Journal of midwifery & women's health
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It is important to recognize excessive blood loss during childbirth, which is a significant cause of morbidity and mortality. This article reviews methods to measure blood loss that could be used during childbirth. PubMed, CINAHL, and MEDLINE databases were searched using the phrases "blood loss" and "measurement." The bibliographies of publications were scanned for applicable references. ⋯ Photometry is the most precise, but also the most expensive and complex to use. A variety of miscellaneous methods are presented, but none is a practical or reliable method. Visual estimation of blood loss is so inaccurate that its continued use in practice is questionable and it should not be used in research to evaluate treatment.
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J Midwifery Womens Health · Nov 2009
Review Case ReportsAssessment and management of bleeding in the first trimester of pregnancy.
Vaginal bleeding occurs in 15% to 25% of early pregnancies. While 50% of women who have vaginal bleeding in the first trimester of pregnancy will continue to have a viable pregnancy, the event creates significant anxiety for the woman and can be managed in a multitude of ways. ⋯ This article reviews early pregnancy development, etiologies of vaginal bleeding in the first trimester, strategies for evaluation, and recognition and management of the main diagnostic considerations. Case study examples illustrating the complexity of the assessment and management of vaginal bleeding in early pregnancy are presented.
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J Midwifery Womens Health · Sep 2009
Third stage of labour care for women at low risk of postpartum haemorrhage.
In normal birth there should be a valid reason to interfere with normal processes. Yet, active management of third stage labor is being imposed on women who have no known risks of postpartum hemorrhage. This article examines the evidence from existing randomised trials comparing active and physiological third stage care for its relevance and validity to the effectiveness of physiological third stage care for women who are at low risk of postpartum hemorrhage. ⋯ These studies are examined in terms of their potential generalisability to women who are at low risk of postpartum hemorrhage. All trials included women who were at high risk of postpartum hemorrhage. The existing research does not provide relevant and valid evidence about the effectiveness of physiological third stage care, as defined by midwives, for women who are at low risk of postpartum hemorrhage.
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J Midwifery Womens Health · Sep 2009
Comparative StudyComparison of induction of labour and expectant management in postterm pregnancy: a matched cohort study.
Randomized clinical trials have shown that induction of labour does not result in higher caesarean delivery rates in women who are postterm. Despite this evidence, the policy of inducing women who are postterm is not generally applied in the Netherlands. This provides us with the opportunity to assess whether the findings from randomized studies can also be observed in nonrandomized studies and to validate these findings in the Dutch obstetric population. ⋯ However, the incidence of shoulder dystocia (RR, 4.3; 95% CI, 1.3-15) and meconium-stained amniotic fluid (RR, 1.8; 95% CI, 1.4-2.3) were higher in the expectant management group. Induction of labour does not result in an increased risk of caesarean delivery in women who are postterm. Because epidemiologic studies suggest an increased risk of perinatal death and birth injury beyond 42 weeks' gestation, induction of labour should be offered to all women who are postterm.
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J Midwifery Womens Health · Sep 2009
Randomized Controlled TrialThe effect of an Iranian herbal drug on primary dysmenorrhea: a clinical controlled trial.
Our objective was to examine the effect of an Iranian herbal drug in the treatment of primary dysmenorrhea. A randomized, double-blind, placebo-controlled pilot trial among 180 female students at Isfahan University dormitory aged 18 to 27 who suffered from primary dysmenorrhea was undertaken. The participants were randomly divided into three groups: herbal drug, mefenamic acid, and placebo. ⋯ The magnitude of the reduction was significantly greater in the SCA group than in the mefenamic acid and placebo groups. Both drugs effectively relieved menstrual pain as compared with the placebo. More clinical trials are needed to establish the efficacy of this herbal drug.