BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study
Estimation of population-based incidence of pregnancy-related illness and mortality (PRIAM) in two districts in West Java, Indonesia.
We introduce a new and untested approach for the measurement of life-threatening maternal morbidity in populations where not all women give birth in a health facility. By defining complications at the very extreme end of the severity spectrum, we postulate that its count in hospitals can be used to represent the incidence in the general population. ⋯ The approach tested in this study--relying on conditions that are 'absolutely' life-threatening such that their count in hospitals can be used to represent the incidence in the general population--is promising but needs further testing in populations with varied disease epidemiology and access to care. Continued investments in hospital-based audits of life-threatening morbidity may ultimately improve the quality and reliability of information on obstetric complications and facilitate the development of rigorous and standard criteria for the definition of life-threatening morbidity.
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Multicenter Study Clinical Trial
A prospective cohort study of maternal and neonatal morbidity in relation to use of episiotomy at operative vaginal delivery.
To evaluate the maternal and neonatal morbidity of operative vaginal delivery in relation to the use of episiotomy. ⋯ The use of episiotomy did not reduce or greatly increase anal sphincter tears and was associated with greater maternal and neonatal morbidity. This may reflect the complexity of deliveries. The role of episiotomy at operative vaginal delivery should be evaluated in a randomised controlled trial.
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Multicenter Study Comparative Study
Vaginal delivery compared with elective caesarean section: the views of pregnant women and clinicians.
To quantify the risk of morbidity from vaginal delivery (VD) that pregnant women would be prepared to accept before requesting an elective caesarean section and to compare these views with those of clinicians. ⋯ Pregnant women were willing to accept significantly higher risks of potential complications of VD than clinicians involved in their care. Pregnant women's views were more closely aligned to midwives than to medical specialists.
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Randomized Controlled Trial Multicenter Study
Titrated low-dose vaginal and/or oral misoprostol to induce labour for prelabour membrane rupture: a randomised trial.
To evaluate the clinical effectiveness and safety of titrated low-dose misoprostol for induction of labour (IOL) in the presence of prelabour rupture of membranes (PROM). ⋯ Titrated low-dose misoprostol may be a reasonable alternative for IOL in the presence of PROM, particularly in women with an unfavourable cervix. Safety and rare serious adverse events could not be evaluated in a trial of this size.
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Review Multicenter Study Comparative Study
Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis.
The efficacy and safety of mesh/graft in surgery for anterior or posterior pelvic organ prolapse is uncertain. ⋯ Evidence for most outcomes was too sparse to provide meaningful conclusions. Rigorous long-term RCTs are required to determine the comparative efficacy of using mesh/graft.