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https://www.readbyqxmd.com/read/28515516/changes-in-cardiac-index-during-labour-analgesia-a-double-blind-randomised-controlled-trial-of-epidural-versus-combined-spinal-epidural-analgesia-a-preliminary-study
#1
Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or uterine hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. METHODS: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28511452/the-effect-of-entonox-on-labour-pain-relief-among-nulliparous-women-a-randomized-controlled-trial
#2
Parisa Parsa, Nafiseh Saeedzadeh, Ghodratallah Roshanaei, Fatameh Shobeiri, Faryar Hakemzadeh
INTRODUCTION: Labour pain is one of the most severe pain in humans. Fear of labour pain is the most dreadful reason for Caesarean Section (CS). Entonox (a mixture of nitrous oxide+oxygen) is a safe inhalational analgesia during labour pain. AIM: This study investigated the effect of entonox on pain relief and length of labour in nulliparous women. MATERIALS AND METHODS: A clinical trial study was conducted among 120 nulliparous women (60 in intervention and 60 in control group) in 2015 in Atieh Hospital, Hamadan city, Iran...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28486938/barriers-and-facilitators-related-to-the-uptake-of-four-strategies-to-prevent-neonatal-early-onset-group-b-haemolytic-streptococcus-disease-a-qualitative-study
#3
Diny G E Kolkman, Margot A H Fleuren, Maurice G A J Wouters, Christianne J M de Groot, Marlies E B Rijnders
BACKGROUND: Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). Low adherence to guidelines preventing EOGBS has been reported. Each strategy has drawbacks and clinical outcomes are affected by care providers' and women's adherence...
May 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28472859/lifestyle-interventions-for-the-treatment-of-women-with-gestational-diabetes
#4
REVIEW
Julie Brown, Nisreen A Alwan, Jane West, Stephen Brown, Christopher Jd McKinlay, Diane Farrar, Caroline A Crowther
BACKGROUND: Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. OBJECTIVES: To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. SEARCH METHODS: We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28464006/antenatal-small-class-education-versus-auditorium-based-lectures-to-promote-positive-transitioning-to-parenthood-a-randomised-trial
#5
Vibeke Koushede, Carina Sjöberg Brixval, Lau Caspar Thygesen, Solveig Forberg Axelsen, Per Winkel, Jane Lindschou, Christian Gluud, Pernille Due
Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time after delivery, each session lasted 2...
2017: PloS One
https://www.readbyqxmd.com/read/28458123/the-motivation-and-capacity-to-go-above-and-beyond-qualitative-analysis-of-free-text-survey-responses-in-the-m-ngo-randomised-controlled-trial-of-caseload-midwifery
#6
Jyai Allen, Sue Kildea, Donna L Hartz, Mark Tracy, Sally Tracy
OBJECTIVE: to explore whether women allocated to caseload care characterise their midwife differently to those allocated to standard care. DESIGN: multi-site unblinded, randomised, controlled, parallel-group trial. SETTING: the study was conducted in two metropolitan teaching hospitals across two Australian cities. POPULATION: women of all obstetric risk were eligible to participate. Inclusion criteria were: 18 years or older, less than 24 week's gestation with a singleton pregnancy...
March 29, 2017: Midwifery
https://www.readbyqxmd.com/read/28440898/comparing-induction-of-labour-with-oral-misoprostol-or-foley-catheter-at-term-cost-effectiveness-analysis-of-a-randomised-controlled-multi-centre-non-inferiority-trial
#7
Mieke L G Ten Eikelder, Gert-Jan van Baaren, Katrien Oude Rengerink, Marta Jozwiak, Jan Willem de Leeuw, Gunilla Kleiverda, Inge Evers, Karin de Boer, Josien Brons, Kitty W M Bloemenkamp, Ben W Mol
OBJECTIVE: To assess the costs of labour induction with oral misoprostol compared to Foley catheter. DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Obstetric departments of six tertiary and 23 secondary care hospitals in the Netherlands. POPULATION: Women with a viable term singleton pregnancy in cephalic presentation, intact membranes, an unfavourable cervix (Bishop score <6) without a previous caesarean section, had been randomised for labour induction with oral misoprostol (n = 924) or Foley catheter (n = 921)...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#8
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/28416501/protocol-for-a-placebo-controlled-within-participants-crossover-trial-evaluating-the-efficacy-of-intranasal-oxytocin-to-improve-pain-and-function-among-women-with-chronic-pelvic-musculoskeletal-pain
#9
Joshua A Rash, Kirsti Toivonen, Magali Robert, Maryam Nasr-Esfahani, John F Jarrell, Tavis S Campbell
INTRODUCTION: This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28414983/a-randomised-controlled-trial-in-comparing-maternal-and-neonatal-outcomes-between-hands-and-knees-delivery-position-and-supine-position-in-china
#10
Hongyu Zhang, Shurong Huang, Xiaolan Guo, Ningning Zhao, Yujing Lu, Min Chen, Yingxia Li, Junqin Wu, Lihua Huang, Fenglan Ma, Yuhong Yang, Xiaoli Zhang, Xiaoyu Zhou, Renfei Guo, Wenzhi Cai
BACKGROUND: the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. METHODS: a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012...
