PregnanciesCerclage versus expectant managementOutcomesPerinatalVaginalGestational ageSevereInterventionSpontaneous deliverySepsisPPROMProphylacticCervicalInterventionsOutcomeWomenCervixIntrauterineDifferencesMaternalCONCLUSIONSPregnancyIncidenceGroupAntibioticsLaborMETHODSThird stagePhysiologicalPatientsConsistsUnclearDeliveryParticipantsLabour managementWeeksTermInfectionsActive managementApproachesStudyEpidemiology
Pregnancies5
- Women randomised to early birth had a decreased total length of hospitalisation (MD -1.75 days, 95% CI -2.45 to -1.05, six trials, 2848 women, evidence graded moderate).Subgroup analyses indicated improved maternal and infant outcomes in expectant management in pregnancies greater than 34 weeks' gestation, specifically relating to RDS and maternal infections. (qxmd.com)
- Clinicians should be familiar with the acceptable alternative methods of management of late-term and post-term pregnancies. (harvard.edu)
- Management of late-term and post-term pregnancies. (harvard.edu)
- Among those having "planned deliveries" at 36 weeks gestation, a composite of stillbirth, neonatal death, assisted ventilation, and neonatal seizures (the study's primary endpoint) was roughly four times as common than in women who continued their pregnancies ("expectant management"), at 10.0% versus 2.6% (P =0.04), reported Lorie M. Harper, MD , of the University of Alabama at Birmingham, and colleagues. (medpagetoday.com)
- Nine case-control studies found a significantly higher prevalence of factor V Leiden in women with pre-eclampsia (8%-26%) compared with women with normal pregnancies (2%-10%) with ORs ranging from 2 to 6 (10,11,12,13,14) In contrast, 15 other studies found no association of factor V Leiden with pre-eclampsia. (contemporaryobgyn.net)
Cerclage versus expectant management3
- Pessary versus cerclage versus expectant management for cervical dilat" by Alexis C. Gimovsky, Anju Suhag et al. (jefferson.edu)
- Pessary versus cerclage versus expectant management for cervical dilation with visible membranes in the second trimester. (jefferson.edu)
- Patient should be adequately counseled by perinatologist regarding risks and benefits of surgical management with emergency cerclage versus expectant management with bed rest, antibiotics and tocolysis. (contemporaryobgyn.net)
Outcomes8
- There was a significant difference in all the perinatal outcomes with cerclage compared with either pessary or expectant management. (jefferson.edu)
- CONCLUSIONS: Perinatal outcomes with pessary were not superior to expectant management in women with dilated cervix with exposed membranes in the second trimester in this small retrospective cohort. (jefferson.edu)
- To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and induction of labour at 42 weeks. (afar.info)
- For primary outcomes, we identified no clear differences between early birth and expectant management in neonatal sepsis (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.66 to 1.30, 12 trials, 3628 babies, evidence graded moderate), or proven neonatal infection with positive blood culture (RR 1.24, 95% CI 0.70 to 2.21, seven trials, 2925 babies). (qxmd.com)
- DISCUSSION: The present trial will provide evidence as to whether or not, in women affected by gestational diabetes, induction of labour between 38+0 and 39+0 weeks is an effective management to ameliorate maternal and neonatal outcomes. (unito.it)
- Evidence Central , evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314053/all/Cesarean_rates_and_neonatal_outcomes_similar_with_induction_vs_expectant_management_with_unripe_cervix. (unboundmedicine.com)
- Objectives: To assess, using the best available evidence, the effects of immediate delivery versus expectant management of the term suspected compromised baby on neonatal, maternal and long-term outcomes. (mendeley.com)
- Examining secondary outcomes, there were no statistically significant differences between expectant management and planned delivery until 38 weeks gestation. (medpagetoday.com)
Perinatal4
- The study was stopped early owing to a significantly higher rate of perinatal mortality in the expectant management group. (afar.info)
- No perinatal deaths occurred in the induction group but six (five stillbirths and one early neonatal death) occurred in the expectant management group (P=0.03). (afar.info)
- This study comparing induction of labour at 41 weeks with expectant management and induction at 42 weeks does not show any significant difference in the primary composite adverse perinatal outcome. (afar.info)
- Expectant management risks include but are not limited to: intrauterine fetal demise, perinatal death, meconium aspiration syndrome and dysmaturity syndrome. (harvard.edu)
Vaginal1
- TITLE OF THE STUDY: Perineal re-suturing versus expectant management following vaginal delivery complicated by a dehisced wound (PREVIEW): A mixed methods study, incorporating a pilot and feasibility randomised controlled trial. (staffs.ac.uk)
