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Caesarean Delivery for Pregnancies in the First Stage of Labor: Clinical Effectiveness and Guidelines Caesarean Delivery for Pregnancies in the First Stage of Labor: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Caesarean Delivery for Pregnancies in the First Stage of Labor: Clinical Effectiveness and Guidelines Caesarean Delivery for Pregnancies in the First Stage of Labor: Clinical Effectiveness and Guidelines Last updated: September 9, 2019 Project Number (...) : RB1393-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the benefits and harms of caesarean delivery for Robson group 1 pregnancies with failure to progress in the latent phase of labor? What are the benefits and harms of caesarean delivery for Robson group 2A pregnancies with failure to progress in the latent phase of labor? What are the benefits and harms of caesarean delivery for Robson group 1 pregnancies with failure
Caesarean Delivery for Pregnancies in the Second Stage of Labor: Clinical Effectiveness and Guidelines Caesarean Delivery for Pregnancies in the Second Stage of Labor: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Caesarean Delivery for Pregnancies in the Second Stage of Labor: Clinical Effectiveness and Guidelines Caesarean Delivery for Pregnancies in the Second Stage of Labor: Clinical Effectiveness and Guidelines Last updated: September 16, 2019 Project (...) Number: RB1394-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the benefits and harms of caesarean delivery for Robson group 1 pregnancies with failure to progress in the second stage of labour? What are the benefits and harms of caesarean delivery for Robson group 2A pregnancies with failure to progress in the second stage of labour? What are the evidence-based guidelines regarding the use of caesarean delivery for Robson
Methamphetamine Addiction in Pregnancy: A Review of Clinical Effectiveness and Guidelines Last updated: June 17, 2019 Project Number: RC1130-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of interventions for the withdrawal management or treatment of persons who are pregnant and addicted to crystal methamphetamine? What are the evidence-based guidelines regarding withdrawal management (...) Withdrawal Management and Treatment of Crystal Methamphetamine Addiction in Pregnancy: A Review of Clinical Effectiveness and Guidelines Withdrawal Management and Treatment of Crystal Methamphetamine Addiction in Pregnancy: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Withdrawal Management and Treatment of Crystal Methamphetamine Addiction in Pregnancy: A Review of Clinical Effectiveness and Guidelines Withdrawal Management and Treatment of Crystal
in pregnancy since the last Australian Haemophilia Centre Directors’ Organisation (AHCDO) consensus statement was published in 2009. This updated consensus statement provides practical information for clinicians managing pregnant women who have, or carry a gene for, inherited bleeding disorders, and their potentially affected infants. It represents the consensus opinion of all AHCDO members; where evidence was lacking, recommendations have been based on clinical experience and consensus opinion. Main (...) Updated Australian consensus statement on management of inherited bleeding disorders in pregnancy Updated Australian consensus statement on management of inherited bleeding disorders in pregnancy | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date range to Article type Author's surname Volume First page doi: 10.5694/mja__.______ Search Reset close Individual Login Purchase options Connect person_outline Login
(depending on contraceptive used and personal circumstance – see guidance below) ensure that an effective form of contraception is used during treatment and for 2 months after discontinuation stop fingolimod 2 months before a pregnancy is planned and consider alternative treatments Management if pregnancy exposed should a woman on fingolimod become pregnant, stop treatment immediately and refer to an obstetrician for close monitoring during pregnancy, including ultrasound assessments exposed pregnancies (...) trials and routine clinical practice (more than 677,700 patient-years). In the UK, 9025 patients have received fingolimod since it was marketed in 2011. Risk of congenital malformations At the time of licence of fingolimod in 2011, little clinical data were available about safety of use in pregnancy. The product information for fingolimod noted that animal data suggested a risk of foetal harm and therefore advised that women should not become pregnant while taking fingolimod. A registry
