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35

Normal Labor and Delivery: Practice Essentials, Definition, Stages of Labor and Epidemiology

Labor is a physiologic process during which the fetus, membranes, umbilical cord, and placenta are expelled from the uterus. Stages of labor Obstetricians have divided labor into 3 stages that delineate milestones in a continuous process.  
emedicine.medscape.com
over 4 years ago
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5

Methods for assessing pre-induction cervical ripening, the ability of the cervix to open in response to spontaneous uterine contractions | Cochrane

In this review, researchers from The Cochrane Collaboration examined a comparison between the Bishop score and any other method for checking pre-induction cervical ripening in women admitted for induction of labour. The Bishop score is the traditional method of determining the readiness of the cervix to open (dilate) before labour induction. It also assesses the position, softening and shortening of the cervix, and the location of the presenting part of the baby. After searching for relevant trials up to 31 March 2015, we included two randomised controlled trials that recruited 234 pregnant women.  
cochrane.org
over 4 years ago
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14

Tranexamic acid for preventing bleeding after delivery | Cochrane

Postpartum haemorrhage is a common and an occasionally life-threatening complication of labour. The majority of women receive drugs that directly stimulate the uterus (prophylactic uterotonics) during childbirth to prevent haemorrhages resulting from failure of the uterine muscle to contract normally (uterine atony).  
cochrane.org
over 4 years ago
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12

Antibiotic prophylaxis during the second and third trimester in pregnancy to reduce adverse pregnancy outcomes and morbidity | Cochrane

Antibiotics are administered to pregnant women during the second and third trimester of pregnancy (before labour) to prevent bacteria in the vagina and cervix affecting the pregnancy. Infection by some infectious organisms in a woman’s genital tract can cause health problems for the mother and her baby, and has been associated with preterm births. This review of eight randomised trials involved approximately 4300 women in their second or third trimester. We found that antibiotics did not reduce the risk of preterm prelabour rupture of the membranes (one trial, low quality of evidence), or the risk of preterm birth (six trials, high quality of evidence). Preterm delivery was reduced in pregnant women who had a previous preterm birth and an imbalance of bacteria in the vagina (bacterial vaginosis) during the current pregnancy. There was no reduction in preterm delivery in pregnant women with previous preterm birth without a bacterial imbalance during the current pregnancy (two trials). Postpartum endometritis, or infection of the uterus following birth, was reduced overall (three trials, moderate quality of evidence), as well as in a trial of high-risk women who had a previous preterm birth (one trial, moderate quality of evidence). No reduction in neonatal illness was observed. Outcomes of interest were available in trials with high losses to follow-up. We could not estimate the side effects of antibiotics since side effects were rare; however, antibiotics may still have serious side effects on women and their babies.  
cochrane.org
over 4 years ago
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3
118

Molecular mechanisms within fetal lungs initiate labor

Researchers have identified two proteins in a fetus' lungs responsible for initiating the labor process, providing potential new targets for preventing preterm birth. They discovered that the proteins SRC-1 and SRC-2 activate genes inside the fetus' lungs near full term, leading to an inflammatory response in the mother's uterus that initiates labor.  
sciencedaily.com
over 4 years ago
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49

Fallopian Tube Disorders: Overview, Salpingitis, Salpingitis Isthmica Nodosa

The human oviduct, also known as the fallopian tube, is an essential component of the normal reproductive process. The tube, which connects the peritoneal space to the endometrial cavity, captures the egg after ovulation and transports the sperm from the uterus to the fertilization site in the ampulla (the middle portion of the tube).  
emedicine.medscape.com
over 4 years ago
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0

Methods to reduce pain with insertion of intrauterine contraception | Cochrane

Fear of pain with insertion of intrauterine contraception (IUC) may cause women to avoid using this very effective method of birth control. IUC includes devices with copper and with the hormone levonorgestrel. Researchers have studied many ways of reducing pain with IUC insertion. These include drugs that lessen uterine cramps, soften and open the cervix (uterus opening), or numb the cervix.  
cochrane.org
over 4 years ago
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1
5

Measuring the height of the uterus from the symphysis pubis (SFH) in pregnancy for detecting problems with fetal growth | Cochrane

Monitoring the baby’s growth is important during pregnancy. If growth is poor then this should be identified as soon as possible, because delay might result in the baby’s death. The simplest way to determine growth is to examine the baby by palpating the mother's by abdomen and estimate the size of her womb compared with a landmark such as the navel (umbilicus). An alternative method is to use a tape measure to take a measurement, known as the symphysial fundal height (SFH) measurement, from the mother’s pubic bone (symphysis pubis) to the top of the womb. The measurement is then applied to the gestation by a simple rule of thumb and compared with normal growth.  
cochrane.org
over 4 years ago
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2

Drug treatments for pain relief in hysterosalpingography | Cochrane

Hysterosalpingography (HSG) is a test used in investigating infertility in women. HSG involves a dye being introduced into the uterus and the connecting tubes, which enables them to be visualised using an x-ray, allowing the clinician to assess how open the connecting tubes are. This can be a painful procedure. There is disagreement regarding the best form of pain relief during the procedure.  
cochrane.org
over 4 years ago
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6

Cervical ripening before first trimester surgical evacuation for non-viable pregnancy | Cochrane

Using medications or devices to soften and dilate the cervix can reduce the amount of manual dilation required before the uterus is surgically emptied of a non-viable pregnancy, or miscarriage. The purpose of this cervical ripening is to reduce the possibility of injury to the uterus and cervix and make the procedure easier to perform, although the ripening agents can have side effects.  
cochrane.org
about 4 years ago
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2

