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Trial of labour

Nigel Lee, Sue Kildea, Helen Stapleton
PROBLEM/BACKGROUND: Sterile water injections (SWI) are gaining popularity amongst women and midwives for the relief of back pain in labour. However the brief but intense pain associated with the injection has been cited as a deterrent to use and may negatively affect the birth experience. AIM: To explore women's experiences of using sterile water injections as analgesia for back pain in labour. DESIGN: A qualitative study, which generated data through individual semi-structured interviews with postnatal women...
October 19, 2016: Women and Birth: Journal of the Australian College of Midwives
P Rozenberg
Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia...
October 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
C Baeza, N Mottet, C Coppola, M Desmarets, R Ramanah, D Riethmuller
OBJECTIVE: To assess delivery mode, maternal morbidity including uterine rupture and scar dehiscence and neonatal outcome, during a pregnancy after a previous caesarean delivery before 32 weeks of amenorrhea. METHODS: A retrospective descriptive study was carried out at the Besançon University Hospital during an 8-year period. We identified 292 consecutive patients presenting a singleton pregnancy delivery before 32 weeks of amenorrhea. We analysed the next pregnancy...
October 17, 2016: Gynécologie, Obstétrique & Fertilité
Debra Betts, Caroline A Smith, Hannah G Dahlen
BACKGROUND: Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a 'watchful waiting' approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage. METHODS: A mixed methods study involving a randomised controlled trial and semi structured interviews...
October 7, 2016: BMC Pregnancy and Childbirth
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Jillian M Doyle, Neil Merovitch, Russell C Wyeth, Matthew R Stoyek, Michael Schmidt, Florentin Wilfart, Alan Fine, Roger P Croll
We describe here an automated apparatus that permits rapid conditioning paradigms for zebrafish. Arduino microprocessors were used to control the delivery of auditory or visual stimuli to groups of adult or juvenile zebrafish in their home tanks in a conventional zebrafish facility. An automatic feeder dispensed precise amounts of food immediately after the conditioned stimuli, or at variable delays for controls. Responses were recorded using inexpensive cameras, with the video sequences analysed with ImageJ or Matlab...
September 19, 2016: Behavioural Brain Research
Braganza Veena, Rajinish Samal, Leeberk R Inbaraj, Carolin Elizabeth George
BACKGROUND: Prostaglandins are popular agents for induction of labour, owing to their dual action of cervical ripening and inducing uterine contractions. Sublingual misoprostol offers high efficacy as it bypasses first-pass metabolism. Researchers have proved that intracervical PGE1 is as effective as PGE2 except for increased caesarean rate and hyperstimulation. Limited knowledge is available on the efficacy of sublingual PGE1 and intracervical PGE2. This study was designed to compare the effectiveness of sublingual PGE1 with intracervical PGE2...
October 2016: Journal of Obstetrics and Gynaecology of India
Raffaele Bruno, Elisabetta Petrella, Valentina Bertarini, Giulia Pedrielli, Isabella Neri, Fabio Facchinetti
This study aims to determine whether the prescription of a detailed lifestyle programme in overweight/obese pregnant women influences the occurrence of gestational diabetes (GDM), and if this kind of prescription increases the adherence to a healthier lifestyle in comparison to standard care. The study was designed as a randomized controlled trial, with open allocation, enrolling women at 9-12 weeks of pregnancy with a BMI ≥ 25 kg/m(2) . The women assigned to the Intervention group (I = 96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations...
September 19, 2016: Maternal & Child Nutrition
Diane Farrar, Mark Simmonds, Maria Bryant, Trevor A Sheldon, Derek Tuffnell, Su Golder, Fidelma Dunne, Debbie A Lawlor
OBJECTIVES:  To assess the association between maternal glucose concentrations and adverse perinatal outcomes in women without gestational or existing diabetes and to determine whether clear thresholds for identifying women at risk of perinatal outcomes can be identified. DESIGN:  Systematic review and meta-analysis of prospective cohort studies and control arms of randomised trials. DATA SOURCES:  Databases including Medline and Embase were searched up to October 2014 and combined with individual participant data from two additional birth cohorts...
September 13, 2016: BMJ: British Medical Journal
Gerson Weiss, Sam Teichman, Dennis Stewart, David Nader, Susan Wood, Peter Breining, Elaine Unemori
BACKGROUND: Nonclinical studies indicate that the hormone relaxin is a good candidate for a safe cervical ripening agent that does not cause uterine contractions. METHODS: This Phase II study (conducted November 2, 2005-October 20, 2006) was a randomised, double blind, placebo controlled trial testing 24-h intravenous infusion of serelaxin (recombinant human relaxin) or placebo for cervical ripening in 72 healthy, primiparous women. Eligible subjects had a singleton pregnancy ≥40 weeks, were planned for elective induction, had vertex presentation of the fetus, intact membranes and a Bishop score at screening ≤4...
2016: BMC Pregnancy and Childbirth
Zarko Alfirevic, Edna Keeney, Therese Dowswell, Nicky J Welton, Nancy Medley, Sofia Dias, Leanne V Jones, Gillian Gyte, Deborah M Caldwell
BACKGROUND: More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. OBJECTIVE: To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. METHODS: We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group's Trials Register was searched (March 2014)...