Gestational age2
- Babies of women randomised to early birth were delivered at a gestational age lower than those randomised to expectant management (mean difference (MD) -0.48 weeks, 95% CI -0.57 to -0.39, eight trials, 3139 babies). (qxmd.com)
- Accurate assessment of gestational age is of paramount importance for management of pregnancy, interpretation of test results, and timing of interventions. (harvard.edu)
Severe5
- After 39 weeks, women with chronic hypertension who received expectant management showed a significant increase in severe preeclampsia versus women with planned deliveries, 10.3% versus 0% ( P =0.001). (medpagetoday.com)
- It has also been used as an immunosuppressive agent in the prevention of graft versus host disease and in the treatment of severe psoriasis and rheumatoid arthritis. (medscape.com)
- Hall DR, Odendaal HJ, Steyn DW, Grové D . Expectant management of early onset, severe pre-eclampsia: maternal outcome. (nature.com)
- Aggressive or expectant management for patients with severe preeclampsia between 28-34 weeks' gestation: a randomized controlled trial. (nature.com)
- Aggressive versus expectant management of severe preeclampsia at 28-32 weeks' gestation: a randomized controlled trial. (nature.com)
Intervention5
- Penetrating injuries, unstable patients and grade V injuries often require surgical intervention. (ugeskriftet.dk)
- Some investigators have questioned the need for unnecessary surgical or medical intervention in very early cases and have advocated expectant management in select cases. (medscape.com)
- 7 of 10 fractures were initially managed expectantly with 1 ultimately failing expectant management and requiring surgical intervention. (harvard.edu)
- Future studies are also needed to determine the cost-effectiveness of PET/CT versus MRI and compare the morbidity associated with expectant management versus surgical intervention in patients with symptomatic fractures. (harvard.edu)
- Sont retenues tous les dossiers des femmes qui ont eu un travail spontané, sans autre médication ou intervention en dehors de la délivrance dirigée. (afar.info)
Spontaneous delivery1
- Women who opt to take part will be randomized according to induction of labour or expectant management for spontaneous delivery. (unito.it)
Sepsis1
- Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group - A (expectant management group). (journalcra.com)
PPROM2
- Current management of preterm prelabour rupture of the membranes (PPROM) involves either initiating birth soon after PPROM or, alternatively, adopting a 'wait and see' approach (expectant management). (qxmd.com)
- Randomised controlled trials comparing planned early birth with expectant management for women with PPROM prior to 37 weeks' gestation. (qxmd.com)
Prophylactic1
- The use of prophylactic antibiotics were shown to be effective in reducing maternal infections in women randomised to expectant management.Overall, we assessed all 12 studies as being at low or unclear risk of bias. (qxmd.com)
Cervical1
- Whichever method is chosen (membrane sweep, cervical ripening agent, cervical dilator, oxytocin or amniotomy), the prenatal record must indicate that a discussion regarding management of pregnancy exceeding 41 weeks gestation occurred between the obstetrical provider and the patient and risks and benefits were reviewed. (harvard.edu)
Interventions1
- In a recent randomized study on induction after 12 hours versus expectant management during 48 hours, in the induction group the need for pain medication was significantly greater and there were more interventions, while mild neonatal infection occurred in 1.6% in the induction group versus 3.2% in the group with expectant management. (nzdl.org)
Outcome2
- Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome. (qxmd.com)
- But there was no significant difference in the primary outcome between women who received expectant management compared with those who underwent planned delivery at 37-39 weeks gestation. (medpagetoday.com)
Women14
- Women received pessary, cerclage or expectant management. (jefferson.edu)
- 1381 women were assigned to the induction group and 1379 were assigned to the expectant management group. (afar.info)
- To assess the effect of planned early birth versus expectant management for women with preterm prelabour rupture of the membranes between 24 and 37 weeks' gestation for fetal, infant and maternal well being. (qxmd.com)
- Women assigned to the expectant arm will be sent to their domicile where they will be followed up until delivery, through maternal and fetal wellbeing monitoring twice weekly. (unito.it)
- The primary objective is to determine whether caesarean section rate could be reduced among women undergoing induction of labour, in comparison to patients allocated to expectant monitoring. (unito.it)
- Selection criteria: Randomised or quasi-randomised controlled trials comparing expectant management versus planned early delivery for women with a suspected compromised fetus from 37 weeks' gestation or more. (mendeley.com)
