolescent Health, Medicine and Therapeutics
https://www.readbyqxmd.com/read/29132336/study-protocol-the-labor-progression-study-laps-does-the-use-of-a-dynamic-progression-guideline-in-labor-reduce-the-rate-of-intrapartum-cesarean-sections-in-nulliparous-women-a-multicenter-cluster-randomized-trial-in-norway
#9
Stine Bernitz, Rebecka Dalbye, Pål Øian, Jun Zhang, Torbjørn Moe Eggebø, Ellen Blix
BACKGROUND: The increasing rate of intrapartum cesarean sections is subject of attention and concern as it is associated with adverse outcomes. Labor dystocia is one of the most frequent indications for cesarean sections even though there is no consensus on criteria for labor dystocia. Traditionally the progression of labor follows guidelines based on Friedman's curve from the mid 1950s. In 2010 Zhang presented a new labor curve and a dynamic guideline for labor progression based on contemporary research...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29128995/a-systematic-review-of-dietary-interventions-for-gestational-weight-gain-and-gestational-diabetes-in-overweight-and-obese-pregnant-women
#10
REVIEW
Reeta Lamminpää, Katri Vehviläinen-Julkunen, Ursula Schwab
PURPOSE: The number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women. METHODS: The search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016...
November 11, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/29126412/obstetric-fistulae-in-southern-mozambique-incidence-obstetric-characteristics-and-treatment
#11
Sibone Mocumbi, Claudia Hanson, Ulf Högberg, Helena Boene, Peter von Dadelszen, Anna Bergström, Khátia Munguambe, Esperança Sevene
BACKGROUND: Obstetric fistula is one of the most devastating consequences of unmet needs in obstetric services. Systematic reviews suggest that the pooled incidence of fistulae in community-based studies is 0.09 per 1000 recently pregnant women; however, as facility delivery is increasing, for the most part, in Africa, incidence of fistula should decrease. Few population-based studies on fistulae have been undertaken in Sub-Saharan Africa, including Mozambique. This study aimed to estimate the incidence of obstetric fistulae in recently delivered mothers, and to describe the clinical characteristics and care, as well as the outcome, after surgical repair...
November 10, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29121350/individualized-fsh-dosing-based-on-ovarian-reserve-testing-in-women-starting-ivf-icsi-a-multicentre-trial-and-cost-effectiveness-analysis
#12
Theodora C van Tilborg, Simone C Oudshoorn, Marinus J C Eijkemans, Monique H Mochtar, Ron J T van Golde, Annemieke Hoek, Walter K H Kuchenbecker, Kathrin Fleischer, Jan Peter de Bruin, Henk Groen, Madelon van Wely, Cornelis B Lambalk, Joop S E Laven, Ben Willem J Mol, Frank J M Broekmans, Helen L Torrance
STUDY QUESTION: Is there a difference in live birth rate and/or cost-effectiveness between antral follicle count (AFC)-based individualized FSH dosing or standard FSH dosing in women starting IVF or ICSI treatment? SUMMARY ANSWER: In women initiating IVF/ICSI, AFC-based individualized FSH dosing does not improve live birth rates or reduce costs as compared to a standard FSH dose. WHAT IS KNOWN ALREADY: In IVF or ICSI, ovarian reserve testing is often used to adjust the FSH dose in order to normalize ovarian response and optimize live birth rates...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29112650/maternal-pulse-pressure-and-the-risk-of-postepidural-complications-a-randomized-controlled-trial
#13
Justin R Lappen, Stephen A Myers, Norman Bolen, Brian M Mercer, Edward K S Chien
OBJECTIVE: To test the hypothesis that increasing the intravenous fluid bolus volume at the time of epidural placement in women with narrow pulse pressure would reduce postepidural fetal heart rate (FHR) abnormalities, hypotension, and resuscitative obstetric interventions. METHODS: We performed a single-center randomized controlled trial. Eligible participants were normotensive with a nonanomalous singleton gestation at or after 35 weeks and with a narrow pulse pressure (less than 45 mm Hg) on admission...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29099021/a-prospective-randomized-trial-of-postural-changes-vs-passive-supine-lying-during-the-second-stage-of-labor-under-epidural-analgesia
#14
María Simarro, José Angel Espinosa, Cecilia Salinas, Ricardo Ojea, Paloma Salvadores, Carolina Walker, José Schneider
There exist very few studies comparing different postures or postural changes during labor in parturients with epidural analgesia. AIM: To disclose whether the intervention of a multidisciplinary nursing team including a physiotherapist during the second stage of labor improves the obstetric outcome in parturients with epidural analgesia. DESIGN: Prospective randomized trial. SETTING: University-affiliated hospital. POPULATION: Women undergoing labor with epidural analgesia after a normal gestation...