August 2016: Health Technology Assessment: HTA
C Barasinski, D Lemery, F Vendittelli
OBJECTIVES: To assess, through a literature review, the maternal and neonatal morbidity associated with the type of pushing used during the second stage of labour. METHODS: We searched the Cochrane Library and the Medline database for randomised controlled trials from 1980 to 2015, using the following keywords: "delivery", "birth", "birthing", "bearing down, coached, uncoached, pushing", "second and stage and labour", "randomised controlled trials" and "meta-analysis"...
August 24, 2016: Gynécologie, Obstétrique & Fertilité
Stina Attebery
Biomedicine is increasingly shaped by the speculative economical values of neoliberal capitalism. A key feature of this new bioeconomical regime is the patenting and circulation of organisms and tissue samples, allowing rapid commercialisation of bacterial, animal and human biomedical materials. When thinking about this trend towards commercialisation, we must consider the ways by which biomedicine has been shaped by economics to better address these exploitative relationships between medical researchers and subjects...
August 24, 2016: Medical Humanities
Eog van Vliet, G H Dijkema, E Schuit, K Y Heida, C Roos, Jam van der Post, E C Parry, L McCowan, D J Lyell, Y Y El-Sayed, D B Carr, A L Clark, Z A Mahdy, M Uma, N C Sayin, G F Varol, B W Mol, M A Oudijk
BACKGROUND: Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48 hours of rescue tocolysis improves neonatal outcome is unproven. OBJECTIVES: To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). SEARCH STRATEGY: We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour...
October 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Tone Langjordet Johnsen, Aage Indahl, Valborg Baste, Hege Randi Eriksen, Torill Helene Tveito
BACKGROUND: Subjective health complaints, such as musculoskeletal and mental health complaints, have a high prevalence in the general population, and account for a large proportion of sick leave in Norway. It may be difficult to prevent the occurrence of subjective health complaints, but it may be possible to influence employees' perception and management of these complaints, which in turn may have impact on sick leave and return to work after sick leave. Long term sick leave has many negative health and social consequences, and it is important to gain knowledge about effective interventions to prevent and reduce long term sick leave...
2016: BMC Public Health
Y M Du, L Y Zhu, L N Cui, B H Jin, J L Ou
BACKGROUND: Induction of labour has become an increasingly common procedure. Ripening methods, including mechanical devices and pharmacological agents, improve the success rate of labour induction. OBJECTIVE: To compare the efficacy and safety of the double-balloon catheter with prostaglandin E2 agents used for labour induction. SEARCH STRATEGY: We searched electronic sources from MEDLINE, Embase and Web of Science, the Cochrane Library Database of Systematic Reviews, and ClinicalTrials...
August 17, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Hideaki Anan, Yasuhiro Otomo, Hisayoshi Kondo, Masato Homma, Yuichi Koido, Kazuma Morino, Kenichi Oshiro, Kiyokazu Harikae, Osamu Akasaka
This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course...
October 2016: Prehospital and Disaster Medicine
D W da Costa, L M Dijksman, S A Bouwense, N J Schepers, M G Besselink, H C van Santvoort, D Boerma, H G Gooszen, M G W Dijkgraaf
BACKGROUND: Same-admission cholecystectomy is indicated after gallstone pancreatitis to reduce the risk of recurrent disease or other gallstone-related complications, but its impact on overall costs is unclear. This study analysed the cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis. METHODS: In a multicentre RCT (Pancreatitis of biliary Origin: optimal timiNg of CHOlecystectomy; PONCHO) patients with mild gallstone pancreatitis were randomized before discharge to either cholecystectomy within 72 h (same-admission cholecystectomy) or cholecystectomy after 25-30 days (interval cholecystectomy)...
August 12, 2016: British Journal of Surgery
Neil Marlow, Hannah Bower, David Jones, Peter Brocklehurst, Sara Kenyon, Katie Pike, David Taylor, Alison Salt
BACKGROUND: Antibiotics used for women in spontaneous preterm labour without overt infection, in contrast to those with preterm rupture of membranes, are associated with altered functional outcomes in their children. METHODS: From the National Pupil Database, we used Key Stage 2 scores, national test scores in school year 6 at 11 years of age, to explore the hypothesis that erythromycin and co-amoxiclav were associated with poorer educational outcomes within the ORACLE Children Study...
August 11, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Christian Krauth, Wolfgang Kuchinke, Martin Eckert, Rene Bergmann, Benjamin Braasch, Töresin Karakoyun, Christian Ohmann
For research in biomedical sciences, cross-domain searches through several different databases are an increasingly necessary task that often becomes a time consuming and labour-intense process. This is especially the case when different domain databases have to be combined, for example combined searches in clinical trials registries, publication databases and research databases. The Clinical Trial Information Mediator (CTIM) addresses this problem and offers a novel way for the combined search in ClinicalTrials...
August 8, 2016: Journal of Biomedical Informatics
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