Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Jan 2006
Randomized Controlled TrialIdentifying hazardous alcohol consumption during pregnancy: implementing a research-based model in real life.
It has been repeatedly demonstrated that hazardous alcohol use during pregnancy is rarely detected in regular antenatal care, and that detection can be markedly improved using systematic screening. A major challenge is to translate research-based strategies into regular antenatal care. Here, we examined whether a screening strategy using the Alcohol Use Disorder Test (AUDIT) and time-line follow-back (TLFB) could be implemented under naturalistic conditions and within available resources; and whether it would improve detection to the extent previously shown in a research context. ⋯ We confirm previous findings that alcohol use during pregnancy is more extensive in Sweden than has generally been realized. Systematic screening using AUDIT and TLFB detects hazardous use in a manner which regular antenatal care does not. This remains true under naturalistic conditions, following minimal training of regular antenatal care staff, and can be achieved with minimal resources. The proposed strategy appears attractive for broad implementation.
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To describe indications for cesarean section for extremely preterm delivery, peri- and postoperative complications and perinatal outcome. ⋯ In balancing the risks of complications related to the surgical procedure against the purported benefits of the infant, this study adds support to the argument to deliver even extremely preterm infants by cesarean section.
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Acta Obstet Gynecol Scand · Jan 2006
New ultrasonographic criteria for the prenatal diagnosis of Chiari type 2 malformation.
During prenatal ultrasonography, characteristic malformations including the lemon sign, the banana sign, and obliteration of the cisterna magna are widely used for diagnosis of Chiari type 2 malformation (Arnold Chiari malformation). However, these signs are often obscured by 25 weeks' gestation. Here, we report an investigation of ultrasonographic markers of Chiari type 2 malformation for diagnosis after 24 weeks' gestation. ⋯ At 24 weeks' gestation or later, Chiari type 2 malformation can be precisely and efficiently diagnosed by two new characteristics detected during ultrasonography: triangular shape and quadrilateral angular shape.
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Acta Obstet Gynecol Scand · Jan 2006
Performance of acupuncture as labor analgesia in the clinical setting.
Three randomized controlled trials have shown that acupuncture during labor can reduce the use of epidural analgesia and meperidine. To supplement these trials, we have designed an observational study to answer the research question: "Do laboring women in a normal hospital setting who receive acupuncture require less epidural analgesia than those who do not receive acupuncture?" ⋯ Women having acupuncture as labor analgesia in the clinical setting have a reduced use of epidural analgesia.
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Acta Obstet Gynecol Scand · Jan 2006
Outcome in obstetric care related to oxytocin use. A population-based study.
The purpose of this study was to investigate the delivery outcome in relation to oxytocin use in labor. ⋯ In deliveries with relatively short duration (< or =12 h), a significant association was seen between oxytocin use and adverse outcome. Even though the results are difficult to interpret, the significant difference between the use of oxytocin in different hospitals, as well as the increase of oxytocin use over time, calls for a randomized controlled study to elucidate the advantages and disadvantages of oxytocin use during labor and delivery.