Directive clinique N 395 - Excision génitale féminine.

Objectifs: La présente directive clinique vise à diminuer la probabilité que la pratique de l'excision génitale féminine (EGF) se poursuive et à améliorer les soins prodigués aux filles et aux femmes qui ont subi une EGF ou qui risquent d'en subir une en fournissant (1) des renseignements destinés à améliorer les connaissances et la compréhension de la pratique, (2) des renseignements sur les enjeux juridiques liés à cette pratique, (3) des directives relatives au traitement des complications obstétricales et gynécologiques connexes et (4) des directives sur la compétence culturelle dans la prestation de soins aux filles et femmes touchées par l'EGF.

Options: Des stratégies de prévention primaire, secondaire et tertiaire de l'EGF et de ses complications. RéSULTATS: Les conséquences à court et à long terme de l'EGF.

Guideline No. 395-Female Genital Cutting.

Objectives: To decrease the likelihood that the practice of female genital cutting (FGC) be continued in the future and to improve the care of girls and women who have been subjected to FGC or who are at risk by providing (1) information intended to strengthen knowledge and understanding of the practice, (2) information regarding the legal issues related to the practice, (3) guidance for the management of its obstetrical and gynaecological complications, and (4) guidance on the provision of culturally competent care to girls and women affected by FGC.

Options: Strategies for the primary, secondary, and tertiary prevention of FGC and its complications.

Outcomes: The short- and long-term consequences of FGC.

N 235 - Prise en charge active du troisième stade du travail: Prévention et prise en charge de l'hémorragie postpartum.

Objectif: Analyser les aspects cliniques de l'hémorragie postpartum (HPP) et fournir des lignes directrices visant à guider les cliniciens pour ce qui est de la prévention et de la prise en charge de l'HPP. La présente directive clinique est une mise à jour de la directive clinique précédente de la Société des obstétriciens et gynécologues du Canada (SOGC) sur l'HPP, publiée en avril 2000. RéSULTATS: Des recherches ont été menées dans Medline, PubMed, la Cochrane Database of Systematic Reviews, le ACP Journal Club et le BMJ Clinical Evidence afin d'en tirer les articles pertinents, en portant une attention particulière aux essais comparatifs randomisés (ECR), aux analyses systématiques et aux directives cliniques publiées entre 1995 et 2007.

No. 235-Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage.

Objective: To review the clinical aspects of postpartum hemorrhage (PPH) and provide guidelines to assist clinicians in the prevention and management of PPH. These guidelines are an update from the previous Society of Obstetricians and Gynaecologists of Canada (SOGC) clinical practice guideline on PPH, published in April 2000.

Evidence: Medline, PubMed, the Cochrane Database of Systematic Reviews, ACP Journal Club, and BMJ Clinical Evidence were searched for relevant articles, with concentration on randomized controlled trials (RCTs), systematic reviews, and clinical practice guidelines published between 1995 and 2007.

No. 279-Female Sexual Health Consensus Clinical Guidelines.

Objective: To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women.

Evidence: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e.g.

No. 279-Female Sexual Health Consensus Clinical Guidelines.

Objective: To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women.

Evidence: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e .g.

No. 245-Alcohol Use and Pregnancy Consensus Clinical Guidelines.

Objective: To establish national standards of care for the screening and recording of alcohol use and counselling on alcohol use of women of child-bearing age and pregnant women based on the most up-to-date evidence.

Evidence: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in May 2009 using appropriate controlled vocabulary (e.g.

Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis.

Background: The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32+0 weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection.

Methods: Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective.

RETIRED: Female genital cutting.

This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.

Health professionals working with First Nations, Inuit, and Métis consensus guideline.

Objective: Our aim is to provide health care professionals in Canada with the knowledge and tools to provide culturally safe care to First Nations, Inuit, and Métis women and through them, to their families, in order to improve the health of First Nations, Inuit, and Métis.

Evidence: Published literature was retrieved through searches of PubMed, CINAHL, Sociological Abstracts, and The Cochrane Library in 2011 using appropriate controlled vocabulary (e.g.

Preventable obstetrical interventions: how many caesarean sections can be prevented in Canada?

Public health authorities have been alarmed by the progressive rise in rates of Caesarean section in Canada, approaching one birth in three in several provinces. We aimed therefore to consider what were preventable obstetrical interventions in women with a low-risk pregnancy and to propose an analytic framework for the reduction of the rate of CS. We obtained statistical variations of CS rates over time, across regions, and within professional practices from MED-ÉCHO, the Quebec hospitalization database, from 1969 to 2009.

RETIRED: Cancer chemotherapy and pregnancy.

This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.

Emergency contraception: no. 280 (replaces No. 131, August 2003).

Objective: To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting.

Options: The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital use of copper intrauterine devices, are reviewed.

Outcomes: Efficacy in terms of reduction in risk of pregnancy, safety, and side effects of methods for EC and the effect of the means of access to EC on its appropriate use and the use of consistent contraception.

Advanced reproductive age and fertility: no. 269, November 2011.

Objective: To improve awareness of the natural age-related decline in female and male fertility with respect to natural fertility and assisted reproductive technologies (ART) and provide recommendations for their management,and to review investigations in the assessment of ovarian aging.

Options: This guideline reviews options for the assessment of ovarian reserve and fertility treatments using ART with women of advanced reproductive age presenting with infertility.

Outcomes: The outcomes measured are the predictive value of ovarian reserve testing and pregnancy rates with natural and assisted fertility.

The diagnosis and management of ovarian hyperstimulation syndrome: No. 268, November 2011.

Objective: To review the clinical aspects of ovarian hyperstimulation syndrome and provide recommendations on its diagnosis and clinical management.

Outcomes: These guidelines will assist in the early recognition and management of ovarian hyperstimulation. Early recognition and prompt systematic supportive care will help avert poor outcomes.

SOGC clinical practice guidelines: Oral contraceptives and the risk of venous thromboembolism: an update: no. 252, December 2010.

Objective: To provide current and emerging evidence on oral contraceptives and the risk of venous thromboembolism.

Evidence: Articles published in English from 2005 were retrieved through searches of PubMed and Medline, using the following terms: venous thromboembolism, VTE, contraception, oral contraceptives, hormonal contraception. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies.

Asymptomatic endometrial thickening.

Objective: To formulate clinical recommendations for the assessment of endometrial thickening when it is found on ultrasound in a postmenopausal patient without bleeding.

Outcomes: Ensure that women with asymptomatic thickening and endometrial polyps found on ultrasound are managed appropriately.

Evidence: Published literature was retrieved through searches of English language articles from the EMBASE, Cochrane, and PubMed databases for relevant peer-reviewed articles dating from 1970 to 2009, using appropriate controlled vocabulary (e.