Background: Delivery after preterm prelabour rupture of the membranes (PPROM) may be initiated soon after PPROM or, alternatively, be delayed. It is unclear which strategy is most beneficial for mothers and their babies.
Objectives: To assess the effect of planned early birth compared with expectant management for pregnancies complicated with PPROM prior to 37 weeks' gestation.
Search Strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2009), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 1), MEDLINE (1996 to May 2009), EMBASE (1974 to May 2009), and reference lists of trials and other review articles.
Selection Criteria: Randomised controlled trials comparing expectant management with early delivery for women with PPROM prior to 37 weeks' gestation. We excluded quasi randomised trials.
Data Collection And Analysis: Two review authors independently evaluated trials for inclusion into the review and for methodological quality.
Main Results: We included seven trials (690 women) in the review. We identified no difference in the primary outcomes of neonatal sepsis (risk ratio (RR) 1.33, 95% confidence interval (CI) 0.72 to 2.47) or respiratory distress (RR 0.98, 95% CI 0.74 to 1.29). Early delivery increased the incidence of caesarean section (RR 1.51, 95% CI 1.08 to 2.10). There was no difference in the overall perinatal mortality (RR 0.98, 95% CI 0.41 to 2.36), intrauterine deaths (RR 0.26, 95% CI 0.04 to 1.52) or neonatal deaths (RR 1.59, 95% CI 0.61 to 4.16) when comparing early delivery with expectant management. There was no significant difference in measures of neonatal morbidity, including cerebroventricular haemorrhage (RR 1.90 95% CI 0.52 to 6.92), necrotising enterocolitis (RR 0.58, 95% CI 0.08 to 4.08), or duration of neonatal hospitalisation (mean difference (MD) -0.33 days, 95% CI -1.06 to 0.40 days). In assessing maternal outcomes, we found that early delivery increased endometritis (RR 2.32, 95% CI 1.33 to 4.07), but that early delivery had no effect on chorioamnionitis (RR 0.44, 95% CI 0.17 to 1.14). There was a significant reduction of early delivery on the duration of maternal hospital stay (MD -1.13 days, 95% CI -1.75 to -0.51 days).
Authors' Conclusions: There is insufficient evidence to guide clinical practice on the benefits and harms of immediate delivery compared with expectant management for women with PPROM. To date all of the clinical trials have had methodological weaknesses and have been underpowered to detect meaningful measures of infant and maternal morbidity.
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http://dx.doi.org/10.1002/14651858.CD004735.pub3 | DOI Listing |
SAGE Open Nurs
December 2024
Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
Introduction: Pregnancy can cause various physical and physiological changes. It affects confidence, resulting in depression and disturbing health not only for a mother but also for her fetus. These will also determine the ability of the mother to take care of her baby after delivery.
View Article and Find Full Text PDFDigit Health
December 2024
Pediatric Department, Faculty of Nursing, Khonkaen University, Khonkaen, Thailand.
Objective: This study aims to evaluate the effectiveness of digital health interventions compared to standard care in promoting exclusive breastfeeding (EBF) among postpartum women in low-and middle-income countries (LMICs).
Methods: The PRISMA guidelines of reporting were followed for the searching of four databases and screening following eligibility criteria: articles presenting digital health interventions, conducted as randomized control trials (RCTs), quasi-experimental, or mixed-method studies, reporting on EBF duration and early initiation of breastfeeding, and published in the English language were included.
Results: Of 1595 articles screened, only 10 published between 2013 and 2023 met the criteria.
Acta Biomater
December 2024
Institute for Vision Research, Carver College of Medicine; University of Iowa, Iowa City, IA; Department of Ophthalmology and Visual Sciences, Carver College of Medicine University of Iowa, Iowa City, IA. Electronic address:
In retinal diseases such as age-related macular degeneration (AMD) and choroideremia, a key pathophysiologic step is loss of endothelial cells of the choriocapillaris. Repopulation of choroidal vasculature early in the disease process may halt disease progression. Prior studies have shown that injection of donor cells in suspension results in significant cellular efflux and poor cell survival.
View Article and Find Full Text PDFHealth Technol Assess
December 2024
Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK.
Talanta
December 2024
NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Shandong Engineering Research Center for Transdermal Drug Delivery Systems, Jinan, Shandong, 250000, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong, 250012, China. Electronic address:
Esophageal cancer (EC), the fifth most common cause of cancer-related mortality in China, poses a significant threat to public health. Among the pathological types, esophageal squamous cell carcinoma (ESCC) is predominant, comprising approximately 90 % of cases. Screening is crucial for early detection, diagnosis and treatment, thereby reducing ESCC mortality.
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