OBJECTIVE: To evaluate the effect of suggesting coitus as a safe and effective means to expedite labour on pregnancy duration and requirement for labour induction. DESIGN: A randomised trial. SETTING: Antenatal clinic in a university hospital in Malaysia. POPULATION: Women from 35 weeks of gestation with an uncomplicated singleton pregnancy. METHODS: ...

Conventionally, most in vitro fertilization (IVF) embryos are transferred in fresh treatment cycles with freezing reserved for spare ones. Improvement in cryopreservation facilities over time has encouraged the greater use of this technology with the success rate of frozen replacement cycles approaching that associated with fresh embryo transfer. Data from ...

Please cite this paper as: Althuizen E, van der Wijden CL, van Mechelen W, Seidell JC, van Poppel MNM. The effect of a counselling intervention on weight changes during and after pregnancy: a randomised trial. BJOG 2012; DOI: 10.1111/1471-0528.12014. Objectives  To evaluate the effects of a counselling intervention on excessive ...

Background: A randomized controlled trial (RCT) comparing highly purified human Choriogonadotrophin (HP-hCG) and recombinant hCG (r-hCG) both administered subcutaneously for triggering ovulation in controlled ovarian stimulation (COS) for Assisted Reproductive Technology (ART). Methods: Multi-centre (n = 4), prospective, controlled, randomized, non-inferiority, parallel group, investigator blind design, including 147 patients. The ...

OBJECTIVE:: To estimate the efficacy and acceptability of medical abortion at 64-70 days from last menstrual period (LMP) and to compare it with the already proven 57-63 days from LMP gestational age range. METHODS:: This prospective, comparative, open-label trial enrolled 729 women with pregnancies 57-70 days from LMP requesting abortion ...

Nausea and vomiting in pregnancy is a common complaint of nearly 50-80% of pregnant women. The problem begins around the 4th weeks of pregnancy and often stays up to the 12th weeks and may continue to the 16th week in a few patients. The aim of our study is to ...

AIM: The aim of this study was to examine the effect of endometrial scratching in women with unexplained infertility. MATERIAL AND METHODS: A randomized controlled trial was conducted in Mansoura University Teaching Hospital and a private practice setting. A total of 105 couples with unexplained infertility were randomly allocated into ...

BACKGROUND: Buccal misoprostol 800 mcg and sublingual misoprostol 800 mcg show high efficacy when used with 200 mg mifepristone for early pregnancy termination but have different side effect profiles. This is the first double-blind randomized trial comparing the side effect profiles of these two routes of administration of misoprostol when ...

ABSTRACT: BACKGROUND: Low birth weight and maternal anemia remain intractable problems in many developing countries. The adequacy of the current strategy of providing iron-folic acid (IFA) supplements only during pregnancy has been questioned since many women enter pregnancy with poor iron stores, the substantial micronutrient demand by maternal and fetal ...

BACKGROUND: This study was conducted to evaluate the efficacy, safety and acceptability of a newly developed benzalkonium chloride (BZK) contraceptive gel which was compared to nonoxynol-9 (N-9) gel. STUDY DESIGN: A Phase II, multicenter, randomized, controlled study at three Chinese centers was conducted to compare 120 women who used BZK ...

STUDY QUESTION: What is the treatment success rate of systemic methotrexate (MTX) compared with expectant management in women with an ectopic pregnancy or a pregnancy of unknown location (PUL) with low and plateauing serum hCG concentrations? SUMMARY ANSWER: In women with an ectopic pregnancy or a PUL and low and ...

BACKGROUND:The impact of metformin medication in pregnant women with polycystic ovary syndrome on weight gain during pregnancy and after delivery and the impact on growth of the offspring are essentially unexplored.METHODS:This is a follow-up study of a randomized controlled trial (The Metformin treatment in pregnant PCOS women study), conducted in ...

ABSTRACT: BACKGROUND: Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA) interventions may assist cessation; however, trials examining these ...

Introduction: Pregnancies in women with thrombophilia are associated with a higher risk of obstetric complications. We systematically reviewed the findings of relevant randomised controlled trials (RCTs) with the aim of investigating the effectiveness of low-molecular-weight heparins (LMWHs) in pregnant women with inherited thrombophilic disorders and its effect on the incidence ...

Birth by caesarean section is rising rapidly around the world and is associated with a range of adverse short and long-term outcomes in offspring. The latter include features of the metabolic syndrome, type-1 diabetes, and asthma. Though there are several plausible candidate biological mechanisms, evidence of a causal relationship between ...

While the cesarean delivery (CD) rates have increased worldwide, operative vaginal delivery (OVD) rates continue to decline, with the United States having some of the lower rates amongst developed countries. It is clear that the use of forceps or vacuum can safely assist in accomplishing a vaginal delivery and prevent ...

