Active versus expectant management for women in the third stage of labour.

CONCLUSIONS: Although the data appeared to show that active management reduced the risk of severe primary PPH greater than 1000 mL at the time of birth, we are uncertain of this finding because of the very low-quality evidence. Active management may reduce the incidence of maternal anaemia (Hb less than 9 g/dL) following birth, but harms such as postnatal hypertension, pain and return to hospital due to bleeding were identified.In women at low risk of excessive bleeding, it is uncertain whether there was a difference between active and expectant management for severe PPH or maternal Hb less than 9 g/dL (at 24 to 72 hours). Women could be given information on the benefits and harms of both methods to support informed choice. Given the concerns about early cord clamping and the potential adverse effects of some uterotonics, it is critical now to look at the individual components of third-stage management. Data are also required from low-income countries.It must be emphasised that this review includes only a small number of studies with relatively small numbers of participants, and the quality of evidence for primary outcomes is low or very low. PMID: 30754073 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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The objective of the study was to estimate the current direct-action antiviral candidates, according to risky practices. The exposed population was determined according to each risky practice and age, based on the data obtained in two epidemiological studies and other bibliographic sources. The overall prevalence of positive serology for the Hepatitis C virus according to the analyzed data was 1.1% (41% with an active infection). The most at-risk group are intravenous drug users (60,368-82,454). It is estimated that between 37,387 to 51,065 patients would be infected via sexual transmission, between 55,505 and 75,812 patie...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We present the case of a male diagnosed with a giant hepatic artery aneurysm, which first presented with pain and hemorrhage due to a partial rupture of the aneurysm. After discarding treatment with a stent or surgery due to the wide extension, we chose to embolize the hepatic artery with coils. However, the progress was unfavorable after the procedure, with the appearance of liver failure that was resolved by an urgent liver transplantation. Giant hepatic artery pseudoaneurysms are an infrequent entity and their management is a great challenge. The diagnosis is usually delayed due to non-specific clinical signs and the li...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Rovira Argelagués M, Calvet Medina EJ, Pierres Mir M, Navarro Sanahuja J Abstract Radiological images of a patient consulting the emergency room for pain in the right hypochondrium and hypercalcified images in the right-medial area of ​​the upper hemiabdomen, which correspond to the floating gallbladder. PMID: 31526007 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Gutta A, Gromski MA Abstract Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple risk factors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managed endoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB, resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patient is stabilized. Future areas of research in PPB include the risks of direc...
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Authors: Marinelli C, Savarino E, Inferrera M, Lorenzon G, Rigo A, Ghisa M, Facchin S, D'Incà R, Zingone F Abstract Background/Aim: Inflammatory bowel disease (IBD) is a chronic disorder affecting patients' quality of life and increasing their disability. The aim of our study was to evaluate clinical and pharmacological factors associated with impaired quality of life and disability in a large cohort of IBD patients during IBD treatment. Methods: We consecutively and prospectively recruited all IBD patients referred to the IBD Unit of the "Azienda Ospedaliera" of Padua. Demographics and clinica...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Authors: Liñares A, Pico A, Blanco C, Blanco J Abstract PURPOSE: To show the clinical and radiographic results of intrabony peri-implantitis lesions treated nonsurgically with adjunctive systemic metronidazole with a mean follow-up of 50 months. MATERIALS AND METHODS: Subjects diagnosed with peri-implantitis (probing depth ≥ 5 mm with concomitant bleeding on probing and/or suppuration) with radiographic evidence of intrabony defects> 2 mm were included in this study. Implants affected received one session of nonsurgical mechanical debridement with ultrasonic and steel curettes. Systemic metronidazo...
Source: International Journal of Oral and Maxillofacial Implants - Category: ENT & OMF Tags: Int J Oral Maxillofac Implants Source Type: research
This study included non-anemic (hemoglobin ≥ 12 g/dL) female volunteers aged 18 to 22 years who were not taking mineral/vitamin supplements and living in the metropolitan area of Tokyo, Japan. These volunteers were classified into two groups based on their sFer (serum ferritin) levels: normal group (sFer ≥ 20 ng/mL, n = 36) and IDNA group (sFer
Source: Journal of Trace Elements in Medicine and Biology - Category: Biochemistry Source Type: research
ConclusionsThe present drug-free IVA approach may be suitable for POR patients with DOR, as it increased the number of antral follicles. The procedure also eliminated the need for 2-day incubation with drugs and required only one surgery. This approach could allow the retrieval of more oocytes in middle-age women to achieve higher pregnancy rates and deserves proper evaluation in future randomized controlled trials.
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
ConclusionsWe can accept that G-CSF is a encouraging immunological treatment choice for recurrent miscarriage patients with KIR-HLA-C mismatch. Administration of G-CSF during the first phases of pregnancy does not convey a higher risk of perinatal complications
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
Publication date: Available online 18 September 2019Source: Reproductive BioMedicine OnlineAuthor(s): Ge Gao, Xianfeng Cui, Shuang Li, Pan Ding, Shuai Zhang, Yunshan ZhangAbstractResearch QuestionThis meta-analysis aimed to explore whether endometrial thickness (EMT) could predict pregnancy outcomes after in-vitro fertilization (IVF). Moreover, the associations of EMT with the incidence of pregnancy outcomes according to study and individual characteristics were also assessed.DesignStudies evaluating the associations of EMT with the incidence of pregnancy rate, implantation rate, abortion rate, live birth or ongoing pregna...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
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