Cochrane Making a Difference: Midwifery

The Cochrane Making a Difference series focuses on stories of how Cochrane evidence has made an impact on real-world health decision making and outcomes. This story focuses on the improved outcomes that women experience in pregnancy and delivery when they are cared for by a midwife that they know.A Cochrane Review on continuity of midwife care was first published in 2004, and most recently updated in 2016. As more trials have been added to the Cochrane Review, uncertainties in the original findings have been reduced. The current evidence demonstrates that women who have received continuity of care from a midwife they know, rather than receiving medical-led or shared care, are: 24% less likely to experience preterm birth,19% less likely to lose their baby before 24 weeks gestation, and16% less likely to lose their baby at any gestation.These women are also more likely to have a vaginal birth, fewer interventions during birth (instrumental birth, amniotomy, epidural and episiotomy), and are likely to have a more positive experience of labour and birth. These findings apply to both low- and mixed-risk populations of women, and there are no significant differences in outcomes between caseload and team care models. Both the World Health Organization and the UK’s Department of Health have identified this Cochrane Review as a priority topic for updating. Its findings have had a significant influence on recent policy developments in relation to maternity care in the UK and beyo...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news

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ConclusionWomen having a VBAC after emergency caesarean have a higher rate of OASI than primiparous women. This is important in the counselling of women considering VBAC.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
The objective of this study was to describe the proportion of genital tract tears in women who gave birth on a birth seat compared to women who did not. METHOD: An observational cohort study based on birth information collected prospectively. In total 10 629 live, singleton, non-instrumental births in cephalic presentation were studied. RESULTS: Fewer women who gave birth on a birth seat experienced an overall intact genital tract compared to women who gave birth in any other position. Women who gave birth on a birth seat were less likely to have an episiotomy performed. Women who gave birth vaginally on a birth ...
Source: Women Birth - Category: Midwifery Authors: Tags: Women Birth Source Type: research
CONCLUSIONS: Women with Diabetes Mellitus without a previous cesarean section who gave birth vaginally to a single child at term or near term did not experienced an increased risk of lower genital tract tears. However, nulliparous women with Type 1 Diabetes Mellitus experienced a higher risk of episiotomy. These results may be used to individualised counselling of women with Diabetes Mellitus regarding mode of birth and may reduce worries about genital tract tears in women with Diabetes Mellitus considering vaginal birth. PMID: 30500727 [PubMed - as supplied by publisher]
Source: Midwifery - Category: Midwifery Authors: Tags: Midwifery Source Type: research
Objective: To determine clinical and hematological risk factors for immediate postpartum hemorrhage (PPH).Design: A cohort study.Setting: Obstetric unit of Brest University Hospital (France).Population: All women who underwent a vaginal delivery between April 1, 2013 and May 29, 2015.Methods: Clinical data were collected by obstetricians or midwives during antenatal care visits, labor and delivery, and recorded by trained research assistants in a standardized electronic case report form. Hematological variables, including immature platelet fraction, were measured from a blood sample systematically performed at the entrance...
Source: Blood - Category: Hematology Authors: Tags: 322. Disorders of Coagulation or Fibrinolysis: Poster I Source Type: research
Publication date: Available online 14 November 2018Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): J Boujenah, A Tigaizin, M Fermaud, R Murtada, A Benbara, M Benchimol, I Pharisien, L CarbillonAbstractObjectivesEpisiotomy is a marker of Obstetric Anal Sphincter Injury (OASIS) condition, therefore, unmeasured factors could have biased the strength of the association between episiotomy and reduced OASIS during Operative Vaginal Delivery (OVD). The aim of this study was to compare the OASIS rate during OVD according to episiotomy practice.Study DesignRetrospective cohort study of all ...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
CONCLUSIONS: Women with perinatal distress were more likely to use an epidural than non-distressed women. The use of an epidural might help them manage pain and uncertainties related to childbirth. Women who were dissatisfied in their partner relationship may be more likely to undergo induction of childbirth, episiotomy and/or vacuum extraction. IMPLICATION FOR PRACTICE: Midwives need to acknowledge the possible association of distress and use of an epidural during childbirth and screen for distress early in pregnancy. It is important to offer counselling and help during pregnancy for expectant parents who are distres...
Source: Midwifery - Category: Midwifery Authors: Tags: Midwifery Source Type: research
ConclusionsPrenatal EMG may be used to predict the impact of right-sided mediolateral episiotomy on EAS and perhaps also function following delivery.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
Publication date: September 2018Source: Saudi Journal of Biological Sciences, Volume 25, Issue 6Author(s): Kıymet Yeşilçiçek Çalik, Nazende Korkmaz Yildiz, Reyhan ErkayaAbstractAbstract It is already known that maternal overweight, obesity, and morbid obesity are associated with adverse obstetric and neonatal outcomes. To assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcomes in Turkey. The study population consisted of 698 singleton pregnancies whose height and weight follow up were performed from the first trimester of pregnancy an...
Source: Saudi Journal of Biological Sciences - Category: Biology Source Type: research
Authors: Kovavisarach E, Laiamnuay J Abstract Background: The use of episiotomy, a previously popular obstetric procedure, has been declining for the last 25 years, falling from 65% of deliveries in 1979 to 18% in 2003. Some complications have been reported in terms of maternal side effects; however, many episiotomies are still performed in Rajavithi Hospital. Objective: To compare maternal and neonatal outcomes and complications in the 48-hour period after vaginal delivery in healthy parturients with and without episiotomy. Material and Method: A historical cohort study was conducted by reviewing the medic...
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
AbstractObjectiveTo investigate the association between episiotomy and perineal damage in the subsequent delivery.Study designA retrospective cohort study was conducted, comparing outcome of subsequent singleton deliveries of women with and without episiotomy in their first (index) delivery. Deliveries occurred between the years 1991 –2015 in a tertiary medical center. Traumatic vaginal tears, multiple pregnancies, and cesarean deliveries (CD) in the index pregnancy were excluded from the analysis. Multiple logistic regression models were used to control for confounders.ResultsDuring the study period, 43,066 women me...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
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