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https://www.readbyqxmd.com/read/28427805/confounding-causality-and-confusion-the-role-of-intermediate-variables-in-interpreting-observational-studies-in-obstetrics
#1
Cande V Ananth, Enrique F Schisterman
Both prospective and retrospective cohort, and case-control studies are some of the most important study designs in epidemiology because, under certain assumptions, they can mimic a randomized trial when done well. These assumptions include but not limited to properly accounting for two important sources of bias: confounding and selection bias. While not adjusting the causal association for an intermediate variable will yield an unbiased estimate of the exposure-outcome's total causal effect, it is often that obstetricians will want to adjust for an intermediate variable to assess if the intermediate is the underlying driver of the association...
April 17, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#2
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28426126/actinomyces-in-pregnancy-a-review-of-the-literature
#3
Sarah M Estrada, Everett F Magann, Peter G Napolitano
Importance: Actinomyces is commonly found in many areas of the body where it derives a benefit without harming the host. When it does infect the host during pregnancy, is that infection a threat to the obstetric patient and does that infection cause adverse pregnancy outcomes? Objective: The aim of this study was to review what is known about Actinomyces infections and the impact of an Actinomyces infection on pregnancy outcomes. Evidence Acquisition: A PubMed search was undertaken with the search years unlimited to April 1, 2016, and restricted to articles in English...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28412995/development-and-validation-of-prediction-models-for-risks-of-complications-in-early-onset-pre-eclampsia-prep-a-prospective-cohort-study
#4
Shakila Thangaratinam, John Allotey, Nadine Marlin, Ben W Mol, Peter Von Dadelszen, Wessel Ganzevoort, Joost Akkermans, Asif Ahmed, Jane Daniels, Jon Deeks, Khaled Ismail, Ann Marie Barnard, Julie Dodds, Sally Kerry, Carl Moons, Richard D Riley, Khalid S Khan
BACKGROUND: The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. OBJECTIVE: To develop and validate prediction models for outcomes in early-onset pre-eclampsia. DESIGN: Prospective cohort for model development, with validation in two external data sets. SETTING: Model development: 53 obstetric units in the UK...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28403414/a-national-survey-of-videolaryngoscopy-in-the-united-kingdom
#5
T M Cook, F E Kelly
Background.: There are increasing numbers of videolaryngoscopes marketed and increasing interest in the technology. The Difficult Airway Society's 2015 guidelines recommend that videolaryngoscopes should be immediately available at all times and that all anaesthetists should be trained and skilled in their use. Methods.: An electronic survey was sent to all UK National Health Service hospitals to examine availability, use, and attitudes to videolaryngoscopy, and closed in January 2014...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403187/effectiveness-of-advertising-availability-of-prenatal-ultrasound-on-uptake-of-antenatal-care-in-rural-uganda-a-cluster-randomized-trial
#6
RANDOMIZED CONTROLLED TRIAL
William Cherniak, Geoffrey Anguyo, Christopher Meaney, Ling Yuan Kong, Isabelle Malhame, Romina Pace, Sumeet Sodhi, Michael Silverman
In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda...
2017: PloS One
https://www.readbyqxmd.com/read/28396302/development-and-testing-of-the-myhealthypregnancy-app-a-behavioral-decision-research-based-tool-for-assessing-and-communicating-pregnancy-risk
#7
Tamar Krishnamurti, Alexander L Davis, Gabrielle Wong-Parodi, Baruch Fischhoff, Yoel Sadovsky, Hyagriv N Simhan
BACKGROUND: Despite significant advances in medical interventions and health care delivery, preterm births in the United States are on the rise. Existing research has identified important, seemingly simple precautions that could significantly reduce preterm birth risk. However, it has proven difficult to communicate even these simple recommendations to women in need of them. Our objective was to draw on methods from behavioral decision research to develop a personalized smartphone app-based medical communication tool to assess and communicate pregnancy risks related to preterm birth...