is required for fetal growth and development (Scholl, ), as well as for increased maternal erythropoiesis (Bothwell, ; Fisher & Nemeth, ). The current Hb thresholds defining anaemia in pregnancy are based on historical normal values derived from non‐pregnant populations, which are not clearly linked to clinical outcomes and there is ongoing debate as to the applicability of these values (Pasricha et al , ). The WHO is reviewing the evidence relating to the Hb below which anaemia should be defined (WHO (...) period are recognised as a critical period where there is rapid brain development, high neural plasticity and high nutritional requirement (Gluckman & Hanson, ; Georgieff et al , ). Animal studies show maternal iron deficiency late in pregnancy is associated with neurodevelopmental impairment. Observational studies in pregnant women have found that iron deficiency anaemia late in pregnancy is associated with premature birth and low Apgar score (<5 at 1 min) (Lone et al , ), and impaired motor
Non-invasive prenatal testing to determine the risk of autosomal trisomies 13, 18 and 21 in high-risk pregnancies 1 Translation of the key statement of the final report S16-06 Nicht invasive Pränataldiagnostik (NIPD) zur Bestimmung des Risikos autosomaler Trisomien 13, 18 und 21 bei Risikoschwangerschaften (Version 1.0; Status: 30 April 2018). Please note: This document was translated by an external translator and is provided as a service by IQWiG to English-language readers. However, solely (...) the German original text is absolutely authoritative and legally binding. Extract IQWiG Reports – Commission No. S16-06 Non-invasive prenatal testing (NIPT) to determine the risk of autosomal trisomies 13, 18 and 21 in high-risk pregnancies 1 Extract of final report S16-06 Version 1.0 Non-invasive prenatal testing (NIPT) 30 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Non-invasive
is currently not possible.To assess the association of a high-dose vitamin D supplementation in pregnant women with enamel defects and caries in their offspring.Post hoc analysis of a double-blind, single-center, randomized clinical trial, the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort (COPSAC2010). Enrollment began March 2009 and included 623 women recruited at 24 weeks of pregnancy and 588 of their children. A dental examination was completed at age 6 years in 496 of 588 children (...) Association of High-Dose Vitamin D Supplementation During Pregnancy With the Risk of Enamel Defects in Offspring: A 6-Year Follow-up of a Randomized Clinical Trial Enamel defects of developmental origin affect up to 38% of schoolchildren and is recognized as a global public health challenge. The impaired enamel formation results in pain owing to hypersensitivity, posteruptive breakdowns, rapid caries progression, and extractions in some cases. The etiology is unknown; therefore, prevention
Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Hypertension is the most common medical disorder in pregnancy, complicating one in ten pregnancies. Treatment of severely increased blood pressure is widely recommended to reduce the risk for maternal complications. Regimens for the acute treatment of severe hypertension typically include intravenous medications. Although (...) effective, these drugs require venous access and careful fetal monitoring and might not be feasible in busy or low-resource environments. We therefore aimed to compare the efficacy and safety of three oral drugs, labetalol, nifedipine retard, and methyldopa for the management of severe hypertension in pregnancy.In this multicentre, parallel-group, open-label, randomised controlled trial, we compared these oral antihypertensives in two public hospitals in Nagpur, India. Pregnant women were eligible
2019LancetControlled trial quality: predicted high
July 2018), and reference lists of retrieved studies.Eligible studies were randomised controlled trials (RCT) of calcium supplementation, including women not yet pregnant, or women in early pregnancy. Cluster-RCTs, quasi-RCTs, and trials published as abstracts were eligible, but we did not identify any.Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked them for accuracy. They assessed the quality of the evidence for key outcomes using (...) Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy. The hypertensive disorders of pregnancy include pre-eclampsia, gestational hypertension, chronic hypertension, and undefined hypertension. Pre-eclampsia is considerably more prevalent in low-income than in high-income countries. One possible explanation for this discrepancy is dietary differences, particularly calcium deficiency. Calcium supplementation in the second half
Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and increased serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth, and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment without an adequate evidence base. We aimed to evaluate whether ursodeoxycholic acid reduces adverse (...) perinatal outcomes in women with intrahepatic cholestasis of pregnancy.We did a double-blind, multicentre, randomised placebo-controlled trial at 33 hospital maternity units in England and Wales. We recruited women with intrahepatic cholestasis of pregnancy, who were aged 18 years or older and with a gestational age between 20 weeks and 40 weeks and 6 days, with a singleton or twin pregnancy and no known lethal fetal anomaly. Participants were randomly assigned 1:1 to ursodeoxycholic acid or placebo
2019LancetControlled trial quality: predicted high
) Serology Screening Requisition is available. Continue to check off Syphilis Antibody (1 st Trimester) in the prenatal screening section. Check the box for Perinatal Syphilis for the ‘at delivery’ screen. If using any other requisition (e.g., outpatient maternity requisition), include the gestational age on the requisition. Any individual of reproductive age and able to get pregnant who is diagnosed with syphilis should have a pregnancy test performed. Troy Grennan, MD MSc FRCPC Physician Lead, HIV/STI (...) Program, BC Centre for Disease Control Julie van Schalkwyk, MD MSc FRCSC Department Head, Obstetrics and Gynecology, BC Women’s Hospital & Health Centre Ellen Giesbrecht, MD FRCSC Consultant Obstetrician, Perinatal Services BC and Senior Medical Director, Maternal Newborn Program, BC Women’s Hospital & Health Centre All pregnant individuals should have syphilis screening performed at two time points: 1. During the first trimester of pregnancy or at the first prenatal visit (existing recommendation
on OUD in particular; to draft preliminary recommendations regarding screening, pain management, and medication-assisted therapy (MAT) for OUD during pregnancy; and to delineate research gaps. Epidemiology of opioid use in pregnancy Epidemiologic evidence that was presented at the workshop demonstrated that rates of substance use in pregnancy have increased significantly in the past decade and that rates of OUD in pregnant and postpartum women have increased in parallel: • One study reported (...) that 21.6% of pregnant women enrolled in Medicaid receive a prescription for opioids. x 1 Desai, R.J., Hernandez-Diaz, S., Bateman, B.T., and Huybrechts, K.F. Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstet Gynecol . 2014 ; 123 : 997–1002 • From 2000–2009, antepartum maternal opiate use increased from 1.19 (95% confidence interval (CI), 1.01–1.35) to 5.63 (95% CI, 4.40–6.71) per 1000 hospital births per year. x 2 Patrick, S.W., Schumacher, R.E., Benneyworth
Pregnancy duration and endometrial cancer risk: nationwide cohort study. To explore the association between pregnancy duration and risk of endometrial cancer.Nationwide register based cohort study.Denmark.All Danish women born from 1935 to 2002.Relative risk (incidence rate ratio) of endometrial cancer by pregnancy number, type, and duration, estimated using log-linear Poisson regression.Among 2 311 332 Danish women with 3 947 650 pregnancies, 6743 women developed endometrial cancer during 57 (...) 347 622 person years of follow-up. After adjustment for age, period, and socioeconomic factors, a first pregnancy was associated with a noticeably reduced risk of endometrial cancer, whether it ended in induced abortion (adjusted relative risk 0.53 (95% confidence interval 0.45 to 0.64) or childbirth (0.66, 0.61 to 0.72). Each subsequent pregnancy was associated with an additional reduction in risk, whether it ended in induced abortion (0.81, 0.77 to 0.86) or childbirth (0.86, 0.84 to 0.89