March 31, 2017: Midwifery
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#11
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28410419/the-electrical-heart-axis-and-st-events-in-fetal-monitoring-a-post-hoc-analysis-following-a-multicentre-randomised-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Rik Vullings, Kim M J Verdurmen, Alexandra D J Hulsenboom, Stephanie Scheffer, Hinke de Lau, Anneke Kwee, Pieter F F Wijn, Isis Amer-Wåhlin, Judith O E H van Laar, S Guid Oei
OBJECTIVE: Reducing perinatal morbidity and mortality is one of the major challenges in modern health care. Analysing the ST segment of the fetal electrocardiogram was thought to be the breakthrough in fetal monitoring during labour. However, its implementation in clinical practice yields many false alarms and ST monitoring is highly dependent on cardiotocogram assessment, limiting its value for the prediction of fetal distress during labour. This study aims to evaluate the relation between physiological variations in the orientation of the fetal electrical heart axis and the occurrence of ST events...
2017: PloS One
https://www.readbyqxmd.com/read/28409530/digital-stretching-of-cervix-in-the-active-phase-of-labour-to-shorten-its-duration-a-randomised-control-trial
#13
Deepti Pinto Rosario, Anuja Abraham, Swati Rathore, Santosh Joseph Benjamin, Visalakshi Jeyaseelan, Jiji Elizabeth Mathews
An assessment of the efficacy and satisfaction of women in active labour having digital cervical stretching compared to women who did not have this intervention. Ours was a randomised controlled trial at a tertiary centre in India. Low-risk women at term with vertex presentation in active labour with ruptured membranes and cervical dilation of 4-6 cm were included. Stretching to delivery interval was 247.5 ± 158.2 min in the intervention group and 265.5 ± 158.4 in the control group. The mode of delivery, incidence of cervical tear, and maternal, fetal and neonatal complications were similar in both groups...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28408145/cost-effectiveness-of-silver-dressings-for-paediatric-partial-thickness-burns-an-economic-evaluation-from-a-randomized-controlled-trial
#14
E Gee Kee, K Stockton, R M Kimble, L Cuttle, S M McPhail
BACKGROUND: Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome...
April 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#15
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28404155/survival-outcomes-following-laparoscopic-versus-open-d3-dissection-for-stage-ii-or-iii-colon-cancer-jcog0404-a-phase-3-randomised-controlled-trial
#16
Seigo Kitano, Masafumi Inomata, Junki Mizusawa, Hiroshi Katayama, Masahiko Watanabe, Seiichiro Yamamoto, Masaaki Ito, Shuji Saito, Shoichi Fujii, Fumio Konishi, Yoshihisa Saida, Hirotoshi Hasegawa, Tomonori Akagi, Kenichi Sugihara, Takashi Yamaguchi, Tadahiko Masaki, Yosuke Fukunaga, Kohei Murata, Masazumi Okajima, Yoshihiro Moriya, Yasuhiro Shimada
BACKGROUND: Although benefits of laparoscopic surgery compared with open surgery have been suggested, the long-term survival of patients undergoing laparoscopic surgery for colon cancer requiring Japanese D3 dissection remains unclear. We did a randomised controlled trial to establish non-inferiority of laparoscopic surgery to open surgery. METHODS: We did an open-label, multi-institutional, randomised, two-arm phase 3 trial in 30 hospitals in Japan. Patients aged 20-75 years who had histologically proven colon cancer; tumours located in the caecum or ascending, sigmoid, or rectosigmoid colon; T3 or deeper lesions without involvement of other organs, node stages N0-2, and metastasis stage M0; and tumour size of 8 cm or smaller were included...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#17
Fatima Leon-Larios, Isabel Corrales-Gutierrez, Rosa Casado-Mejía, Carmen Suarez-Serrano
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28382858/new-japanese-regulatory-frameworks-for-clinical-research-and-marketing-authorization-of-gene-therapy-and-cellular-therapy-products
#18
Sumimasa Nagai, Keiya Ozawa
In Japan, the Pharmaceuticals and Medical Devices Law was passed in 2014. In this new law, regenerative medical products were defined, and a conditional and term-limited approval system only for regenerative medical products was instituted. Gene therapy and adoptive cellular therapy are categorized as regenerative medical products. This law is intended for registration trials for marketing authorization. The Act on the Safety of Regenerative Medicine was also implemented in 2014. This act is intended for clinical research and medical practice involving processed cells other than registration trials...
April 6, 2017: Current Gene Therapy
https://www.readbyqxmd.com/read/28351386/midwife-led-maternity-care-in-ireland-a-retrospective-cohort-study
#19
Anna Dencker, Valerie Smith, Colette McCann, Cecily Begley
BACKGROUND: Midwife-led maternity care is shown to be safe for women with low-risk during pregnancy. In Ireland, two midwife-led units (MLUs) were introduced in 2004 when a randomised controlled trial (the MidU study) was performed to compare MLU care with consultant-led care (CLU). Following study completion the two MLUs have remained as a maternity care option in Ireland. The aim of this study was to evaluate maternal and neonatal outcomes and transfer rates during six years in the larger of the MLU sites...
March 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#20
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
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