Current opinion in obstetrics & gynecology
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Curr. Opin. Obstet. Gynecol. · Dec 2014
Review Historical ArticleBack to the future: a history of ACOG in social media's golden age.
To chronicle a medical professional society's adoption of innovation and to describe themes pertinent to the adoption. ⋯ Through a thoughtful and dedicated process, the ACOG Fellow and Junior Fellow leadership partnered to navigate the appropriate balance of innovation and prudence that propelled ACOG into social media's golden age, and paved the pathway for more progressive institutional changes.
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This article presents an overview of the most recent scientific evidence of the role of maternal vitamin D on pregnancy outcomes, with a particular emphasis on those articles in the English-language literature published between 1 January 2013 and 1 July 2014 in PubMed. ⋯ Recent evidence supports that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. Interventional studies demonstrate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status. Large, well designed, multicentre RCTs are required to determine whether vitamin D supplementation in pregnant women with low vitamin D status reduces the risk of adverse pregnancy outcomes.
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Curr. Opin. Obstet. Gynecol. · Dec 2014
Review Meta AnalysisPlanned caesarean section or trial of vaginal delivery? A meta-analysis.
This systematic review with meta-analysis aims to determine whether maternal outcomes are better with antenatal choice to give birth by caesarean section compared to vaginal birth, in singleton pregnancies in low-risk women without a subsequent pregnancy. The main outcome measures used were as follows: postpartum haemorrhage, postnatal depression, urinary incontinence and maternal mortality. ⋯ On the basis of the current research and the findings of this review, planned caesarean section is associated with a lower risk of developing urinary incontinence symptoms postpartum or having a blood transfusion yet conversely results showed an increased risk of postpartum haemorrhage. The synthesized data are not applicable to clinical practice; however, they prompt much further investigation into planned delivery and its associated morbidity risk.
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Curr. Opin. Obstet. Gynecol. · Dec 2014
ReviewDoes current evidence support the use of intraoperative cell salvage in reducing the need for blood transfusion in caesarean section?
An important cause of maternal morbidity and direct maternal death is obstetric haemorrhage at caesarean section. Concerns regarding allogeneic blood safety, limited blood supplies and rising health costs have collectively generated enthusiasm for the utility of methods intended to reduce the use of allogeneic blood transfusion in cases of haemorrhage at caesarean section. This can be achieved by intraoperative cell salvage (IOCS). The aim of this review is to summarize and examine the evidence for the efficacy of IOCS during caesarean section, in women at risk of haemorrhage, in reducing the need for allogeneic blood transfusion. ⋯ Current evidence is limited to reported case series and two small controlled studies. Overall, IOCS may reduce the need for allogeneic blood transfusions during caesarean section. Future large randomized trials are required to assess effectiveness, cost effectiveness and safety. The results of the current ongoing SALVO (A randomised controlled trial of intra-operative cell salvage during caesarean section in women at risk of haemorrhage) trial will shed light on these aspects.