International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Feb 2012
Randomized Controlled Trial Comparative StudySublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women.
To compare sublingual misoprostol with intramuscular oxytocin for prevention of postpartum hemorrhage (PPH) in low-risk vaginal birth. ⋯ The efficacy of 400 μg of misoprostol administered sublingually was equivalent to that of 10 units of oxytocin given intramuscularly for prevention of PPH in low-risk vaginal delivery.
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To review maternal mortality in a large stand-alone maternity hospital in a European city and to determine whether the increased cesarean rate was associated with an increase in maternal deaths. ⋯ In Ireland, a large stand-alone maternity hospital can achieve a low maternal mortality ratio, according to international standards, despite an increase in cesarean rate over the past 2 decades. There was no evidence that the increased cesarean rate had an adverse impact on maternal mortality ratio.
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Int J Gynaecol Obstet · Feb 2012
Randomized Controlled TrialEffect of coadministration of dexamethasone with intrathecal morphine on postoperative outcomes after cesarean delivery.
To investigate the effect of intrathecal dexamethasone administered with intrathecal morphine at cesarean delivery on postoperative adverse effects and patient satisfaction. ⋯ Intrathecal administration of dexamethasone with morphine significantly decreased PONV and improved overall patient satisfaction after cesarean delivery.
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Int J Gynaecol Obstet · Feb 2012
Obstetrician-gynecologists' knowledge of and attitudes toward medical abortion in Guatemala.
To characterize the legal and clinical knowledge of Guatemalan obstetrician-gynecologists (OB/GYNs) regarding medical abortion and to determine factors associated with approval of its use for specific indications. ⋯ Current indications for abortion under Guatemalan law, as well as OB/GYN practices and beliefs regarding medical abortion, are hindering women's access to safe medical abortion and, therefore, potential reductions in maternal morbidity and mortality. Future research should aim to identify whether and why Guatemalan OB/GYNs are unfamiliar with these drugs, prefer to use other methods, or are completely against abortion.
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Int J Gynaecol Obstet · Jan 2012
Misoprostol for postpartum hemorrhage: moving from evidence to practice.
Clinical and operational evidence indicates that misoprostol is a safe and effective technology for addressing postpartum hemorrhage, a major cause of maternal death. This research has not yet been translated into effective policies, programs, and practice in many parts of the world. Efforts to expand evidence-based use of misoprostol are often complicated by misoprostol's range of indications, insufficient availability, a lack of evidence-based guidelines and provider training, and misconceptions about the drug. The medical and health policy communities need to work together to translate research findings into changes in policy, knowledge, and clinical practice so that we can deliver on the world's promise to improve maternal health.