- IUDs do not protect against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and women using these methods should be counseled that consistent and correct use of the male latex condom reduces the risk for transmission of HIV and other STDs. (cdc.gov)
- However, those women who received expectant management after 38 weeks gestation (full-term) had nonsignificant increases in the primary endpoint compared with women having planned deliveries during this period, they wrote in Obstetrics and Gynecology . (medpagetoday.com)
- Women with pre-eclampsia/eclampsia were more likely to have heterozygous factor V Leiden mutation, heterozygous G20210A prothrombin gene mutation, homozygous MTHFR C677T mutation, protein C deficiency, protein S deficiency or activated protein C resistance compared with controls. (contemporaryobgyn.net)
- Women who had active management had a higher risk of a blood loss of more than 500 mL, the risk was 2.761 when a woman was actively managed (95% CI: 2.441-3.122) when compared to physiological management. (afar.info)
- Women giving birth at home and in a primary unit were more likely to have physiological management. (afar.info)
- For women who were given a uterotonic drug as a treatment rather than prophylaxis a postpartum haemorrhage of more than 500 mL was twice as likely in the actively managed group compared to the physiological managed group (6.9% vs. 3.7%, RR 0.54, CI: 0.5, 0.6). (afar.info)
- It reviews the diagnosis, evaluation, and management of the hypertensive disorders of pregnancy (HDPs), the prediction and prevention of preeclampsia, and the postpartum care of women with a previous HDP. (bvsalud.org)
- Labor induction versus expectant management in low-risk nulliparous women. (msdmanuals.com)
Cervix1
- OBJECTIVE: We evaluated pessary for dilated cervix and exposed membranes for prolonging pregnancy compared to cerclage or expectant management. (jefferson.edu)
Intrauterine1
- Intrauterine fetoscopic laser surgery versus expectant management in stage 1 twin-to-twin transfusion syndrome: an international randomized trial. (amedeo.com)
Differences2
- I take this opportunity to summarize my own attitude during the third stage of labour, in order to stress the differences between my experience and the "expectant" or so-called "physiological" management used in randomized studies (Odent 1998). (midwiferytoday.com)
- In this retrospective study, researchers used the Safer Dx tool to explore differences in diagnostic errors among NEPL versus English-proficient (EP) patients. (ahrq.gov)
Maternal2
- These statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards. (thieme-connect.de)
- System versus Standard Use for the Prevention of Postpartum hemorrhage (PPH) is a leading cause of maternal death. (bvsalud.org)
CONCLUSIONS1
- Conclusions and Relevance Among patients with a persisting pregnancy of unknown location , patients randomized to receive active management, compared with those randomized to receive expectant management , more frequently achieved successful pregnancy resolution without change from the initial management strategy. (bvsalud.org)
Pregnancy4
- Effect of an Active vs Expectant Management Strategy on Successful Resolution of Pregnancy Among Patients With a Persisting Pregnancy of Unknown Location: The ACT or NOT Randomized Clinical Trial. (bvsalud.org)
- To determine if active management is more effective in achieving pregnancy resolution than expectant management and whether the use of empirical methotrexate is noninferior to uterine evacuation followed by methotrexate if needed. (bvsalud.org)
- SMFM Special Statement: Updated checklists for management of monochorionic twin pregnancy. (amedeo.com)
- Among the greatest advances in the management of ectopic pregnancy has been the development of medical management, which became available in the mid-1980s. (medscape.com)
Incidence1
- Despite known risk factors and recent reports describing the incidence on the order of 30 percent, there has been a dearth of translational research or consensus statements to guide clinical management. (harvard.edu)
Group5
- Time until delivery was 16.1 ± 18.9 days in the pessary group, 61.7 ± 48.2 days in the cerclage group and 26.8 ± 33.4 days in the expectant group (p (jefferson.edu)
- Ninety-nine patients (39%) declined their randomized allocation (26.7% declined expectant management , 48.3% declined uterine evacuation , and 41.5% declined empirical methotrexate ) and crossed over to a different group. (bvsalud.org)
- Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours. (journalcra.com)
- 12 hours in 72 % of induced groups (Group B) and 10% (5) in group- A (conservative or expectant group). (journalcra.com)
- LSCS rate was 10 % in group-A (expectant group) &15 % in group -B (induced group). (journalcra.com)
Antibiotics1
- In different populations a more active management may be advisable, with the use of antibiotics and earlier induction of labour. (nzdl.org)
