International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Dec 2015
Randomized Controlled TrialA randomized placebo-controlled trial of preoperative tranexamic acid among women undergoing elective cesarean delivery.
To study the efficacy and safety of preoperative intravenous tranexamic acid to reduce blood loss during and after elective lower-segment cesarean delivery. ⋯ Preoperative administration of tranexamic acid safely reduces blood loss during elective lower-segment cesarean delivery. Australian New Zealand Clinical Trials Registry:ACTRN12615000312549.
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Int J Gynaecol Obstet · Nov 2015
Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program.
To validate a simplified objective structured clinical examination (OSCE) tool for evaluating the competency of birth attendants in low-resource countries who have been trained in neonatal resuscitation by the Helping Babies Breathe (HBB) program. ⋯ The simplified OSCE tool could facilitate efficient implementation of national-level HBB programs. Limitations in inter-rater reliability might be improved through additional training.
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Int J Gynaecol Obstet · Oct 2015
ReviewChallenges affecting access to cesarean delivery and strategies to overcome them in low-income countries.
Most maternal deaths occur in low-income countries where access to appropriate medical care is restricted. ⋯ Maternal and infant mortality rates could be lowered by increasing access to cesarean delivery. Additional education of patients and providers, establishment of more heath facilities, and governmental support of obstetric care could help to reach this goal.
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Int J Gynaecol Obstet · Oct 2015
Randomized Controlled Trial Comparative StudyA randomized trial of artesunate-amodiaquine versus artemether-lumefantrine for the treatment of acute uncomplicated malaria in pregnancy.
To compare the artesunate-amodiaquine and artemether-lumefantrine combinations in the treatment of acute uncomplicated falciparum malaria during pregnancy. ⋯ Efficacies of the regimens are similar among pregnant women. However, adverse effects are more common with artesunate-amodiaquine. Pan-African Clinical Trial Registry: PACTR201310000484185.
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The end of the Millennium Development Goal (MDG) era was marked in 2015, and while maternal and child mortality have been halved, MGD 4 and MDG 5 are off-track at the global level. Reductions in neonatal death rates (age <1 month) lag behind those for post-neonates (age 1-59 months), and stillbirth rates (omitted from the MDGs) have been virtually unchanged. Hence, almost half of under-five deaths are newborns, yet about 80% of these are preventable using cost-effective interventions. ⋯ The plan provides an evidence-based framework for scaling up of essential interventions across the continuum of care with the potential to prevent the deaths of approximately three million newborns, mothers, and stillbirths every year. Two million stillbirths and newborns could be saved by care at birth and care of small and sick newborns, giving a triple return on investment at this key time. Commitment, investment, and intentional leadership from global and national stakeholders, including all healthcare professionals, can make these ambitious goals attainable.