BJOG : an international journal of obstetrics and gynaecology
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Randomized Controlled Trial Multicenter Study
Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial.
Decreasing the prevalence of severe postpartum haemorrhages (PPH) is a major obstetrical challenge. These are often considered to be associated with substandard initial care. Strategies to increase the appropriateness of early management of PPH must be assessed. We tested the hypothesis that a multifaceted intervention aimed at increasing the translation into practice of a protocol for early management of PPH, would reduce the incidence of severe PPH. ⋯ This educational intervention did not affect the rate of severe PPH as compared with control units, although it improved some practices.
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Multicenter Study Comparative Study
Effect of Swedish snuff (snus) on preterm birth.
To compare the effects of Swedish snuff and cigarette smoking on risks of preterm birth. ⋯ The use of Swedish snuff was associated with increased risks of very and moderately preterm birth with both spontaneous and induced onsets. Swedish snuff is not a safe alternative to cigarette smoking during pregnancy.
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Multicenter Study
Termination of pregnancy for fetal anomaly after 23 weeks of gestation: a European register-based study.
To determine the prevalence of termination of pregnancy for fetal anomaly (TOPFA) after 23 weeks of gestation in European countries, and describe the spectrum of anomalies for which late TOPFA is recorded. ⋯ Late TOPFA is rare in Europe, and varies in prevalence between countries. Compared with earlier TOPFA, late TOPFA is more often performed for a nonchromosomal isolated major structural anomaly and less often for a fetus with a chromosomal syndrome or multiple anomalies.
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Multicenter Study
Increased risk of low birthweight and small for gestational age infants among women with tuberculosis.
As the relationship between tuberculosis (TB) and fetal outcomes remains unclear, this study used a 3-year nationwide population-based data set to determine the risk of adverse pregnancy outcomes [low birthweight (LBW), preterm birth and small for gestational age (SGA) infants] among women with TB. ⋯ We concluded that women diagnosed with TB during pregnancy are at increased risk for having LBW and SGA babies, compared with unaffected mothers. We suggest that clinicians should make women with TB aware of the potential risks before planning a child.
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To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. ⋯ Maternal mortality in the Netherlands has increased since 1983-1992. Pre-eclampsia remains the number one cause. Groups at higher risk for complications during pregnancy should be better identified early in pregnancy or before conception, in order to receive preconception advice and more frequent antenatal visits. There is an urgent need for the better education of women and professionals concerning the danger signs, and for the training of professionals in order to improve maternal health care.