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 2011
Randomized Controlled TrialEffect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery.
To assess the effect of intravenous tranexamic acid on blood loss during and after cesarean delivery. ⋯ Intravenous tranexamic acid decreased intra- and postoperative blood loss and oxytocin administered in patients delivered by cesarean.
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To review the use of blood cell salvage performed during cesarean delivery. ⋯ Cell salvage was acceptable, beneficial, and without adverse events in both high-risk elective cesareans and emergency cesareans for unexpected hemorrhaging. The skills refined during use of cell salvage in elective cesareans were crucial for successful implementation during emergency situations.
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Int J Gynaecol Obstet · Nov 2011
Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus.
Gestational diabetes mellitus (GDM) is increasingly recognized as an opportunity for early prevention of diabetes and other diseases over the lifespan, and may be responsible for up to 30% of cases of type 2 diabetes. A newly developed mathematical model (the GDModel) provides provisional estimates of the cost and health impact of various GDM screening and management choices, and calculates averted disability-adjusted life-years (DALYs). The model was piloted in 5 different healthcare facilities in India and Israel. ⋯ Some input values are currently being refined. Nevertheless, the current findings of cost-savings or favorable cost-effectiveness are robust to a wide range of plausible input values, including highly unfavorable values. The GDModel will be further developed into a user-friendly tool that can guide policy-makers on decisions regarding GDM screening strategies and guidelines.
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Int J Gynaecol Obstet · Oct 2011
Practice GuidelineThe combination of mifepristone and misoprostol for the termination of pregnancy.
The combination of 200mg of mifepristone followed by 25 μg to 800 μg (depending on gestational age) of misoprostol has been shown to be effective for the termination of pregnancy throughout gestation. The dose of misoprostol should be reduced as gestational age increases. ⋯ The course of treatment and prerequisites for medical abortion and recommended mifepristone and misoprostol regimens for different gestational ages are described, along with the side effects, management of complications, and postabortion care. The use of the mifepristone-misoprostol combination regimen for induction of labor in cases of fetal death is also described.