American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2007
Randomized Controlled Trial Multicenter StudyA French randomized controlled trial of ST-segment analysis in a population with abnormal cardiotocograms during labor.
The purpose of this study was to assess whether knowledge of ST-segment analysis was associated with a reduction in operative deliveries for nonreassuring fetal status (NRFS) or with a need for at least 1 scalp pH during labor. ⋯ In a population with abnormal cardiotocography in labor, cardiotocography combined with ST-segment analysis was not associated with a reduction in operative deliveries for NRFS. The proportion of infants without scalp pH sampling during labor increased substantially, however.
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Am. J. Obstet. Gynecol. · Sep 2006
Multicenter StudyAre the Agency for Healthcare Research and Quality obstetric trauma indicators valid measures of hospital safety?
The objective of the study was to examine whether the United States Agency for Health Care Research and Quality obstetric patient safety indicators are significantly affected by patient-specific and hospital-level characteristics not related to the safety environment. ⋯ The risk of obstetric trauma is significantly influenced by both patient and hospital characteristics and is not a good indicator of patient safety.
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Am. J. Obstet. Gynecol. · Jul 2006
Multicenter StudySTAN in clinical practice--the outcome of 2 years of regular use in the city of Gothenburg.
The purpose of this study was to monitor the introduction of the STAN-methodology (Noventa Medical, Moelndal, Sweden). ⋯ Increasing STAN usage provided consistent improvements in fetal outcome equalling those noted in the Swedish randomized controlled trial (RCT) without increasing operative interventions for fetal distress.
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Am. J. Obstet. Gynecol. · Mar 2006
Randomized Controlled Trial Multicenter StudyThe effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial).
The objective of the study was to compare operative delivery rates for nonreassuring fetal status between 2 groups of laboring women: those having conventional cardiotocograph monitoring and those having cardiotocograph monitoring plus fetal pulse oximetry. ⋯ The use of fetal pulse oximetry to augment fetal well-being assessment during labor resulted in a statistically significant reduction in the operative intervention for nonreassuring fetal status, compared with the use of conventional cardiotocograph monitoring alone. This reduction was achieved with no significant difference in neonatal outcomes.
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Am. J. Obstet. Gynecol. · Sep 2005
Multicenter StudyProgesterone for prevention of recurrent preterm birth: impact of gestational age at previous delivery.
Preterm birth occurs in 1 of 8 pregnancies and may result in significant morbidity and mortality. 17-alpha hydroxyprogesterone caproate (17-OHP caproate) has been found to be efficacious in reducing the risk of subsequent preterm delivery in women who have had a previous spontaneous preterm birth (sPTB). This analysis was undertaken to evaluate if 17-OHP caproate therapy works preferentially depending on the gestational age at previous spontaneous delivery. We hypothesized that treatment with 17-OHP caproate is more effective in prolonging pregnancy depending on the gestational age of the earliest previous preterm birth (20-27.9, 28-33.9 vs 34-36.9 weeks). ⋯ 17-OHP caproate therapy given to prevent recurrent PTB is associated with a prolongation of pregnancy overall, and especially for women with a previous spontaneous PTB at <34 weeks.