Trends in Maternal and Fetal Outcomes Among Pregnant Women With Systemic Lupus Erythematosus in the United States: A Cross-sectional Analysis. Although pregnancy in systemic lupus erythematosus (SLE) carries a high risk for mother and fetus, outcomes may be improving.To assess nationwide trends and disparities in maternal and fetal complications among pregnant women with SLE.Retrospective cohort study.United States, 1998 to 2015.Adult pregnant women with and without SLE who had hospitalizations (...) and poststratification weights were obtained.An estimated 93 820 pregnant women with SLE and 78 045 054 without SLE were hospitalized in the United States from 1998 through 2015. Outcomes improved during those 18 years. In-hospital maternal deaths (per 100 000 admissions) declined among patients with as well as those without SLE (442 vs. 13 for 1998 to 2000 and <50 vs. 10 for 2013 to 2015), although the decrease was greater in women with SLE (difference in trends, P < 0.002). The percentage of patients with SLE
Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial Pregnant women with metabolic risk factors are at high risk of complications. We aimed to assess whether a Mediterranean-style diet reduces adverse pregnancy outcomes in high-risk women.We conducted a multicentre randomised trial in 5 maternity units (4 in London and 1 in Birmingham) between 12 September 2014 and 29 February 2016. We randomised inner-city pregnant women (...) individual components of the composite outcomes. Mothers gained less gestational weight (mean 6.8 versus 8.3 kg; adjusted difference -1.2 Kg, 95% CI -2.2 to -0.2, p = 0.03) with intervention versus control. There was no difference in any of the other maternal and offspring complications between both groups. When we pooled findings from the Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes (ESTEEM) trial with similar trials using random effects meta
Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial Pregnancy interventions that improve maternal and infant outcomes are urgently needed in populations with high rates of obesity. We undertook the Healthy Mums and Babies (HUMBA) randomized controlled trial to assess the effect of dietary interventions and or probiotics in a multiethnic population of pregnant women with obesity, living (...) in an area of high deprivation.To determine whether a culturally tailored dietary intervention and or daily probiotic capsules in pregnant women with obesity reduces the co-primary outcomes of (1) excessive gestational weight gain (mean >0.27 kg/week) and (2) birthweight.We conducted a 2 × 2 factorial, randomized controlled trial in women without diabetes at pregnancy booking, body mass index ≥30 kg/m2, and a singleton pregnancy. At 12+0 to 17+6 weeks' gestation, eligible women were randomized
Could the YEARS algorithm be used to exclude pulmonary embolism during pregnancy? Data from the CT-PE-pregnancy study The recently proposed YEARS algorithm was shown to safely exclude pulmonary embolism (PE) and reduce the use of computed tomography pulmonary angiography (CTPA) among pregnant women with suspected PE. Our aim was to externally validate this finding.We performed a post hoc analysis of a prospective management outcome study for PE diagnosis in pregnant women. PE was diagnosed (...) levels (<1000 ng/mL in women with no items, and <500 ng/mL in women with one or more items), 77 women (21%) met the criteria for PE exclusion and would not have undergone CTPA as per the YEARS algorithm. None of these 77 women had PE diagnosed during the initial work-up or 3-month follow-up. Therefore, the failure rate of the YEARS algorithm in our pregnant women population was 0/77 (95% confidence interval 0.0-3.9).In our study, application of the YEARS algorithm would have resulted in safe
The objective of this guideline is to evaluate bacterial vaginosis in pregnancy concerning • Different treatments for prevention of preterm delivery. • Screening of pregnant women with low as well as high risk of sPTD. • Stratification into gestational ages below and above 16 weeks. • Diagnostic methods. Key words Bacterial vaginosis, vaginal pH, pH-glove, vaginal discharge, Nugent score, Amsel score, Gardnerella vaginalis, Mobiluncus species, preterm delivery, preterm birth, GRADE, clindamycin (...) , clindamycin might be used for treatment of symp- toms). • This recommendation addresses both treatment with metronidazole and clindamycin. • This recommendation addresses all gestational ages of pregnancy. Treatment with probiotics ??: We suggest against treatment of BV-positive pregnant women with probiotics in order reducing the risk of sPTD. • This recommendation addresses both women at low and high risk of sPTD. • This recommendation addresses asymptomatic as well as symptomatic women