Labor, Delivery, Postpartum

Oct 1, 2007 Issue
Repeat Cesarean Delivery vs. Planned Induction of Labor [Cochrane for Clinicians]

There are no randomized controlled trials (RCTs) of labor induction in women with a low–transverse uterine scar. Observational studies indicate that there is a small increased risk of uterine rupture and adverse fetal outcomes, especially in women induced with prostaglandins. Although induction in t...

Aug 1, 2007 Issue
Cesarean Delivery Rate Hits All-Time High [Practice Guidelines]

According to the Centers for Disease Control and Prevention (CDC), nearly one in three live births in the United States in 2005 was a cesarean delivery, marking the highest U.S. total cesarean rate ever reported.

Jun 1, 2007 Issue
Dystocia in Nulliparous Women [Article]

Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise, physicians providing maternity care should be skilled in the diagnosis, management, and prevention of dystocia. If labor is not progre...

Apr 1, 2007 Issue
ACOG Releases Guideline for Managment of Postpartum Bleeding [Practice Guidelines]

The American College of Obstetricians and Gynecologists (ACOG) has reviewed the risks associated with postpartum hemorrhage and released recommendations on its management.

Mar 15, 2007 Issue
ACOG Releases Opinion on Inducing Labor for VBAC [Practice Guidelines]

The American College of Obstetricians and Gynecologists (ACOG) has released an updated opinion on inducing labor for vaginal birth after cesarean delivery (VBAC). There is a continued debate regarding whether the induction of labor with or without prostaglandins increases the risk of uterine rupture during labor.

Mar 15, 2007 Issue
Prevention and Management of Postpartum Hemorrhage [Article]

Postpartum hemorrhage, the loss of more than 500 mL of blood after delivery, occurs in up to 18 percent of births and is the most common maternal morbidity in developed countries. Although risk factors and preventive strategies are dearly documented, not all cases are expected or avoidable. Uterine ...

Mar 1, 2007 Issue
Are Oral Betamimetics Effective Maintenance Therapies After Threatened Preterm Labor? [Cochrane for Clinicians]

There is no evidence to support the use of oral betamimetics for maintenance therapy after treatment for threatened preterm labor, and there is a risk of adverse effects with these drugs.

Dec 1, 2006 Issue
ACOG Recommends that Physicians Restrict Use of Episiotomy [Practice Guidelines]

According to a practice bulletin from the American College of Obstetricians and Gynecologists (ACOG), prophylactic use of episiotomy does not result in maternal or fetal benefit and should be restricted.

Oct 1, 2006 Issue
Expectant Management vs. Surgical Treatment for Miscarriage [Cochrane for Clinicians]

Expectant management and surgical treatment are safe and effective for first-trimester miscarriage. Among patients who choose expectant management, there is a lower rate of pelvic infection but higher rates of mild bleeding, need for unplanned surgical treatment, and incomplete miscarriage.

Jul 1, 2006 Issue
Planned Early Birth vs. Expectant Management for PROM [Cochrane for Clinicians]

Induction of labor in patients with PROM does not increase the rates of cesarean delivery or operative vaginal delivery. Among patients who are induced there is a slightly lower incidence of chorioamnionitis (relative risk [RR] 0.74; 95% confidence interval [CI], 0.56 to 0.97) and a lower rate of in...

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