Latest & greatest articles for pregnancy

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Top results for pregnancy

2101. Low-dose aspirin in prevention and treatment of intrauterine growth retardation and pregnancy-induced hypertension. Italian study of aspirin in pregnancy. (Abstract)

Low-dose aspirin in prevention and treatment of intrauterine growth retardation and pregnancy-induced hypertension. Italian study of aspirin in pregnancy. Meta-analysis of data from several controlled trials has shown that low-dose aspirin reduces the risk of pregnancy-induced hypertension (PIH) and intrauterine growth retardation (IUGR) in women at high risk of these disorders. We have assessed the efficacy of low-dose aspirin in women judged to be at moderate risk. Women were included (...) on prophylactic criteria--age under 18 or over 40 years, mild or moderate chronic hypertension (diastolic pressure between 90 and 110 mm Hg), nephropathy with normal renal function and blood pressure, history of PIH or IUGR, and twin pregnancy--or therapeutic criteria--PIH or early signs of IUGR in current pregnancy. Eligible women were randomly assigned treatment with 50 mg aspirin daily until delivery (583) or no treatment (523); 18 and 46 women, respectively, were lost to follow-up. The groups were well

1993 Lancet Controlled trial quality: uncertain

2102. Termination of pregnancy with reduced doses of mifepristone. World Health Organisation Task Force on Post-ovulatory Methods of Fertility Regulation. Full Text available with Trip Pro

Termination of pregnancy with reduced doses of mifepristone. World Health Organisation Task Force on Post-ovulatory Methods of Fertility Regulation. To compare the abortifacient efficacy and side effects of three doses of the antiprogestin mifepristone plus prostaglandin for termination of early pregnancy.Randomised, double blind multicentre trial.11 departments of obstetrics and gynaecology and of family planning, mostly in university hospitals, in seven countries.1182 women with an early (...) pregnancy (menstrual delay of 7-28 days) requesting abortion.Single doses of 200 mg, 400 mg, or 600 mg mifepristone followed, 48 hours later, by vaginal pessary of 1 mg of the prostaglandin E1 analogue gemeprost.Outcome of treatment; duration and subjective amount of menstrual bleeding; side effects and complications; and concentrations of haemoglobin.Outcome was similar with the three doses of mifepristone. Of the 1151 women with known outcome, 95.5% had a complete abortion (364 (93.8%) of those given

1993 BMJ Controlled trial quality: predicted high

2103. Laparoscopic surgery for ectopic pregnancies: technology assessment and public health implications

Laparoscopic surgery for ectopic pregnancies: technology assessment and public health implications Laparoscopic surgery for ectopic pregnancies: technology assessment and public health implications Laparoscopic surgery for ectopic pregnancies: technology assessment and public health implications Maruri F, Azziz R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Laparoscopic surgery for the treatment of ectopic pregnancies. Type of intervention Treatment Economic study type Cost-effectiveness analysis. Study population Women with ectopic pregnancies in the USA. Setting Hospital, the economic study was carried out in Alabama, USA. Dates to which data relate Effectiveness data relates to papers published between 1988 and 1989

1993 NHS Economic Evaluation Database.

2104. Randomised controlled trial of day care for hypertension in pregnancy. (Abstract)

Randomised controlled trial of day care for hypertension in pregnancy. Our aim was to assess the effect of the introduction of a day-care unit on the care of women with non-proteinuric hypertension in pregnancy. A randomised controlled trial was carried out on 54 women who presented at 26 weeks of pregnancy or later with non-proteinuric hypertension (systolic blood pressure 150-170 mm Hg and/or diastolic pressure 90-105 mm Hg on two occasions at least 15 min apart). 30 women were allocated (...) and the development of proteinuria 11.4 times (95% CI 1.8-71.4) more likely. The control group had a mean of 1.5 fewer hospital outpatient visits (95% CI 0.36-2.64). The groups did not differ in their use of antihypertensive drugs. Day-unit care for hypertension in pregnancy significantly reduced the need for and the length of antenatal inpatient admissions and the number of medical interventions, at the cost of an increase in outpatient attendances. Our results are further evidence that inpatient care does

1992 Lancet Controlled trial quality: predicted high

2105. Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. (Abstract)

Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. We have done a randomised controlled trial to assess the effect on primary management and outcome of routine doppler ultrasound examinations of the umbilical and uterine arteries during pregnancy. Over 9 months, 2600 women with singleton pregnancies were recruited from a general obstetric population. Of 2475 women who delivered in hospital after 20 weeks' gestation, 1246 had been allocated (...) at random to receive standard antenatal care with routine doppler examinations. The first doppler ultrasound was done at 19-22 weeks' gestation, and thereafter examinations were monthly if the pregnancy was considered high risk (192) or once at 32 weeks if considered low risk (1054). The control group of 1229 women received standard, antenatal care without doppler ultrasonography. The study groups did not differ in number of antenatal admissions or cardiotocographs, gestational age at delivery, method

1992 Lancet Controlled trial quality: predicted high

2106. Energy supplementation during pregnancy and postnatal growth. (Abstract)

Energy supplementation during pregnancy and postnatal growth. The effect of improving maternal nutrition during pregnancy on growth of the child has not been assessed, since previous studies supplemented the diets of children as well as mothers. In a controlled randomised trial in Madura, East Java, pregnant women received a high (HE) or low (LE) energy supplement that provided 1950 kJ (465 kcal) or 218 kJ (52 kcal), respectively, in the last trimester of pregnancy. The effect (...) were significantly heavier than LE children (p less than 0.05). HE children were also taller throughout the first 5 years (p less than 0.005 from 15 to 48 months, p less than 0.05 at both 3-12 and 60 months). Weight-for-height by age was similar in both groups, but stunting (height-for-age) was less prevalent in HE children. In a community characterised by chronic energy deficiency among women of reproductive age, energy supplementation of women for the last 90 days of pregnancy was effective

1992 Lancet Controlled trial quality: uncertain

2107. Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. (Abstract)

Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. The high birthweights and long duration of pregnancy in the Faroe Islands led us to suggest that a high intake of marine-fat-derived n-3 fatty acids might prolong pregnancy by shifting the balance of production of prostaglandins involved in parturition. We have compared the effects on pregnancy duration, birthweight, and birth length of a fish-oil supplement, a control olive-oil supplement (...) , and no supplementation. 533 healthy Danish women in week 30 of pregnancy were randomly assigned in a ratio of 2/1/1 to fish oil (four 1 g Pikasol capsules [containing 2.7 g n-3 fatty acids] per day), olive oil (four 1 g capsules per day), or no supplement. The three groups differed in mean length of gestation (p = 0.006), which was highest in the fish-oil group and lowest in the olive-oil group; the result was similar when the analysis was restricted to women with an estimate of gestation length based on early

1992 Lancet Controlled trial quality: predicted high

2108. A randomized trial of psychosocial support during high-risk pregnancies. The Latin American Network for Perinatal and Reproductive Research. (Abstract)

A randomized trial of psychosocial support during high-risk pregnancies. The Latin American Network for Perinatal and Reproductive Research. It is often suggested that psychological and social support and health education for women at high risk for delivering a low-birth-weight infant can improve the outcomes of pregnancy, but the evidence is inconclusive. We undertook this prospective trial to evaluate a program of home visits designed to provide psychosocial support during pregnancy.At four (...) centers in Latin America, 2235 women at higher-than-average risk for delivering a low-birth-weight infant were recruited before the 20th week of pregnancy. The women were randomly assigned either to an intervention group (n = 1115) that received four to six home visits from a nurse or social worker in addition to routine prenatal care or to a control group (n = 1120) that received only routine prenatal care (with a mean of eight prenatal visits). The principal measures of outcome were low birth weight

1992 NEJM Controlled trial quality: predicted high

2109. Induction of labor as compared with serial antenatal monitoring in post-term pregnancy. A randomized controlled trial. The Canadian Multicenter Post-term Pregnancy Trial Group. (Abstract)

Induction of labor as compared with serial antenatal monitoring in post-term pregnancy. A randomized controlled trial. The Canadian Multicenter Post-term Pregnancy Trial Group. The rates of perinatal mortality and neonatal morbidity are higher for post-term pregnancies than for term pregnancies. It is not known, however, whether the induction of labor results in better outcomes than does serial fetal monitoring while awaiting spontaneous labor.We studied 3407 women with uncomplicated (...) pregnancies of 41 or more weeks' duration. The women were randomly assigned to undergo induction of labor or to have serial antenatal monitoring and spontaneous labor unless there was evidence of fetal or maternal compromise, in which case labor was induced or cesarean section was performed. In the induction group, labor was induced by the intracervical application of prostaglandin E2. Serial antenatal monitoring consisted of counts of fetal kicks, nonstress tests, and assessments of amniotic-fluid volume

1992 NEJM Controlled trial quality: uncertain

2110. Randomised controlled trial of atenolol and pindolol in human pregnancy: effects on fetal haemodynamics. Full Text available with Trip Pro

