Publications by authors named "James G Thornton"

Article Synopsis
  • Chronic or gestational hypertension affects about 7% of pregnancies, and the WILL Trial aimed to find the best timing for delivery to improve outcomes for mothers and babies.
  • The trial involved women with hypertension at 36 to 37 weeks gestation who were randomly assigned to either an early delivery intervention at 38 weeks or usual care at term, analyzing maternal and neonatal outcomes.
  • Despite aiming for 540 participants, the trial ended early with only 403 participants due to slow recruitment, showing no significant difference in poor maternal outcomes between the two groups, while deliveries in the intervention group occurred about 0.9 weeks earlier.
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Objectives: To determine the extent to which a sample of NHS labor induction leaflets reflects evidence on labor induction.

Setting: Audit of labor induction patient information leaflets-local from WILL trial (When to Induce Labor to Limit risk in pregnancy hypertension) internal pilot sites or national-level available online.

Methods: Descriptive analysis [ = 21 leaflets, 19 (one shared) in 20 WILL internal pilot sites and 2 NHS online] according to NHS "Protocol on the Production of Patient Information" criteria: general information (including indications), why and how induction is offered (including success and alternatives), and potential benefits and harms.

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Objective: To measure the potential for outcome switching and selective reporting, in trials of luteal phase progestogen in assisted reproduction.

Study Design: Trials identified through Medline and Embase in August 2017 using the MeSH term "assisted reproductive technology, luteal phase support" and associated text words. Randomised controlled trials (RCTs) comparing progestogen of any type, dose, and route of administration, with placebo or no treatment as luteal phase support in subfertile women undergoing in vitro fertilization (IVF) or intrauterine insemination (IUI).

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Background: The risk of antepartum stillbirth at term is higher among women 35 years of age or older than among younger women. Labor induction may reduce the risk of stillbirth, but it also may increase the risk of cesarean delivery, which already is common in this older age group.

Methods: We conducted a randomized, controlled trial involving primigravid women who were 35 years of age or older.

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Background: Smoking during pregnancy causes many adverse pregnancy and birth outcomes. Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants.

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Objectives: To determine the consistency between information contained in the registration and publication of randomised controlled trials (RCTs).

Design: An observational study of RCTs published between May 2011 and May 2012 in the British Medical Journal (BMJ) and the Journal of the American Medical Association (JAMA) comparing registry data with publication data.

Participants And Settings: Data extracted from published RCTs in BMJ and JAMA.

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Objectives: To test whether ursodeoxycholic acid reduces pruritus in women with intrahepatic cholestasis of pregnancy, whether early term delivery does not increase the incidence of caesarean section, and the feasibility of recruiting women with intrahepatic cholestasis of pregnancy to trials of these interventions.

Design: First phase of a semifactorial randomised controlled trial.

Setting: Nine consultant led maternity units, United Kingdom.

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Background: Nicotine-replacement therapy is effective for smoking cessation outside pregnancy and its use is widely recommended during pregnancy. We investigated the efficacy and safety of nicotine patches during pregnancy.

Methods: We recruited participants from seven hospitals in England who were 16 to 50 years of age with pregnancies of 12 to 24 weeks' gestation and who smoked five or more cigarettes per day.

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Background: Women with twin pregnancy are at high risk for spontaneous preterm delivery. Progesterone seems to be effective in reducing preterm birth in selected high-risk singleton pregnancies, albeit with no significant reduction in perinatal mortality and little evidence of neonatal benefit. We investigated the use of progesterone for prevention of preterm birth in twin pregnancy.

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The case of a 36 year-old primigravida is presented. After a normal anomaly scan at 22 weeks and a normal pregnancy, she went into labor at term. Dystocia due to massive abdominal distension complicated the second stage.

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Background: Elective preterm delivery of the fetus with gastroschisis may help to limit injury to the extruded fetal gut and thus promote faster recovery of neonatal gut function and earlier hospital discharge. This hypothesis has not previously been tested in a prospective randomized controlled trial.

Methods: Between May 1995 and September 1999, all women referred to a single tertiary center before 34 weeks' gestation with a sonographically diagnosed fetal gastroschisis were invited to participate in a randomized controlled trial.

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Background: Women who are undelivered after 48 hours of tocolysis remain at increased risk of preterm labour, but it is not clear whether prolonged treatment is effective.

Objective: To review the current evidence for the effectiveness of maintenance tocolysis.

Methods: The results of published systematic reviews were summarised.

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