April 10, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28390325/effects-of-early-versus-delayed-umbilical-cord-clamping-during-antepartum-lower-segment-caesarean-section-on-placental-delivery-and-postoperative-haemorrhage-a-randomised-controlled-trial
#8
M Withanathantrige, I M Goonewardene
Introduction: Although recommended, delayed cord clamping (DCC) is not frequently practised during lower segment caesarean section (LSCS). Objectives: To assess the effects of DCC during antepartum LSCS on placental delivery and postoperative hemorrhage Methods: A randomised controlled trial was carried out on 156 women undergoing antepartum LSCS between 37-39 weeks gestation at the Academic Obstetric Unit, Teaching Hospital Mahamodara, Galle from 21st January to 30th April 2013...
March 31, 2017: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28389908/validation-of-rem-score-to-predict-endometrial-cancer-in-patients-with-ultrasound-endometrial-abnormalities-results-of-a-new-independent-dataset
#9
Francesco Plotti, Stella Capriglione, Corrado Terranova, Roberto Montera, Giuseppe Scaletta, Salvatore Lopez, Daniela Luvero, Antonelli Gianina, Alessia Aloisi, Pierluigi Benedetti Panici, Roberto Angioli
The risk of endometrial malignancy (REM) score is a model formulated in a previous single-center validation study, which has been shown to predict endometrial cancer in women with ultrasound endometrial abnormalities based on multiple features (clinical, ultrasound and laboratorial). The purpose of this study was to validate the performance of REM score in an external validation setting. A population-based database with patients, who underwent elective hysteroscopy for ultrasound endometrial abnormalities between 2013 and 2016 at Department of Obstetrics and Gynecology of Campus Bio-medico of Rome, was used...
May 2017: Medical Oncology
https://www.readbyqxmd.com/read/28383770/cost-effectiveness-analysis-and-obstetrics-the-time-has-come
#10
Robert M Silver, Brett D Einerson
In this issue of BJOG, ten Eikelder and colleagues report that oral misoprostol and foley bulb catheters for cervical ripening have equal cost-effectiveness. If women receiving foley bulbs undergo ripening at home or on a less intensive unit than a labor and delivery suite, the foley bulb is considerably more cost-effective. They used data from a Dutch RCT, the PROBAAT2 trial, comparing the two methods, which had similar efficacy. The analysis has many strengths including using comparisons from within an RCT, careful assessment of measurable direct hospital costs, and the use of well-chosen sensitivity analyses to evaluate the assumptions under a wide variety of clinical scenarios...
April 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28372652/dose-ranging-effects-of-pregabalin-on-pain-in-patients-undergoing-laparoscopic-hysterectomy-a-randomized-double-blinded-placebo-controlled-clinical-trial
#11
Zahra Asgari, Safoura Rouholamin, Masoomeh Nataj, Mahdi Sepidarkish, Reihaneh Hosseini, Maryam Razavi
OBJECTIVE: The study aimed to investigate the preemptive analgesia efficacy of different concentrations (75, 150 and 300mg) of preemptive pregabalin for the postoperative pain management after laparoscopic hysterectomy. DESIGN: Prospective, randomized, placebo-controlled, double-blind study. SETTING: The Gynecology and Obstetrics Center of Arash Hospital, Tehran, Iran, from October 2013 to November 2014. PATIENTS: A total of 96 women with American Association of Anesthesiologist (ASA) physical status I and II underwent elective laparoscopic hysterectomy surgery...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28372580/the-effect-of-a-clinical-decision-making-mhealth-support-system-on-maternal-and-neonatal-mortality-and-morbidity-in-ghana-study-protocol-for-a-cluster-randomized-controlled-trial
#12
Hannah Brown Amoakoh, Kerstin Klipstein-Grobusch, Mary Amoakoh-Coleman, Irene Akua Agyepong, Gbenga A Kayode, Charity Sarpong, Diederick E Grobbee, Evelyn K Ansah
BACKGROUND: Mobile health (mHealth) presents one of the potential solutions to maximize health worker impact and efficiency in an effort to reach the Sustainable Development Goals 3.1 and 3.2, particularly in sub-Saharan African countries. Poor-quality clinical decision-making is known to be associated with poor pregnancy and birth outcomes. This study aims to assess the effect of a clinical decision-making support system (CDMSS) directed at frontline health care providers on neonatal and maternal health outcomes...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28369911/trial-of-labor-after-cesarean-delivery-for-pregnancies-complicated-by-gestational-diabetes-mellitus
#13
Hadas Ganer Herman, Zviya Kogan, Jacob Bar, Michal Kovo
OBJECTIVE: To assess rates of, and factors associated with, trial of labor and vaginal delivery among pregnancies complicated by both gestational diabetes (GDM) and a previous cesarean delivery. METHODS: In a retrospective study of singleton deliveries at a university hospital in Israel between 2009 and 2015, women with one previous cesarean delivery and GDM were matched to those without GDM by past cesarean delivery indication: non-favorable (non-progressive labor or failed induction) or favorable (all other indications)...