Randomised controlled trial of atenolol and pindolol in human pregnancy: effects on fetal haemodynamics. To compare the effects of uteroplacental circulation of two beta adrenoceptor blockers, atenolol (cardioselective) and pindolol (non-selective with intrinsic sympathomimetic activity).Controlled double blind double dummy study.Departments of obstetrics and gynaecology in two Swedish university hospitals.29 women with pregnancy induced hypertension in the third trimester, 13 randomised

1992 BMJ Controlled trial quality: predicted high

2111. Calcium supplementation to prevent hypertensive disorders of pregnancy. (Abstract)

Calcium supplementation to prevent hypertensive disorders of pregnancy. Calcium supplementation has been reported to reduce blood pressure in pregnant and nonpregnant women. We undertook this prospective study to determine the effect of calcium supplementation on the incidence of hypertensive disorders of pregnancy (gestational hypertension and preeclampsia) and to determine the value of urinary calcium levels as a predictor of the response.We studied 1194 nulliparous women who were in the 20th (...) week of gestation at the beginning of the study. The women were randomly assigned to receive 2 g per day of elemental calcium in the form of calcium carbonate (593 women) or placebo (601 women). Urinary excretion of calcium and creatinine was measured before calcium supplementation was begun. The women were followed to the end of their pregnancies, and the incidence of hypertensive disorders of pregnancy was determined.The rates of hypertensive disorders of pregnancy were lower in the calcium group

1991 NEJM Controlled trial quality: uncertain

2112. Effect of mifepristone on dilatation of the pregnant and non-pregnant cervix. (Abstract)

Effect of mifepristone on dilatation of the pregnant and non-pregnant cervix. The effect of the progesterone antagonist mifepristone on the cervix was investigated in two randomised double-blind placebo-controlled trials, the first in 30 women undergoing first trimester surgical termination of pregnancy and the second in 30 non-pregnant premenopausal women. 600 mg mifepristone, given orally 48 h before surgery, increased the mean preoperative cervical dilatation in both pregnant and non (...) -pregnant treatment groups and also reduced the force required to dilate the pregnant and non-pregnant cervix.

1990 Lancet Controlled trial quality: uncertain

2113. Conservative treatment of ectopic pregnancy with local injection of hyperosmolar glucose solution or prostaglandin-F2 alpha: a prospective randomised study. (Abstract)

Conservative treatment of ectopic pregnancy with local injection of hyperosmolar glucose solution or prostaglandin-F2 alpha: a prospective randomised study. In a prospective randomised study, 31 patients with an unruptured tubal pregnancy were treated either with local and systemic prostaglandins or with local instillation of a hyperosmolar glucose solution. Prostaglandin therapy was successful in 13 of 15 patients and glucose therapy in 16 of 16. 9 women treated with prostaglandins had (...) cramping abdominal pains postoperatively. No side-effects were noted in those treated with glucose. At subsequent hysterosalpingography 5 of 6 patients treated with prostaglandins and 7 of 8 treated with glucose had normal tubal configuration and patency. 3 patients treated with glucose later had a normal intrauterine pregnancy, demonstrably through the affected tube in 1 case. These results suggest that local instillation of hyperosmolar glucose solution is an option in the laparoscopic management

1990 Lancet Controlled trial quality: uncertain

2114. Routine hospital admission in twin pregnancy between 26 and 30 weeks' gestation. (Abstract)

Routine hospital admission in twin pregnancy between 26 and 30 weeks' gestation. Of 141 women with twin pregnancies, 72 were randomly assigned to outpatient care and 69 to hospital admission between 26 and 30 weeks' gestation. There were no differences between the groups in the frequencies of major maternal complications in pregnancy and labour but more of those admitted to hospital than of the outpatient group had to be admitted after 30 weeks. There were no differences between the groups (...) in the mean birthweights of the twins by birth order, or in their mean gestation at birth whether analysed by intention to treat or by the treatment given. 22 infants were delivered before 32 weeks' gestation in the inpatient group compared with 10 in the outpatient group. With the exception of small-for-dates infants, any trend towards greater morbidity or mortality was seen in the inpatient group. The policy of routine hospital admission of women with twin pregnancies from 26 weeks' gestation

1990 Lancet Controlled trial quality: uncertain

2115. Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. (Abstract)

Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy (...) . The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord

1990 Lancet Controlled trial quality: uncertain

2116. Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial. (Abstract)

Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial. During a 19-month period, 95% of all pregnant women in the greater Helsinki area, Finland, entered a study to compare one-stage ultrasonography screening with selective screening according to antenatal hospital use, obstetric procedures, and fetal outcomes. Of 9310 women who entered the trial, 4691 were randomly allocated to ultrasound screening between (...) vs 9.0/1000); this 49.2% reduction was mainly due to improved early detection of major malformations which led to induced abortion. All twin pregnancies were detected before the 21st gestational week in the screening group compared with 76.3% in the control group; perinatal mortality in the small series of twins was 27.8/1000 vs 65.8/1000, respectively.

