Background: Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical context remains inconclusive.
Methods: In a multicenter, double-blind, randomized, controlled trial, we assigned women undergoing cesarean delivery before or during labor at 34 or more gestational weeks to receive an intravenously administered prophylactic uterotonic agent and either tranexamic acid (1 g) or placebo. The primary outcome was postpartum hemorrhage, defined as a calculated estimated blood loss greater than 1000 ml or receipt of a red-cell transfusion within 2 days after delivery.
Objective: Because pessaries may offer symptomatic improvement for women with pelvic organ prolapse (POP), the study aimed to assess the opinion and knowledge of participants to a french general surgical gynecological congress, about this device.
Material And Methods: An anonymous survey was carried out near 150 surgeons attending a congress by handing them a questionnaire.
Results: The average age of the 70 respondents was 50 years.
Background: The use of tranexamic acid reduces mortality due to postpartum hemorrhage. We investigated whether the prophylactic administration of tranexamic acid in addition to prophylactic oxytocin in women with vaginal delivery would decrease the incidence of postpartum hemorrhage.
Methods: In a multicenter, double-blind, randomized, controlled trial, we randomly assigned women in labor who had a planned vaginal delivery of a singleton live fetus at 35 or more weeks of gestation to receive 1 g of tranexamic acid or placebo, administered intravenously, in addition to prophylactic oxytocin after delivery.
Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides reliable permanent contraception without the risks associated with laparoscopic surgery and general anesthesia. Correct positioning of the Essure device is necessary to achieve the fibrotic reaction induced by the polyethylene terephthalate fibers, subsequently resulting in tubal occlusion usually within 3 months.
View Article and Find Full Text PDFBackground: Postpartum hemorrhage (PPH) is a major cause of maternal mortality, accounting for one quarter of all maternal deaths worldwide. Estimates of its incidence in the literature vary widely, from 3 % to 15 % of deliveries. Uterotonics after birth are the only intervention that has been shown to be effective in preventing PPH.
View Article and Find Full Text PDFObjective: To assess the effect of a policy of manual rotation on the mode of delivery of fetuses in posterior or transverse positions at full dilatation.
Methods: This was a prospective study to compare two policies of management for posterior and transverse positions in two different hospitals (Hospital 1: no manual rotation and Hospital 2: manual rotation). We used univariable and multivariable analyses to study the association between the management policy for posterior and transverse positions at full dilatation in these hospitals and maternal and neonatal outcomes.
Objective: To assess the impact of controlled cord traction on the incidence of postpartum haemorrhage and other characteristics of the third stage of labour in a high resource setting.
Design: Randomised controlled trial.
Setting: Five university hospital maternity units in France.
Objective: To show that early discontinuation of oxytocin will not increase the mean duration of the active labor phase in a clinically significant way.
Design: Controlled non-inferiority study.
Setting: Department of Obstetrics and Gynecology, University of Caen, Clemenceau Hospital, France.