March 8, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29096053/antibiotic-prophylaxis-for-episiotomy-repair-following-vaginal-birth
#15
REVIEW
Mercedes Bonet, Erika Ota, Chioma E Chibueze, Olufemi T Oladapo
BACKGROUND: Bacterial infections occurring during labour, childbirth, and the puerperium may be associated with considerable maternal and perinatal morbidity and mortality. Antibiotic prophylaxis might reduce wound infection incidence after an episiotomy, particularly in situations associated with a higher risk of postpartum perineal infection, such as midline episiotomy, extension of the incision, or in settings where the baseline risk of infection after vaginal birth is high. However, available evidence is unclear concerning the role of prophylactic antibiotics in preventing infections after an episiotomy...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#16
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29095305/umbilical-cord-mesenchyme-stem-cell-local-intramuscular-injection-for-treatment-of-uterine-niche-protocol-for-a-prospective-randomized-double-blinded-placebo-controlled-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Dazhi Fan, Shuzhen Wu, Shaoxin Ye, Wen Wang, Xiaoling Guo, Zhengping Liu
BACKGROUND: Uterine niche is defined as a triangular anechoic structure at the site of the scar or a gap in the myometrium at the site of a previous caesarean section. The main clinical manifestations are postmenstrual spotting and intrauterine infection, which may seriously affect the daily life of nonpregnant women. Trials have shown an excellent safety and efficacy for the potential of mesenchymal stem cells (MSCs) as a therapeutic option for scar reconstruction. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment for the uterine niche...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095006/-influence-of-physical-exercise-during-pregnancy-on-newborn-weight-a-randomized-clinical-trial
#18
Raquel Rodríguez-Blanque, Juan Carlos Sánchez-García, Antonio Manuel Sánchez-López, Norma Mur-Villar, Rafael Fernández-Castillo, María José Aguilar Cordero
INTRODUCTION: Recent studies have proved that physical activity of the pregnant woman brings benefits not only for the mother but also for the fetus, given that it decreases the number of macrosomic newborns and their negative consequences in both of them. OBJECTIVE: To analyze in pregnant women the influence of a moderate physical activity program in the aquatic environment on the weight of the newborn. MATERIAL AND METHODS: A randomized clinical trial with 140 healthy pregnant women, aged between 21 and 43 years, divided into two groups, study (GE, n = 70) and control (GC, n = 70)...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29082725/upcoming-strategies-in-obstetrics-how-the-technology-of-clinical-audit-may-reduce-cesarean-birth
#19
Sara Paracchini, Bianca Masturzo, Domenico Tangolo, Enrica Roletti, Annalisa Piazzese, Rossella Attini, Alessandro Rolfo, Tullia Todros
BACKGROUND: The rate of cesarean delivery is currently increasing all over Europe. In Italy it reaches 38% of all child births. Therefore, it is important to identify the clinical and organizational variables that determine the appropriateness of elective cesarean delivery. With this aim we chose the technology of clinical audit, a process that promotes improvement in clinical practice through systematic review of clinical care in relation with explicit standards derived from scientific literature...
December 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/29081997/implementation-of-effective-practices-in-health-facilities-a-systematic-review-of-cluster-randomised-trials
#20
Emma R Allanson, Özge Tunçalp, Joshua P Vogel, Dina N Khan, Olufemi T Oladapo, Qian Long, Ahmet Metin Gülmezoglu
BACKGROUND: The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. METHODS: All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed...
2017: BMJ Global Health
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