The effects of prophylactic iron during pregnancy on maternal and child health in developing settings with endemic malaria and high prevalence of HIV remain unclear. This paper describes the rationale, implementation and success of a pragmatic randomised controlled trial comparing routine iron supplementation vs. screening and treatment for anaemia during ...

Three to four percent of full-term singleton pregnancies present themselves as breech deliveries. External cephalic version (ECV) is a procedure to try to turn a breech fetus to cephalic by externally maneuvering the fetus through the maternal abdomen. This trial examines a clinical hypnosis intervention against standard medical care of ...

Iron deficiency anemia (IDA) is the most common medical problem in pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran. The aim of this study was to compare the efficacy ...

SUMMARY QUESTION: Is vaginal progesterone gel equivalent to vaginal micronized progesterone tablets concerning ongoing pregnancy rate and superior concerning patient convenience when used for luteal support after IVF/ICSI? SUMMARY ANSWER: Equivalence of treatments in terms of ongoing live intrauterine pregnancy rate has not been demonstrated; the 95% confidence interval (CI) ...

OBJECTIVE: To compare the efficacy of the long GnRH agonist and the fixed GnRH antagonist protocols in IVF poor responders. STUDY DESIGN: This was a randomized controlled trial performed in the Iakentro IVF centre, Thessaloniki, from January 2007 to December 2011, concerning women characterised as poor responders after having 0-4 ...

Our aim was to reevaluate if metformin may reduce late miscarriage/preterm delivery, preeclampsia and gestational diabetes in women with polycystic ovary syndrome (PCOS). We performed an epi-analysis of two randomized controlled trials. The participants were 313 PCOS women with singleton pregnancies, aged 18-42 years. They were randomized to metformin or ...

Background. The impact of maternal vitamin D status in pregnancy on the extra-skeletal health of the offspring has become a "hot topic" with a potential for cost-beneficial prevention. Objective. To systematically review the level A and B evidence. Methods. PubMed, Embase and Cochrane were searched using the MeSH terms "vitamin ...

Hypovitaminosis D is common in pregnancy. To systematically review the evidence on vitamin D-dependent pregnancy outcomes, PubMed and Embase were searched for randomized control trials, cohort and case-control studies. In randomized control trials (n = 7), larger doses of vitamin D resulted in higher 25-hydroxylated vitamin D (25OHD) levels (n ...

ABSTRACT:: Smoking in pregnancy is associated with serious perinatal risks, leading to attempts to prevent smoking with the use of nicotine-replacement therapy (NRT). After more than a decade of studies failing to show the effectiveness of NRT for smoking cessation in pregnancy, a recent large, randomized trial has clearly shown ...

Abstract Objective: The use of herbal remedies has been documented both among various patient groups and in the general population to promote health. The aim of this systematic review is to analyze the benefits of herb use during pregnancy. Methods: A systematic literature search that covering the period between January ...

BACKGROUND: The use of breastfeeding as a method of birth spacing occasionally ends in "unplanned pregnancy." This is due to unexpected expiration of one or more of the lactation amenorrhea method (LAM) prerequisites. The current study tests a new concept that the in-advance provision of single packet of progestogen emergency ...

BACKGROUND: Ginger has been used throughout the world as a therapeutic agent for centuries. The herb is increasingly used in Western society also, with one of the most common indications being pregnancy-induced nausea and vomiting (PNV). OBJECTIVES: To examine the evidence for the safety and effectiveness of ginger for PNV. ...

ABSTRACT: BACKGROUND: We describe the rationale and protocol for a randomized noninferiority controlled trial (RCT) to determine if the Flexi-T380(+) copper intrauterine contraceptive device (IUD) is comparable in terms of effectiveness and expulsion rates to the most common Canadian IUD currently in use, NovaT-200, when placed immediately after a first-trimester ...

Please cite this paper as: Rodriguez M, Seuc A, Sokal D. Comparative efficacy of postpartum sterilisation with the titanium clip versus partial salpingectomy: a randomised controlled trial. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03482.x. A multicentre trial was conducted to compare efficacy of postpartum sterilisation with clip and partial salpingectomy. Life-table estimates of ...

BACKGROUNDFor decades androgens have been considered detrimental to follicle maturation. Animal studies now suggest that they are essential for normal folliculogenesis. Especially in women with premature ovarian aging (POA), recent IVF data in humans are supportive. The literature also suggests an association between recently reported ovarian genotypes of the FMR1 ...

BACKGROUNDThe aim of this meta-analysis was to evaluate the role of androgens or androgen-modulating agents on the probability of pregnancy achievement in poor responders undergoing IVF.METHODSMedline, EMBASE, CENTRAL, Scopus and Web of Science databases were searched for the identification of randomized controlled trials evaluating the administration of testosterone, dehydroepiandrosterone (DHEA), ...

