Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2007
ReviewWITHDRAWN: Prophylactic versus selective blood transfusion for sickle cell anaemia during pregnancy.
Sickle cells have a shorter life span than normal red blood cells. It has been suggested that pregnancy complications for women with sickle cell anaemia may be reduced by regular blood transfusions. The aim is to maintain haemoglobin at 60-70% of the normal total. ⋯ There is not enough evidence to draw conclusions about the prophylactic use of blood transfusion for sickle cell anaemia during pregnancy.
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Folate depletion may result in anaemia during pregnancy. ⋯ Folate supplementation during pregnancy appears to improve haemoglobin levels and folate status. There is not enough evidence to evaluate whether folate supplementation has any effect, beneficial or harmful, on clinical outcomes for mother and baby.
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Cochrane Db Syst Rev · Jul 2007
ReviewWITHDRAWN: Treatments for breast engorgement during lactation.
National surveys have shown that painful breasts are the second most common reason for giving up breastfeeding in the first two weeks after birth in the UK. One factor contributing to such pain can be breast engorgement. Views differ as to how engorgement arises, although restrictive feeding patterns in hospital are likely to have contributed in the past. These differing views are reflected in the range of solutions offered to treat engorgement in breastfeeding mothers and these treatments are assessed in this review. ⋯ Cabbage leaves and gel packs were equally effective in the treatment of engorgement. Since both cabbage extract and placebo cream were equally effective, the alleviation in symptoms may be brought about by other factors, such as breast massage. Ultrasound treatment is equally effective with or without the ultra-wave emitting crystal, therefore its effectiveness is more likely to be due to the effect of radiant heat or massage. Pharmacologically, oxytocin was not an effective engorgement treatment while Danzen and bromelain/trypsin complex significantly improved the symptoms of engorgement. Initial prevention of breast engorgement should remain the key priority.
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Anthrax is a potentially fatal bacterial disease with cutaneous, inhalation, and gastrointestinal forms. Three anthrax vaccines are commercially available, but their comparative effectiveness and safety is not clear. ⋯ Killed anthrax vaccines appear to be effective in reducing the risk of contracting anthrax with low rate of adverse effects. Further research should be carried out on the short and long term safety effects of available vaccines and if possible their effectiveness.
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Cochrane Db Syst Rev · Jul 2007
ReviewWITHDRAWN: Routine ultrasound in late pregnancy (after 24 weeks' gestation).
Diagnostic ultrasound is used selectively in late pregnancy where there are specific clinical indications. However, the value of routine late pregnancy ultrasound screening in unselected populations is controversial. The rationale for such screening would be the detection of clinical conditions which place the fetus or mother at high risk, which would not necessarily have been detected by other means such as clinical examination, and for which subsequent management would improve perinatal outcome. ⋯ Based on existing evidence, routine late pregnancy ultrasound in low risk or unselected populations does not confer benefit on mother or baby. There is a lack of data about the potential psychological effects of routine ultrasound in late pregnancy, and the effects on both short and long term neonatal and childhood outcome. Placental grading in the third trimester may be valuable, but whether reported results are reproducible remains to be seen, and future research of late pregnancy ultrasound should include evaluation of placental textural assessment.