Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Jul 2014
Review Meta Analysis Comparative StudyActive management of the third stage of labor with and without controlled cord traction: a systematic review and meta-analysis of randomized controlled trials.
To determine the specific effect of controlled cord traction in the third stage of labor in the prevention of postpartum hemorrhage. ⋯ Controlled cord traction appears to reduce the risk of any postpartum hemorrhage in a general sense, as well as manual removal of the placenta and the duration of the third stage of labor. However, the reduction in the occurrence of severe postpartum hemorrhage, need for additional uterotonics and blood transfusion is not statistically significant.
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Acta Obstet Gynecol Scand · Jul 2011
Review Meta AnalysisRepeated antenatal corticosteroid treatment: a systematic review and meta-analysis.
To systematically review the efficacy and safety of repeated antenatal corticosteroid on neonatal morbidity, growth and later development. ⋯ Repeated corticosteroid treatment decreased the risk of respiratory distress syndrome among preterm infants. Weekly or biweekly repeated betamethasone restricted intrauterine growth, which raises concerns about long-term consequences on neurodevelopment and metabolism. More follow-up studies are needed to confirm the long-term safety of repeated betamethasone.
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Acta Obstet Gynecol Scand · Jan 2009
Review Meta AnalysisSystematic review of progesterone for the prevention of preterm birth in singleton pregnancies.
A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. ⋯ In women with a singleton pregnancy and previous preterm delivery, progesterone reduces the rates of preterm delivery before 32 weeks, perinatal death, as well as respiratory distress syndrome and necrotizing enterocolitis in the newborn. Women with a short cervix or preterm labor may also benefit from progesterone, but further evidence is needed to support such a recommendation. Follow-up studies should focus on possible metabolic complications in the mother or the offspring.
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Acta Obstet Gynecol Scand · Aug 2005
Review Meta Analysis Comparative StudyA meta-analysis of upright positions in the second stage to reduce instrumental deliveries in women with epidural analgesia.
Epidural analgesia is associated with an increased risk of instrumental delivery. We, in this study, present a systematic review in order to assess the effectiveness of maintaining an upright position during the second stage of labor to reduce instrumental deliveries among women choosing epidural analgesia. The study population included women with uncomplicated pregnancies at term with epidural analgesia established in the first stage of labor. ⋯ There were insufficient data to show a significant benefit from upright positions in the second stage of labor for women who choose epidural or to evaluate safety aspects. However the magnitude of the reductions in instrumental delivery and cesarean section warrants an adequately powered randomized, controlled trial to fully evaluate the practice of upright positions in the second stage for women with an epidural.