ITEMS IN AFP WITH KEYWORD:
Labor, Delivery, Postpartum
This intervention, which included primiparous women with and without urinary incontinence at six weeks post-partum, demonstrated that intensive supervised pelvic floor muscle training did not reduce the prevalence of urinary incontinence at six months. These results are noteworthy because the trial was well designed and the results were unexpected.
Jun 1, 2013 Issue
Oxytocin Augmentation During Labor with Epidural Analgesia [Cochrane for Clinicians]
Oxytocin augmentation does not reduce the frequency of cesarean delivery, instrumental vaginal delivery, or the combined outcome of both. Oxytocin also has no effect on low five-minute Apgar scores, postpartum hemorrhage, uterine hyperstimulation, or neonatal intensive care unit admission.
Jun 1, 2013 Issue
Contraceptive Education for Women After Childbirth [Cochrane for Clinicians]
Postpartum education may increase contraceptive use and reduce unplanned repeat pregnancies, although the evidence is mixed. The optimal timing and content of educational programs are not known.
Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically significant di...
Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a continuous in...
Dec 15, 2011 Issue
CDC Updates Recommendations for Contraceptive Use in the Postpartum Period [Practice Guidelines]
Initiating appropriate contraception in the postpartum period is important to avoid negative outcomes related to short birth intervals. The Centers for Disease Control and Prevention (CDC) recently reevaluated the safety of contraceptive use in the postpartum period.
Use of forceps is more likely to result in a vaginal delivery than use of vacuum devices (relative risk [RR] = 1.5; 95% confidence interval [CI], 1.1 to 2.2), but has a higher rate of perineal trauma, tears, pain, and incontinence, and a trend toward more cesarean deliveries. Use of metal-cup vacuum...
Jun 1, 2011 Issue
Magnesium Sulfate and Other Anticonvulsants for Women with Preeclampsia [Cochrane for Clinicians]
Magnesium sulfate should be considered first-line treatment to prevent eclamptic seizures during labor.
The rate of cesarean delivery has increased dramatically in the United States over the past four decades, perpetuated somewhat by the dictum “once a cesarean, always a cesarean.” However, evidence has shown that many women who have had a cesarean delivery can safely deliver vaginally in subsequent p...
This scenario raises several key questions that are important not only to patient care, but also to physicians' quality of life and satisfaction with practice. First, what are the critical roles for the family physician during prenatal care, labor, and birth?