March 31, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28348720/the-optimum-study-emdr-therapy-in-pregnant-women-with-posttraumatic-stress-disorder-after-previous-childbirth-and-pregnant-women-with-fear-of-childbirth-design-of-a-multicentre-randomized-controlled-trial
#14
M A M Baas, C A I Stramrood, L M Dijksman, A de Jongh, M G van Pampus
Background: Approximately 3% of women develop posttraumatic stress disorder (PTSD) after giving birth, and 7.5% of pregnant women show a pathological fear of childbirth (FoC). FoC or childbirth-related PTSD during (a subsequent) pregnancy can lead to a request for an elective caesarean section as well as adverse obstetrical and neonatal outcomes. For PTSD in general, and several subtypes of specific phobia, eye movement desensitization and reprocessing (EMDR) therapy has been proven effective, but little is known about the effects of applying EMDR during pregnancy...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28343558/simulator-based-obstetric-ultrasound-training-a-prospective-randomized-single-blinded-study
#15
Hadar Rosen, Rory Windrim, Yee Man Lee, Lara Gotha, Vsevolod Perelman, Stefania Ronzoni
OBJECTIVE: To compare the use of simulator-based and patient-based obstetric ultrasound training. METHODS: This was a prospective, randomized, single-blinded trial. Eighteen consenting obstetric trainees with minimal previous ultrasound exposure were recruited. Enrolled patients were also fully consenting. Mid-trimester fetal brain anatomy in the standard planes (i.e., biparietal diameter and head circumference, cavum septum pellucidum, posterior fossa, and lateral ventricle) was chosen as a surrogate for all fetal anatomy ultrasound training...
March 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28333696/a-universal-freeze-all-strategy-why-it-is-not-warranted
#16
Baris Ata, Emre Seli
PURPOSE OF REVIEW: There's some preclinical evidence of an adverse effect of multifollicular growth on endometrial function in assisted reproductive technology cycles. Universal elective frozen embryo transfer (eFET) in an unstimulated cycle is being promoted as a panacea, regardless of patient, and cycle characteristics. We review the clinical evidence on the effectiveness and safety of eFETs. RECENT FINDINGS: Randomized controlled trials (RCTs) comparing fresh and eFET yield contradictory results in terms of live birth rates...
March 22, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#17
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28325124/effects-of-obstetric-gel-on-the-process-and-duration-of-labour-in-pregnant-women-randomised-controlled-trial
#18
Mehmet Murat Seval, Tuncay Yüce, Betül Yakıştıran, Yavuz Emre Şükür, Batuhan Özmen, Cem Atabekoğlu, Acar Koç, Feride Söylemez
The present study investigated maternal and neonatal outcomes in pregnant women who used obstetric lubricant gels during active labour. This prospective randomised controlled study included 180 pregnant women. Women were randomly assigned to two groups during the first-stage of labour. Pregnant women in the obstetric gel group received standard antepartum care plus vaginal application of obstetric gel. Women in the control group received standard antepartum care without obstetric gel. Mean duration of the second stage of labour was significantly shorter in the obstetric gel group than control group (45 ± 34 min vs...
March 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28322491/threats-to-reliability-risk-erroneous-conclusions-a-survey-of-prospective-registration-and-sample-sizes-of-randomised-trials-in-women-s-health
#19
S K Nijjar, K S Khan
OBJECTIVE: Prospective registration of clinical trials has been required since 2005. We aimed to assess concordance between registered and reported sample sizes among prospectively registered randomised controlled trials (RCTs) in obstetrics and gynaecology. DESIGN: Analysis of prospectively registered and published data. SETTING: Women's health. SAMPLE: Obstetrics and gynaecology RCTs published in eight journals in 2015...
March 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#20
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
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