Antenatal maternal glucose administration has been suggested to improve the efficiency of antepartum fetal heart rate testing. The objective of this review was to assess the merits or adverse effects of antenatal maternal glucose administration in conjunction with tests of fetal wellbeing. We searched the Cochrane Pregnancy and Childbirth Group's ...

The polycystic ovary syndrome (PCOS) affects approximately 6-10% of women of reproductive age and is characterized by chronic anovulation and hyperandrogenism. However, a comprehensive understanding of the mechanisms that dictate androgen overproduction is lacking, which may account for inconsistencies between measures of androgen excess and clinical presentation in individual cases. ...

To compare the rate of uterine scar disruption after a locked versus an unlocked single-layer closure of the hysterotomy incision at a previous cesarean. A retrospective cohort study in a population where both locked and unlocked single-layer closure are commonly used. All singleton pregnancies at 24 weeks' gestation or more ...

The aim of this study was to determine the factors associated with intrapartum asphyxia in singleton deliveries beyond 37 weeks' gestation. We reviewed the obstetric records of Japanese singleton deliveries after 37 weeks' gestation managed at Japanese Red Cross Katsushika Maternity Hospital from 2005 through 2010. Forty-nine cases were diagnosed ...

Uncontrolled asthma during pregnancy is associated with the maternal hazards of disease exacerbation, and perinatal hazards including intrauterine growth restriction and preterm birth. Interventions directed at achieving better asthma control during pregnancy should be considered a high priority in order to optimise both maternal and perinatal outcomes. Poor compliance with ...

Maternal oxygen administration has been used in an attempt to lessen fetal distress by increasing the available oxygen from the mother. This has been used for suspected fetal distress during labour, and prophylactically during the second stage of labour on the assumption that the second stage is a time of ...

Maternal immunization has gained traction as a strategy to diminish maternal and young infant mortality attributable to infectious diseases. Background rates of adverse pregnancy outcomes are crucial to interpret results of clinical trials in Sub-Saharan Africa. We developed a mathematical model that calculates a clinical trial's expected number of neonatal ...

Failure of implantation and conception may result from an inability of the blastocyst to escape from its outer coat, which is known as the zona pellucida. Artificial disruption of this coat is known as assisted hatching and has been proposed as a method for improving the success of assisted conception ...

When couples are faced with the dilemma of a higher-order multiple pregnancy there are three options. Termination of the entire pregnancy has generally not been acceptable to women, especially for those with a past history of infertility. Attempting to continue with all the fetuses is associated with inherent problems of ...

To date, there are no data available concerning the impact of iron therapy on the long-term well-being and health-related quality of life (HRQoL) in pregnancy. To assess the long-term effect of iron therapy on HRQoL in pregnancy. This is a follow-up study conducted between January 2010 and January 2011 of ...

Multiple-micronutrient deficiencies often coexist in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother. Substantive evidence regarding the effectiveness of multiple-micronutrient supplements (MMS) during pregnancy is not available. To evaluate the benefits to both mother and infant ...

Smoking in pregnancy is a substantial public health problem. When used by non-pregnant smokers, pharmacotherapies [nicotine replacement therapy (NRT), bupropion and varenicline] are effective treatments for smoking cessation, however, their efficacy and safety in pregnancy remains unknown. To determine the efficacy and safety of smoking cessation pharmacotherapies, including NRT, varenicline ...

Intra-uterine insemination (IUI) is a widely used fertility treatment for couples with unexplained subfertility. Although IUI is less invasive and less expensive than in vitro fertilisation (IVF), the safety of IUI in combination with ovarian hyperstimulation (OH) is debated. The main concern about IUI treatment with OH is the increase ...

Objectives. Yoga is used for a variety of immunological, neuromuscular, psychological, and pain conditions. Recent studies indicate that it may be effective in improving pregnancy, labour, and birth outcomes. The purpose of this paper is to evaluate the existing literature on yoga for pregnancy. Methods. Six databases were searched using ...

A maternity waiting home (MWH) is a facility within easy reach of a hospital or health centre which provides emergency obstetric care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and ...

Twin pregnancies are associated with a high risk of neonatal mortality and morbidity due to an increased rate of preterm birth. Betamimetics can decrease contraction frequency or delay preterm birth in singleton pregnancies by 24 to 48 hours. The efficacy of oral betamimetics in women with a twin pregnancy is ...

A varicocele is a meshwork of distended blood vessels in the scrotum, usually left-sided, due to dilatation of the spermatic vein. Although the concept that a varicocele causes male subfertility has been around for more than 50 years now, the mechanisms by which a varicocele would affect fertility have not ...

One of my 35-year-old pregnant patients has been treated with enalapril for primary hypertension. She learned she was pregnant at 11 weeks' gestation. I read somewhere that angiotensin-converting enzyme (ACE) inhibitors can cause malformations. What advice do you give to Motherisk callers? Most published studies have failed to show an ...