BJOG : an international journal of obstetrics and gynaecology
-
Multicenter Study Comparative Study
Effects of environmental tobacco smoke on perinatal outcomes: a retrospective cohort study.
To evaluate the effects of environmental tobacco smoke (ETS) on perinatal outcomes. ⋯ Exposure of nonsmoking pregnant women to ETS is associated with a number of adverse perinatal outcomes including lower birthweight, smaller head circumference and stillbirth, as well as shorter birth length. This information is important for women, their families and healthcare providers, and reinforces the continued need for increased public policy and education on prevention of exposure to ETS.
-
Multicenter Study
Specific second-line therapies for postpartum haemorrhage: a national cohort study.
To describe the characteristics, management and outcomes of women undergoing specific second-line therapies for postpartum haemorrhage (PPH). ⋯ Overall, a quarter of women treated had a hysterectomy as a rescue therapy. Uterine compression sutures and interventional radiological techniques have higher success rates than rFVIIa and pelvic vessel ligation. However, cases managed with rFVIIa and ligation tend to be more clinically complex.
-
Review of the literature regarding the relation between the timing of epidural analgesia and the rate of caesarean or instrumental vaginal deliveries. ⋯ This systematic review showed no increased risk of caesarean delivery or instrumental vaginal delivery for women receiving early epidural analgesia at cervical dilatation of 3 m or less in comparison with late epidural analgesia.
-
To critically evaluate any benefit or harm for the mother and her baby of Valsalva pushing versus spontaneous pushing in the second stage of labour. ⋯ The evidence from our review does not support the routine use of Valsalva pushing in the second stage of labour. The Valsalva pushing method has a negative effect on urodynamic factors according to one study. The duration of the second stage of labour is shorter with Valsalva pushing but the clinical significance of this finding is uncertain. The primary studies are sparse, diverse and some flawed. Further research seems warranted. In the mean time supporting spontaneous pushing and encouraging women to choose their own method of pushing should be accepted as best clinical practice.