No. 203-Rubella in Pregnancy.

Objective: To provide an update on rubella and pregnancy so that health professionals remain aware of the potentially devastating effects on the developing fetus.

Outcomes: Rubella vaccination has been effective in virtually eliminating congenital rubella syndrome in Canada.

Evidence: Medline, PubMed, and Cochrane Database were searched for articles published between 1985 and 2007.

The fetal safety of hydrocortisone-pramoxine (Proctofoam-HC) for the treatment of hemorrhoids in late pregnancy.

Objective: Fetal safety has never been studied for any drug used in the treatment of hemorrhoids. Proctofoam-HC is a combination of a corticosteroid and a local anaesthetic that is proven effective for the treatment of hemorrhoids. The objective of this study was to assess prospectively the fetal safety of third trimester exposure to Proctofoam-HC.

Rubella in pregnancy.

Objective: To provide an update on rubella and pregnancy so that health professionals remain aware of the potentially devastating effects on the developing fetus.

Outcomes: Rubella vaccination has been effective in virtually eliminating congenital rubella syndrome in Canada.

Evidence: Medline, PubMed, and Cochrane Database were searched for articles published between 1985 and 2007.

Guidelines for operative vaginal birth.

Objective: To provide guidelines for operative vaginal birth in the management of the second stage of labour.

Options: Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth. outcome: Reduced fetal and maternal morbidity and mortality.

Exercise in pregnancy and the postpartum period.

Objective: To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy.

Outcomes: Knowledge of the impact of exercise on maternal, fetal, and neonatal morbidity, and of the maternal measures of fitness.

Evidence: MEDLINE search from 1966 to 2002 for English-language articles related to studies of maternal aerobic and strength conditioning in a previously sedentary population, maternal aerobic and strength conditioning in a previously active population, impact of aerobic and strength conditioning on early and late pregnancy outcomes, and impact of aerobic and strength conditioning on neonatal outcomes, as well as for review articles and meta-analyses related to exercise in pregnancy.

The management of nausea and vomiting of pregnancy.

Objectives: To review the evidence-based management of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum.

Evidence: MEDLINE and Cochrane database searches were performed using the medical subject headings (MeSH) of treatment, nausea, vomiting, pregnancy, and hyperemesis gravidarum. The quality of evidence reported in these guidelines has been described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam.

Hemorrhagic shock.

Objective: To review the clinical aspects of hemorrhagic shock and provide recommendations for therapy.

Options: Early recognition of hemorrhagic shock and prompt systematic intervention will help avoid poor outcomes.

Outcomes: Establish guidelines to assist in early recognition of hemorrhagic shock and to conduct resuscitation in an organized and evidence-based manner.