1990 Lancet Controlled trial quality: uncertain

2117. Atenolol in essential hypertension during pregnancy. Full Text available with Trip Pro

Atenolol in essential hypertension during pregnancy. To determine the effect of atenolol on the outcome of pregnancy in women with essential hypertension.Prospective, randomised, double blind, placebo controlled study.Hospital clinic.33 Women with mild essential hypertension (systolic blood pressure 140-170 mm Hg or diastolic pressure 90-110 mm Hg on two occasions at least 24 hours apart) consecutively referred to two obstetric medical clinics. Four patients in the placebo group were withdrawn (...) given from the end of the first trimester in patients with mild hypertension is associated with intrauterine growth retardation. When taken in conjunction with the results of a previous study in which methyldopa was given these findings indicate that benefit is unlikely to result from treating mild essential hypertension in pregnancy.

1990 BMJ Controlled trial quality: predicted high

2118. Pregnancy potential of human oocytes--the effect of cryopreservation. (Abstract)

Pregnancy potential of human oocytes--the effect of cryopreservation. In vitro fertilization, sometimes involving the cryopreservation of human embryos, has become a routine procedure for the treatment of infertility. Even though there are embryos available for transfer in about 85 percent of the treatment cycles, the rate of pregnancy rarely exceeds 25 percent per cycle. We designed this study to investigate two questions: Does this high rate of failure result from inadequate technique (...) , or does it simply reflect the maximal potential of a cohort of aspirated eggs to produce a pregnancy? And to what extent does cryopreservation affect the capacity for implantation of embryos?The study was conducted among patients enrolled in an egg-donation program. Aspirated eggs from a given cohort were distributed to the donor herself and a few recipients. The recipients were prepared by a standard protocol of hormone replacement and were assigned at random to the transfer of either fresh or frozen

1990 NEJM Controlled trial quality: uncertain

2119. Lack of efficacy of pyrimethamine prophylaxis in pregnant Nigerian women. (Abstract)

Lack of efficacy of pyrimethamine prophylaxis in pregnant Nigerian women. To evaluate the efficacy of pyrimethamine on the blood stage (suppressive prophylaxis) and liver stage (causal prophylaxis) of Plasmodium falciparum in pregnant women, in vivo and in vitro field studies were conducted in Ilorin, Nigeria, from Jan 1 to June 30, 1988. For pregnant women with P falciparum infections who received 25 mg of pyrimethamine weekly for suppressive prophylaxis, 67% (59/88) of in vivo and 60% (6/10 (...) ) of in vitro tests showed pyrimethamine resistance. A second group of parasitaemic and parasite-free pregnant women was enrolled to evaluate the efficacy of pyrimethamine as a primary tissue schizonticide; after receiving a curative dose of chloroquine (25 mg/kg), half the women were given 25 mg of pyrimethamine weekly and half received no prophylaxis. Parasitologic failure rates did not differ between the pyrimethamine-treated (8/34) and the control (11/37) groups during the 16-week follow-up. Thus

1989 Lancet Controlled trial quality: uncertain

2120. Zinc supplementation during pregnancy: a double blind randomised controlled trial. Full Text available with Trip Pro

Zinc supplementation during pregnancy: a double blind randomised controlled trial. To see whether zinc supplementation during pregnancy improves maternal and fetal outcome.Prospective study started at booking and continued till discharge of mother and baby from the maternity hospital. Mothers were randomly assigned to receive zinc supplementation or placebo in a double blind trial.Mothers booking at one hospital.Women booking before 20 weeks of gestation who agreed to take part in the study (...) . 494 Mothers were followed up till the end of pregnancy. There was no difference between the groups given zinc and placebo in their social or medical backgrounds.Mothers in the active treatment group received one capsule of 20 mg elemental zinc daily and those in the placebo treated group a capsule identical in appearance and taste with the active capsule but which contained inert substances.Various adverse outcomes were tested, including maternal bleeding, hypertension, complications of labour

1989 BMJ Controlled trial quality: predicted high