Elective Labor Induction With Unfavorable Cervix Appears Safe

Elective labor induction in first-time mothers with an unfavorable cervix led to a small but statistically insignificant increase in cesarean deliveries, but not everyone is comfortable with the practice.  
medscape.com
about 4 years ago
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0

Diagnosis and management of menopause: summary of NICE guidance

Menopause is a clinical diagnosis in healthy women over 45 years who have not had a period for at least 12 months and are not using hormonal contraception, or who do not have a uterus and have menopausal symptoms  
feeds.bmj.com
about 4 years ago
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0

Diagnosis and management of menopause: summary of NICE guidance

Menopause is a clinical diagnosis in healthy women over 45 years who have not had a period for at least 12 months and are not using hormonal contraception, or who do not have a uterus and have menopausal symptoms  
feeds.bmj.com
about 4 years ago
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1

Diagnosis and management of menopause: summary of NICE guidance

Menopause is a clinical diagnosis in healthy women over 45 years who have not had a period for at least 12 months and are not using hormonal contraception, or who do not have a uterus and have menopausal symptoms  
feeds.bmj.com
about 4 years ago
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Use of nitroglycerin to deliver a retained placenta | Cochrane

Failure to deliver the placenta after a vaginal birth is an uncommon event that can be associated with significant bleeding and even death if left untreated. The retained placenta may be detached from the uterine wall but is trapped so that it is not expelled through the cervix or non-detached as the placenta fails to separate because of placental inhibition of uterine contractions. Conventional management involves spinal or general anaesthesia to enable introducing a hand inside the uterus to manually remove the placenta, which carries risks of infection and from the anaesthetic, and also requires special facilities. The use of uterine relaxing drugs (tocolytics), either alone or with other drugs to stimulate contractions of the uterus (uterotonics), may bring on the delivery of the placenta and avoid the need for this invasive procedure. This review included three trials that randomly assigned 175 women with the placenta remaining undelivered more than 15 minutes after delivery to either a placebo or the tocolytic nitroglycerin. Both groups received oxytocin to stimulate contractions of the uterus. Combined administration of nitroglycerin and oxytocin did not reduce the need for manual removal of placenta, blood loss, nor the incidence of severe postpartum haemorrhage. Nitroglycerin administration did not cause headache but resulted in a mild drop in blood pressure and a related increase in heart rate. Two out of the three trials had low risk of bias but this result needs confirmation in larger trials with adequate sample sizes to verify the role of nitroglycerin and other tocolytic drugs in managing different subtypes of retained placenta. The trials in this review did not specify the type of retained placenta. We have included an explanation of some of the scientific terms that are used in this review in a glossary (see Appendix 1).  
cochrane.org
about 4 years ago
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4
74

Uterus Transplant: First US Clinical Trial Begins

The first clinical trial of uterus transplantation in the United States has begun at Cleveland Clinic in Ohio.  
medscape.com
about 4 years ago
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0

Using biochemical tests to measure placental function and improve pregnancy outcomes | Cochrane

The placenta (afterbirth) develops in the uterus during pregnancy to provide oxygen and nutrients to the growing baby and to remove waste products from the baby's blood. The placenta attaches to the wall of the uterus and is linked to the baby via the umbilical cord. The placenta plays a critical role in determining the health of the baby and mother. The health of the placenta can be assessed by performing tests on mothers' blood or urine to measure chemicals made by the placenta. Having this information could improve the outcome of pregnancy as professionals could intervene to prevent outcomes such as stillbirth or babies being born too small.  
cochrane.org
about 4 years ago
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6

Prenatal treatments for babies with congenital diaphragmatic hernia | Cochrane

A congenital diaphragmatic hernia (CDH) is a hole in the diaphragm, the muscle that helps with breathing and separates the chest and abdomen. This defect can allow the liver and bowel to move to the chest cavity and interfere with lung development, affecting lung and heart function in newborn babies. At birth, respiratory insufficiency and pulmonary hypertension contribute to poor outcomes. About one in every 3000 babies may be affected and the problem can be diagnosed during a routine mid-pregnancy ultrasound at around 20 weeks. For babies born with a CDH, surgery in early life is necessary, but even with new surgical techniques there can be a poor outlook and many long-term medical problems. Treatments are now possible in pregnancy. Interventions described to date include maternal antenatal corticosteroid administration and prenatal tracheal occlusion to improve lung growth and maturity by obstruction of the fetal trachea. This increases airway pressure by preventing secreted lung fluid from leaving the lungs resulting in growth and expansion of the lungs. There are potential side effects and complications for the mother with this procedure as the uterus and amniotic sac are entered in order to gain access to the unborn baby.  
cochrane.org
about 4 years ago
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14

Misoprostol - Wikipedia, the free encyclopedia

Misoprostol, sold under the brandname Cytotec among others, is a medication used to start labor, cause an abortion, prevent and treat stomach ulcers, and treat postpartum bleeding due to poor contraction of the uterus.[1] For abortions it is often used with mifepristone or methotrexate.[2] By itself effectiveness for this purpose is between 66% and 90%.[3] It is taken either by mouth, under the tongue, or placed in the vagina.[2][4]  
en.wikipedia.org
about 4 years ago
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1

Ewing's Sarcoma of the Cervix, a Diagnostic Dilemma

This case of Ewing's sarcoma of the cervix, initially misdiagnosed as small cell carcinoma, highlights the diagnostic challenges due to their overlapping clinical and histopathological features.  
medscape.com
about 4 years ago