BJOG : an international journal of obstetrics and gynaecology
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Comparative Study
Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion-based audit at two Tanzanian rural hospitals.
To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour. ⋯ The lack of use and awareness of evidence-based guidelines led to misinterpretation of clinical signs, fear of simple interventions, and an excessive rate of emergency caesarean sections.
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To examine the association between intended mode of delivery and severe postpartum haemorrhage. ⋯ Compared with intended vaginal delivery, planned caesarean delivery was associated with a reduced risk of severe postpartum haemorrhage indicated by use of red blood cell transfusion.
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To obtain estimates of the rate of spontaneous resolution of heavy menstrual bleeding and to explore any association with specific menstrual symptoms. ⋯ There is a high prevalence, incidence and significant spontaneous rate of resolution of heavy menstrual bleeding in naturally menstruating women during the perimenopausal years. The rates have potential use for individual women, clinical decisions, devising and implementing interventions and planning the care of populations.
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Comparative Study
Impending macrosomia: will induction of labour modify the risk of caesarean delivery?
To compare the annual incidence rates of caesarean delivery between induction of labour and expectant management in the setting of macrosomia. ⋯ In the setting of known birthweight, it appears that induction of labour may reduce the risk of caesarean delivery. Future research should concentrate on clinical and radiological methods to better estimate birthweight to facilitate improved clinical care. These findings deserve examination in a large, prospective, randomised trial.