BJOG : an international journal of obstetrics and gynaecology
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Obstetric haemorrhage is a significant contributor to worldwide maternal morbidity and mortality. Guidelines for the management of postpartum haemorrhage (PPH) involve a stepwise escalation of pharmacological and eventual surgical approaches. ⋯ There are various balloons available including the Bakri, Foley, Sengstaken-Blakemore, Rusch and condom catheter. This paper reviews these uterine tamponade technologies in the management of PPH.
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Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas. ⋯ This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment.
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Over the past decade, there has been an exponential growth of robot-assisted procedures and of publications concerning robotic-assisted laparoscopic surgery. From a review of the available literature, it becomes apparent that this technology is safe and allows more complex procedures in many fields of surgery, be it at relatively high costs. Although randomised controlled trials in gynaecology are lacking, available evidence suggests that particularly in gynaecology robotic surgery might not only reduce morbidity but also be cost effective if performed in high-volume centres. Training in robotic surgery and programs for safe and effective implementation are necessary.
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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.
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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.