This comparative study carried out on 550 patients has made it possible for us to show how valuable prophylactic antibiotic therapy is when certain intra-uterine manipulations (such as forceps delivery, manual removal of the placenta or exploration of the cavity of the uterus) are carried out during vaginal delivery. Furthermore, we have been able to show that there are certain risk factors of which the most important are premature rupture of the membranes, infected liquor, birth weight of the infant less than 2,500 g and epidural analgesia. The financial study has shown that it is cheaper to use prophylactic antibiotics when the comparison is made with the cost of treating complications of infection associated with these intra-uterine procedures.
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BMJ Open
January 2025
Western Sydney University, School of Nursing and Midwifery, Penrith, New South Wales, Australia.
Objectives: In this descriptive study, we aimed to assess how the index mode of birth and subsequent birth modes vary over time for public and private hospital maternity care funding models. The second aim was to determine to what extent the index mode of birth predicts subsequent birth modes in general and whether this differs in public versus private hospital maternity care funding models. With our aim, we have an innovative approach, specifically the women's life course approach, which is hypothesis-generating and can be assessed in future studies.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Objectives: To study the effect of implementing a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates across five hospitals.
Design: Prospective quality improvement study.
Setting: Five Canadian hospital sites participated, two academic centres and three community hospitals, with annual delivery rates ranging from 2500 to 7500 per site.
Am J Obstet Gynecol MFM
January 2025
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University.
Background: PTB (PTB) remains a leading cause of neonatal morbidity and mortality. Cerclage for short cervical length (CL) ≤25mm in singletons with a history of spontaneous PTB is associated with decreased neonatal morbidity/mortality. Both vaginal progesterone and cerclage individually have level 1 evidence supporting benefit in prevention of PTB in pregnancies complicated by short CL, however there is a paucity of level 1 evidence regarding the potential benefit of cerclage with progesterone compared to progesterone alone for short CL ≤25mm in singletons without a history of spontaneous PTB.
View Article and Find Full Text PDFNurs Outlook
January 2025
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA.
Background: Cesarean birth increases risk of maternal morbidity and mortality.
Purpose: Examine the relationship between labor and delivery staffing and hospital cesarean and vaginal birth after cesarean (VBAC) rates.
Methods: Survey of U.
PLOS Glob Public Health
January 2025
Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
Family medicine was recognized as a distinct specialty in India in the early 1980s, but it is at an early stage of implementation. There are few training programs, and little is known about family physicians' training, perceptions, and current practices. This paper describes the findings from the first national survey of family medicine in India.
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