Labour and Delivery - Related Resources
Cochrane reviews
- In women making slow progress in spontaneous labour, oxytocin appears to reduce the time to delivery of approximately two hours without increasing caesarean sections compared with no treatment or delayed oxytocin treatment Oxytocin Versus No Treatment or Delayed Treatment for Slow Progress in the First Stage of Spontaneous Labour.
- For nulliparous women in normal spontaneous labour, early amniotomy and oxytocin if slow progress in labour ensues may slightly reduce the rate of caesarean section and may decrease the duration of labour compared to expectant management Early Amniotomy and Early Oxytocin in First Stage Spontaneous Labour Compared with Routine Care.
- There may be no difference between internal or external tocodynamometry during induced or augmented labour for any of the maternal or neonatal outcomes Internal Versus External Tocodynamometry during Induced or Augmented Labour.
- Use of the admission cardiotocograph (CTG) for low-risk women on admission in labour appears not to be effective compared with intermittent auscultation Cardiotocography Versus Intermittent Auscultation of Fetal Heart on Admission to Labour Ward for Assessment of Fetal Wellbeing.
- Continuous CTG during labour is effective in reducing neonatal seizures compared with intermittent auscultation. However, continuous CTG may not reduce infant mortality or cerebral palsy. It appears to increase caesarean sections and instrumental vaginal births Continuous Cardiotocography (Ctg) for Fetal Assessment during Labour.
- Fetal pulse oximetry (FPO) appears not to reduce overall caesarean section rate when added to cardiotocography (CTG) even if the rate may be decreased when FPO is used in the presence of a nonreassuring CTG Fetal Pulse Oximetry for Fetal Assessment in Labour.
- Traditional or computerised cardiotocography seems not to improve fetal outcomes, although the data are insufficient for important clinical outomes Antenatal Cardiotocography for Fetal Assessment.
- Partogram use in spontaneous labour at term seems not to be effective compared to no partogram, although the evidence is limited Partogram Use on Outcomes for Women in Spontaneous Labour at Term.
- Walking and upright positions in the first stage of labour may reduce the length of labour and do not seem to be associated with increased intervention or negative effects on mothers' and babies' wellbeing Maternal Positions and Mobility during First Stage Labour.
- Upright posture during the second stage of labour may provide several possible benefits; however, there may be an increased risk of blood loss greater than 500 ml. Women should be encouraged to give birth in the position they find most comfortable Woman's Position during Second Stage of Labour.
- Free intake of oral fluid and food during labour may not increase complications in women at low risk of complications Restricting Oral Fluid and Food Intake during Labour.
- Enemas during labour may not improve puerperal or neonatal infection rates or maternal satisfaction Enemas during Labour.
- The rapid negative pressure application for vacuum assisted vaginal birth appears to reduce duration of the procedure compared with stepwise procedure without difference in maternal or neonatal outcomes Rapid Versus Stepwise Negative Pressure Application for Vacuum Extraction Assisted Vaginal Delivery.
- Active management in labour seems to be effective for slightly reducing the caesarean section rates in low-risk pregnancies compared to routine care, but at the cost of increasing interventions Active Management in Labour for Reducing Caesarean Section Rates in Low-Risk Women.
- For nulliparous women in normal spontaneous labour, early amniotomy and oxytocin if slow progress in labour ensues seems to slightly reduce the rate of caesarean section and may decrease the duration of labour compared to expectant management Early Amniotomy and Early Oxytocin in First Stage Spontaneous Labour Compared with Routine Care.
- Trial of labour appears to be at least as safe for most outcomes as repeat caesarean section Trial of Labour or Repeated Caesarean Section.
- Continuous suturing techniques for perineal closure after childbirth, compared to interrupted methods, are associated with less short-term pain .
- Primary end-to-end repair of obstetric anal sphincter injury may be as effective as primary overlap repair for preventing perineal pain, dyspareunia and faecal incontinence .
- Delayed cord clamping may increase early haemoglobin concentrations and iron stores in infants compared to early clamping in term infants. However, access to treatment for jaundice requiring phototherapy should be available Timing of Umbilical Cord Clamping.
- Delaying umbilical cord clamping by up to two minutes may reduce the need for transfusion and the occurrence of intraventricular haemorrhage in preterm infants Early Versus Delayed Umbilical Cord Clamping in Preterm Infants.
- Tranexamic acid might possibly decrease postpartum blood loss after vaginal birth or caesarean section compared with placebo or no treatment Tranexamic Acid for Preventing Postpartum Haemorrhage.
- Active management of the third stage of labour may reduce the mother´s risk of haemorrhage greater than 1000 ml compared to expectant management Active Versus Expectant Management for Women in the Third Stage of Labour.
- Intravenous carbetocin appears to be as effective as oxytocin for preventing postpartum haemorrhage .
- Anti-D, given within 72 hours after childbirth, reduces the risk of RhD alloimmunisation in Rhesus negative women who have given birth to a Rhesus positive infant Anti-D after Childbirth for Preventing Rhesus Alloimmunisation.
- Midwife-led (licensed) care for pregnant women may be more effective than other models of care for pregnant women at low or mixed risk Midwife-Led Vs other Models of Care for Childbearing Women.
- Interventions that involve health workers in analysing and modifying their practice seem to be effective for reducing caesarean section rates .
- Local cooling treatments (ice packs, cold gel pads, cold/iced baths) applied to the perineum following childbirth seem to have some effect on pain relieving compared to no treatment, although the evidence is limited .
- Hospital-based alternative birth settings compared to conventional settings may be associated with increased likelihood of spontaneous vaginal birth, reduced medical interventions and increased maternal satisfaction, but it is important to watch for signs of complications Home-Like Versus Conventional Institutional Settings for Birth.
- Antibiotic prophylaxis given during the second or third trimester of pregnancy may reduce the risk of prelabour rupture of membranes and postpartum endometritis, but there is absence of evidence of a benefit on neonatal morbidity and mortality .
- Plastic wraps or bags, plastic caps, skin-to-skin care and transwarmer mattresses all keep preterm infants warmer, leading to higher temperatures on admission to neonatal units and less hypothermia Prevention of Hypothermia at Birth in Preterm and/or Low Birthweight Babies.
- Early discharge of healthy mothers and term infants may be safe after uncomplicated delivery for well-informed mothers when accompanied by a policy of offering women at least one nurse-midwife home visit post discharge Safety of Early Postpartum Discharge.
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