European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2009
Attitude towards cessation among French pregnant smokers: explaining the poor uptake of specialised support.
This study investigated pregnant smokers' profile and attitude towards cessation to explain who stops smoking during pregnancy and who is unsuccessful. ⋯ Despite being offered professional help, many pregnant heavy smokers do not feel ready to stop smoking. Their attitude towards cessation illustrates ambivalence. There is thus a need for coordinated efforts between antenatal care providers and smoking treatment specialists in order to enhance pregnant smokers' motivation to quit.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2009
ReviewSplenic artery aneurysm rupture in pregnancy.
Splenic artery aneurysm (SAA) is the commonest visceral artery aneurysm. It is diagnosed more frequently in younger women, with up to 95% presenting during pregnancy. Rupture is associated with a disproportionately high maternal and fetal mortality. ⋯ The maternal death rate was 21.9% (n=7), and fetal death rate was 15.6% (n=5). Most cases are not diagnosed until surgery following rupture. Ruptured SAA should be considered in the differential diagnosis of a pregnant patient with severe and unexplained abdominal pain.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2009
Review Meta AnalysisPreterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses.
Our objective was to determine the risks of preterm birth (PTB) and low birth weight (LBW) in singletons conceived through in vitro fertilization (IVF)+/-intracytoplasmic sperm injection (ICSI) compared to spontaneously conceived singletons after matching or controlling for at least maternal age. The MOOSE guidelines for meta-analysis of observational studies were followed. Medline and Embase were searched using comprehensive search strategies. ⋯ After matching or controlling for maternal age and often other factors, compared to spontaneously conceived singletons, IVF singletons had increased risks of our two primary outcomes, PTB (RR 1.84, 95% CI 1.54, 2.21) and LBW (<2500 g, RR 1.60, 95% CI 1.29, 1.98). Singletons conceived through IVF or IVF/ICSI were at increased risk for late PTB (32-36 weeks, RR 1.52, 95% CI 1.01, 2.30), moderate PTB <32-33 weeks (RR 2.27, 95% CI 1.73, 2.97), very LBW (<1500 g, RR 2.65, 95% CI 1.83, 3.84), and intrauterine growth restriction (RR 1.45, 95% CI 1.04, 2.00), lower birth weights (-97 g, 95% CI -161 g, -33 g) and shorter mean gestations (-0.6 weeks, 95% CI -0.9 weeks, -0.4 weeks). In conclusion, IVF singletons have significantly increased risks of PTB, LBW and other adverse perinatal outcomes compared to spontaneously conceived singletons after matching or controlling for maternal age at least.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2009
Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: a questionnaire study.
Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. ⋯ CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.