BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study
Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage.
To identify women undergoing peripartum hysterectomy in the UK and to describe the causes, management and outcome of the associated haemorrhage. ⋯ For each woman who dies in the UK following peripartum hysterectomy, more than 150 survive. The associated haemorrhage is managed in a variety of ways and not universally according to existing guidelines. Further investigation of the outcomes following some of the more innovative therapies for control of haemorrhage is needed.
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Multicenter Study
Late start of antenatal care among ethnic minorities in a large cohort of pregnant women.
The objectives of this study were to investigate the difference in timing of the first antenatal visit between ethnic groups and to explore the contribution of several noneconomic risk factors. ⋯ We observed a disturbing delay by all ethnic groups in the timing of their first antenatal visit. In women born in non-Dutch-speaking, non-Western countries, these differences were explained by a higher prevalence of the risk factors: poor language proficiency in Dutch, lower maternal education and more teenage pregnancies. In women born in Dutch-speaking, non-Western countries, the disparities cannot be explained by higher prevalence of these risk factors, indicating that cultural factors play a role.
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Randomized Controlled Trial Multicenter Study
PLUTO trial protocol: percutaneous shunting for lower urinary tract obstruction randomised controlled trial.
The primary objective is to determine whether intrauterine vesicoamniotic shunting for fetal bladder outflow obstruction, compared with conservative, noninterventional care, improves prenatal and perinatal mortality and renal function. The secondary objectives are to determine if shunting for fetal bladder outflow obstruction improves perinatal morbidity, to determine if improvement in outcomes is related to prognostic assessment at diagnosis and, if possible, derive a prognostic risk index and to determine the safety and long-term efficacy of shunting. ⋯ Wellbeing of Women. ESTIMATED COMPLETION DATE: September 2010. TRIAL ALGORITHM: [flowchart: see text].
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Multicenter Study
Variations in policies for management of the third stage of labour and the immediate management of postpartum haemorrhage in Europe.
The EUropean Project on obstetric Haemorrhage Reduction: Attitudes, Trial, and Early warning System (EUPHRATES) is a set of five linked projects, the first component of which was a survey of policies for management of the third stage of labour and immediate management of postpartum haemorrhage following vaginal birth in Europe. ⋯ Considerable variations were observed between and within countries in policies for management of the third stage of labour. Variations were observed, but to a lesser extent, in policies for the immediate management of postpartum haemorrhage after vaginal birth. In both cases, policies about the pharmacological agents to be used varied widely.
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Randomized Controlled Trial Multicenter Study
The Control of Hypertension In Pregnancy Study pilot trial.
To determine whether 'less tight' (versus 'tight') control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups. ⋯ The CHIPS pilot trial confirms the feasibility and importance of a large definitive trial to determine the effects of less tight control on serious perinatal and maternal complications.