Induction of labour indications and timing: A systematic analysis of clinical guidelines.

CONCLUSION: Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates. PMID: 31285166 [PubMed - as supplied by publisher]
Source: Women Birth - Category: Midwifery Authors: Tags: Women Birth Source Type: research

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Conclusion Perinatal outcomes were significantly improved by reducing the number of fetuses in higher order multifetal pregnancies. This study involved a large, diverse sample population, and the results can be used as a reference while conducting prenatal counseling. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: American Journal of Perinatology Reports - Category: Perinatology & Neonatology Authors: Tags: Case Report Source Type: research
Abstract Global estimates for 2017 indicated that there were 295,000 maternal deaths, 35 per cent lower than in 2000 with a decline in global maternal mortality ratio from 342 to 211 deaths per 100,000 live births (World Health Organization (WHO) 2019). Maternal hemorrhage is the leading direct cause of maternal death worldwide, representing 27% (20-36) of maternal deaths ( Say L, et al. Lancet 2014). Multiple large retrospective population cohorts have identified risk factors invariably associated with maternal hemorrhage including mode of delivery, prolonged labor, chorioamnionitis, and twins among others (Brile...
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
CONCLUSIONS: Low-certainty evidence means we are not certain if there is any difference between probiotic and placebo groups in maternal hypertensive disorders of pregnancy, caesareans; and large-for-gestational-age babies. There were no adverse events reported by the trials. Due to the variability of probiotics used and small sample sizes of trials, evidence from this review has limited ability to inform practice. Well-designed adequately-powered trials are needed to identify whether probiotics may improve maternal blood glucose levels and/or infant/child/adult outcomes; and whether they can be used to treat GDM. PMI...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Oskovi-Kaplan ZA, Ozgu-Erdinc AS Abstract Once a woman is diagnosed with gestational diabetes mellitus (GDM), two strategies are considered for management; life-style modifications and pharmacological therapy. The management of GDM aims to maintain a normoglycemic state and to prevent excessive weight gain in order to reduce maternal and fetal complications. Lifestyle modifications include nutritional therapy and exercise. Calorie restriction with a low glycemic index diet is recommended to avoid postprandial hyperglycemia and to reduce insulin resistance. Blood glucose levels, HbA1c levels, and ketonuria ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Polycystic ovary syndrome (PCOS) comprises at least two of the following: hyperandrogenism, intermittent or absent menstrual cycles, and polycystic ovaries. It affects 15% −20% of women in their reproductive years, compromising their fertility, fecundity, and cardiometabolic health (1). Assisted reproduction is a common prerequisite for a high conception rate in women with PCOS; but regardless of method of conception, pregnant women are at increased risk for pregnan cy-induced hypertension, preeclampsia, gestational diabetes, spontaneous preterm labor, need for cesarean delivery, and thus severe maternal morbidity.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
CONCLUSION: HbA1c levels between 5.7% and 6.4% in early pregnancy consistently identified patients who went on to develop GMD. The evidence that particular levels are associated with adverse outcomes is less robust. PMID: 32268994 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Abstract Background: Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during Cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone Cesarean section under spinal anesthesia. Method: A prospective cohort study was conducted from 01 February to 28 May 2019 in preeclamptic and non-preeclamptic parturients. We hypothesized preeclamptic parturients are at high risk of spinal anesthesia induced hypotension than non preeclamptic...
Source: Patient Safety in Surgery - Category: Surgery Authors: Tags: Patient Saf Surg Source Type: research
CONCLUSIONS: The multi-disciplinary approach for treating women with PGDM practiced in the high-risk pregnancy clinic at the Sheba Medical Center resulted in lower rates of macrosomia, LGA, and pregnancy induced hypertension compared to rates reported in the literature. PMID: 32147976 [PubMed - in process]
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Preexisting diabetes in pregnancy is associated with an increased risk of adverse outcomes such as; preterm delivery, hypertensive complications, large for gestational age infants (LGA), shoulder dystocia and perinatal mortality (1 –3). In many clinical settings, pregnant women with preexisting diabetes undergo induction of labor before their due date to prevent perinatal complications. However, many will end up with an emergency cesarean section (CS), in fact the rate of emergency CS in pregnancies complicated by preexistin g diabetes is 3-4 fold compared with women without diabetes (1,4,5).
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Full length article Source Type: research
CONCLUSION: A substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated. PMID: 32146087 [PubMed - as supplied by publisher]
Source: Women Birth - Category: Midwifery Authors: Tags: Women Birth Source Type: research
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