Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Mar 2017
Review Meta AnalysisExercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials.
The incidence of overweight and obesity in pregnancy has risen significantly in the last decades. Overweight and obesity have been shown to increase the risk for some adverse obstetric outcomes. Lifestyle interventions, such as diet, physical activity and behavior changes, may reduce these risks by promoting weight loss and/or preventing excessive weight gain. The possible impact of exercise on the risk of preterm birth (PTB) in overweight or obese women is controversial. Therefore, the aim of our study was to evaluate the effect of exercise on the risk of PTB in overweight or obese pregnant women. ⋯ Overweight and obese women with singleton pregnancy can be counseled that, compared with being more sedentary, aerobic exercise for about 30-60 min three to seven times per week during pregnancy is associated with a reduction in the incidence of PTB. Aerobic exercise in overweight and obese pregnant women is also associated with a significant prevention of gestational diabetes mellitus, and should therefore be encouraged.
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Acta Obstet Gynecol Scand · Apr 2016
Review Meta AnalysisEnhanced recovery pathways in abdominal gynecologic surgery: a systematic review and meta-analysis.
Enhanced recovery pathways have been widely accepted and implemented for different types of surgery. Their overall effect in abdominal gynecologic surgery is still underdetermined. A systematic review and meta-analysis were performed to provide an overview of current evidence and to examine their effect on postoperative outcomes in women undergoing open gynecologic surgery. ⋯ The available evidence based on a broad range of non-randomized studies at high risk of bias suggests that enhanced recovery pathways may reduce length of postoperative hospital stay in abdominal gynecologic surgery.
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Acta Obstet Gynecol Scand · Jan 2016
Review Meta AnalysisTranexamic acid for preventing postpartum blood loss after cesarean delivery: a systematic review and meta-analysis of randomized controlled trials.
There are several published clinical trials of the use of tranexamic acid (TXA) in an obstetric setting, but no consensus on its use or guidelines for management. ⋯ Prophylactic TXA given before cesarean skin incision in women undergoing cesarean delivery, under spinal or epidural anesthesia, significantly decreases blood loss, including postpartum hemorrhage and severe postpartum hemorrhage, in addition to the standard prophylactic oxytocin given after delivery of the neonate. The effect of TXA on thromboembolic events and mortality as well as its use in high-risk women should be investigated further.
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Acta Obstet Gynecol Scand · Jan 2016
Review Meta Analysis Comparative StudyST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring: a systematic review and meta-analysis of randomized trials.
ST waveform analysis was introduced to reduce metabolic acidosis at birth and avoid unnecessary operative deliveries relative to conventional cardiotocography. Our objective was to quantify the efficacy of ST waveform analysis vs. cardiotocography and assess the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation tool. ⋯ Absolute effects of ST waveform analysis were minor, and the clinical significance of the observed reduction in metabolic acidosis is questioned. There is not enough evidence to justify the use of ST waveform analysis in contemporary obstetrics.
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Acta Obstet Gynecol Scand · Apr 2015
Review Meta AnalysisCerclage for short cervix in twin pregnancies: systematic review and meta-analysis of randomized trials using individual patient-level data.
To evaluate the efficacy of cerclage for preventing preterm birth in twin pregnancies with a short cervical length. ⋯ Based on these Level 1 data, cerclage cannot currently be recommended for clinical use in twin pregnancies with a maternal short cervical length in the second trimester. Large trials are still necessary.