Labor2
- The objectives of this article are to review the issues and practices regarding the third stage of labor and to examine the evidence that supports particular management strategies. (medscape.com)
- In the earlier studies, elective induction was compared only to spontaneous labor: people who were electively induced versus people who went into spontaneous labor. (evidencebasedbirth.com)
METHODS1
- At the conclusion of today's session the participant will be able to describe the risk factors, endemic areas, and incubation period of hantavirus infection, identify the clinical presentation and methods to identify a patient with hantavirus in the clinical setting, and understand the parameters of clinical management and critical care for patients with hantavirus. (cdc.gov)
Third stage1
- Background during the third stage of labour there are two approaches for care provision - active management or physiological (expectant) care. (afar.info)
Physiological1
- A clear division exists between authorities who advocate the physiological approach and those who advocate the active approach to management. (medscape.com)
Patients8
- Eligible patients were randomized in a 111 ratio to expectant management (n = 86), active management with uterine evacuation followed by methotrexate if needed (n = 87), or active management with empirical methotrexate using a 2- dose protocol (n = 82). (bvsalud.org)
- Knowledge of the management and potential complications in patients with renal trauma is important for all urologists. (ugeskriftet.dk)
- However, expectant management is supported for some patients with grade V blunt trauma. (ugeskriftet.dk)
- The aim of this study was to describe and evaluate the management of patients with renal trauma and their complications at the Department of Urology, Aarhus University Hospital (AUH), Denmark, during a five-year period. (ugeskriftet.dk)
- Patients with hourglassing of membranes prior to 24 weeks can be offered surgical or expectant management. (contemporaryobgyn.net)
- Regardless of the management option, these patients have a very high risk of spontaneous rupture of membranes and preterm delivery. (contemporaryobgyn.net)
- In this chapter, we will address the main anatomical causes that may impact the implantation rates of patients undergoing IVF, as well as recommendations on management and its treatment. (intechopen.com)
- In the majority of patients, the antibody is directed specifically against the P or I antigen on the red blood cell (RBC) surface. (medscape.com)
Consists1
- In such cases, treatment consists of expectant management only. (medscape.com)
Unclear1
- Pathological results would necessitate the need for immediate delivery, but the management for 'suspicious' results remains unclear and varies widely across clinical centres. (mendeley.com)
Delivery3
- Mean GA at delivery was 22.9 ± 4.5 weeks with pessary, 29.2 ± 7.5 weeks with cerclage and 25.6 ± 6.7 weeks with expectant management (p = 0.015). (jefferson.edu)
- Planned early delivery versus exp. (mendeley.com)
- Main results: Of the 20 reports identified by the search strategy, we included three trials (546 participants: 269 to early delivery and 277 to expectant management), which met our inclusion criteria. (mendeley.com)
Participants1
- A total of 58% and 57% of participants received expectant management, while 40% and 41% were treated with IUI. (medscape.com)
Labour management1
- The cause of this small percentage can be twofold: at the introduction of the partograph in the hospitals a discussion of labour management took place which may have affected the way the latent phase is perceived. (nzdl.org)
Weeks2
- Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial. (afar.info)
- Induction of labour at 41 weeks and expectant management and induction of labour at 42 weeks. (afar.info)
Term1
- Strong evidence indicating the best management between induction of labour at term and expectant monitoring are missing. (unito.it)
Infections1
- Exclusive breastfeeding provides a protective effect against respiratory illnesses, ear infections, gastrointestinal diseases, and allergies including asthma, eczema and atopic dermatitis. (who.int)
Active management1
- A longer labour and higher parity increased the odds of having active management. (afar.info)
Approaches1
- While management strategies are often controversial, for disagreement to persist when fairly compelling evidence supports one of the two approaches is somewhat unusual. (medscape.com)
Study1
- Selective vs complete fetoscopic coagulation of vascular equator: a matched comparative study. (amedeo.com)
Epidemiology1
- From 1999 through April 2016, Dr. Mertz was the principal investigator at the National Institutes of Health International Collaborations in infectious diseases research grant U19/U01 focused on epidemiology, natural history and management of hantavirus cardiopulmonary syndrome in Chile and Panama. (cdc.gov)