Current opinion in obstetrics & gynecology
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Curr. Opin. Obstet. Gynecol. · Apr 2015
Review Observational StudyElective cesarean delivery at 38 and 39 weeks: neonatal and maternal risks.
The purpose of this article is to critically review the existing literature with regard to neonatal and maternal outcomes after elective cesarean delivery at 38 completed weeks versus 39 completed weeks of gestation. ⋯ http://links.lww.com/COOG/A18.
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Curr. Opin. Obstet. Gynecol. · Apr 2015
ReviewReducing maternal anxiety and stress in pregnancy: what is the best approach?
To briefly review results of the latest research on approaching antenatal maternal anxiety and stress as distinct constructs within a broad spectrum of maternal antenatal distress and the preventive strategic role of the maternal healthcare practitioner. ⋯ A shift in perception and attitude towards a broad theoretical and practical approach of antenatal maternal mental health and well-being is required. Case finding with subsequent selective and indicated preventive strategies during pregnancy would conform to this approach and are evidence based.
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Curr. Opin. Obstet. Gynecol. · Feb 2015
ReviewNew clinical research strategies for rare gynecologic malignancies.
More than 50% of all gynecologic cancers can be classified as rare tumors (defined as an incidence of <6 per 100 000) and as such represent a major challenge for clinicians. ⋯ This requires international partnerships, harmonization of treatment recommendations, and international collaborations to overcome existing regulatory barriers in international trials. Whereas randomized trials may be possible in some rare tumor types, there are others for which conducting even single arm studies may be challenging. For these very rare tumors, robust collection of data through national registries could lead to improvements in treatment.
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Curr. Opin. Obstet. Gynecol. · Dec 2014
ReviewDoes current evidence support the use of intraoperative cell salvage in reducing the need for blood transfusion in caesarean section?
An important cause of maternal morbidity and direct maternal death is obstetric haemorrhage at caesarean section. Concerns regarding allogeneic blood safety, limited blood supplies and rising health costs have collectively generated enthusiasm for the utility of methods intended to reduce the use of allogeneic blood transfusion in cases of haemorrhage at caesarean section. This can be achieved by intraoperative cell salvage (IOCS). The aim of this review is to summarize and examine the evidence for the efficacy of IOCS during caesarean section, in women at risk of haemorrhage, in reducing the need for allogeneic blood transfusion. ⋯ Current evidence is limited to reported case series and two small controlled studies. Overall, IOCS may reduce the need for allogeneic blood transfusions during caesarean section. Future large randomized trials are required to assess effectiveness, cost effectiveness and safety. The results of the current ongoing SALVO (A randomised controlled trial of intra-operative cell salvage during caesarean section in women at risk of haemorrhage) trial will shed light on these aspects.
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This article presents an overview of the most recent scientific evidence of the role of maternal vitamin D on pregnancy outcomes, with a particular emphasis on those articles in the English-language literature published between 1 January 2013 and 1 July 2014 in PubMed. ⋯ Recent evidence supports that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. Interventional studies demonstrate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status. Large, well designed, multicentre RCTs are required to determine whether vitamin D supplementation in pregnant women with low vitamin D status reduces the risk of adverse pregnancy outcomes.