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A systematic review of ambroxol hydrochloride in patients with meconium aspiration syndrome

Bibliographic details: Yin X, Su N, Chen XH, Tang R, Xu T.  A systematic review of ambroxol hydrochloride in patients with meconium aspiration syndrome. Chinese Pharmaceutical Journal 2012; 47(10): 776-781 Available from: http://lib.cqvip.com/qk/90149X/201210/41882363.html

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Surfactant lavage therapy for meconium aspiration syndrome: a systematic review and meta-analysis.

BACKGROUND: Lung lavage with diluted surfactant has emerged as an innovative treatment for meconium aspiration syndrome (MAS). However, the treatment effect has not yet been fully established.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Efficacy of pulmonary surfactant therapy in neonates with meconium aspiration syndrome: a meta-analysis

OBJECTIVE: The efficacy of pulmonary surfactant (PS) replacement therapy for meconium aspiration syndrome (MAS) remains controversial. This study aimed to evaluate the efficacy of PS therapy in neonates with MAS by a meta-analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Lung lavage for meconium aspiration syndrome in newborn infants

Meconium aspiration syndrome (MAS) is a disease of the newborn lung in which meconium, the fetal stool, is passed before birth and then is inhaled into the lung. Little effective treatment is available, other than supportive measures including artifical respiration and, occasionally, the use of heart‐lung bypass. This review examined whether cleansing the lung using a natural chemical called surfactant, or another similar fluid, is helpful in MAS. This cleansing procedure is known as lung lavage. Lung lavage with diluted surfactant may help improve the clinical course of infants with MAS, in particular, the likelihood of survival without the need for heart‐lung bypass. More trials will be needed to properly evaluate lavage treatment in MAS.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Steroid therapy for meconium aspiration syndrome in newborn infants

More research needed to show whether corticosteroids could reduce complications and mortality in newborn babies with meconium aspiration syndrome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Surfactant for meconium aspiration syndrome in term and late preterm infants

Background: The lungs of newborn babies can be damaged by meconium aspiration syndrome. Meconium aspiration syndrome is caused when a stressed baby passes a bowel movement while still in the womb and then breathes some of this material into the lungs. Pulmonary surfactant, the complex combination of chemicals that line the surface of the lung, may be altered or inactivated in babies who have meconium aspiration. It is thought that treatment with additional surfactant might help overcome this damage.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials

This well-conducted review concluded that there is no support for the use of intrapartum amnioinfusion (AI) for women with meconium-stained amniotic fluid in standard peripartum surveillance settings, but AI appears to reduce foetal morbidity where peripartum surveillance is limited. These conclusions appear reliable and are supported by the evidence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Endotracheal intubation at birth for preventing morbidity and mortality in vigorous, meconium‐stained infants born at term

Meconium is the first stool of a newborn baby, greenish‐black in colour and rather sticky in consistency.  If a baby is distressed before birth meconium may be passed into the amniotic fluid and if the baby then gasps the meconium‐stained fluid may pass into the lungs.  Once in the lungs the meconium can make the baby ill by obstructing the airways and causing inflammation this is called meconium aspiration syndrome.  It is possible to reduce the amount of meconium getting into the lungs by sucking it from the baby’s throat and windpipe (trachea) soon after birth but it is not certain if this leads to overall benefit for the vigorous term newborn baby.  Furthermore, placing a tube in the windpipe (endotracheal intubation) of a vigorous term baby is not always easy and could cause harm.  Four studies enrolled 2844 term infants and randomly allocated them to intubation to clear the airways or routine resuscitation without intubation.  No benefit was found from routine intubation compared to routine resuscitation for vigorous term babies.  The outcomes reported included: meconium aspiration syndrome, lung air leaks, need for oxygen, noisy breathing (stridor) and fits but there were no significant differences between the two groups.  Routine endotracheal intubation of vigorous term babies born through meconium‐stained amniotic fluid cannot be recommended.  For non‐vigorous babies endotracheal intubation is probably indicated until more information becomes available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Amnioinfusion for meconium‐stained liquor in labour

Amnioinfusion is not beneficial for babies releasing medium to heavy meconium during labour, except in settings with limited facilities to monitor the baby's condition during labour.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

This guideline covers the care of healthy women in labour at term (37–42 weeks of gestation). About 600 000 women give birth in England and Wales each year, of whom about 40% are having their first baby. Most of these women are healthy and have a straightforward pregnancy. Almost 90% of women will give birth to a single baby after 37 weeks of pregnancy with the baby presenting head first. Most women (about two-thirds) go into labour spontaneously. Thus the majority of women giving birth in the UK fall under the scope of this guideline.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: September 2007
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Antibiotics for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Meconium‐stained amniotic fluid (MSAF) is the result of waste material from the fetal colon passing into the mother's amniotic cavity. Its incidence increases in post‐term pregnancies. Pregnant women with MSAF are more likely to develop maternal complications including inflammation of the fetal membranes caused by a bacterial infection (chorioamnionitis), postpartum inflammation of the lining of the uterus (endometritis) and neonatal complications such as neonatal sepsis and the need for admission to a neonatal intensive care unit (NICU). Fetal stress or hypoxia may trigger gasping fetal respirations, which results in the aspiration of meconium.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pregnancy and birth: When does labor need to be induced?

If a pregnant woman is a few days overdue but there is no sign of any problems, there is little risk for the unborn child. But if the baby is more than one week late, inducing labor will lower the risk of complications.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 25, 2012

Lactose Intolerance and Health

We systematically reviewed evidence to determine lactose intolerance (LI) prevalence, bone health after dairy-exclusion diets, tolerable dose of lactose in subjects with diagnosed LI, and management.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: February 2010
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Outcomes of Maternal Weight Gain

The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on outcomes of gestational weight gain and their confounders and effect modifiers, outcomes of weight gain within or outside the 1990 Institute of Medicine (IOM) guidelines, risks and benefits of weight gain recommendations, and anthropometric measures of weight gain.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: May 2008
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Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy

This clinical guideline concerns the management of hypertensive disorders in pregnancy and their complications from preconception to the postnatal period. For the purpose of this guideline, ‘pregnancy’ includes the antenatal, intrapartum and postpartum (6 weeks after birth) periods. The guideline has been developed with the aim of providing guidance in the following areas: information and advice for women who have chronic hypertension and are pregnant or planning to become pregnant; information and advice for women who are pregnant and at increased risk of developing hypertensive disorders of pregnancy; management of pregnancy with chronic hypertension; management of pregnancy in women with gestational hypertension; management of pregnancy for women with pre-eclampsia before admission to critical care level 2 setting; management of pre-eclampsia and its complications in a critical care setting; information, advice and support for women and healthcare professionals after discharge to primary care following a pregnancy complicated by hypertension; care of the fetus during pregnancy complicated by a hypertensive disorder.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2010
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Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care

Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. Children and young people and their families are often given conflicting advice and practice is inconsistent, making treatment potentially less effective and frustrating for all concerned. Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management. Implementation of this guideline will provide a consistent, coordinated approach and will improve outcomes for children and young people.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Caesarean Section

This guidance is a partial update of NICE clinical guideline 13 (published April 2004) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2011

Drug Class Review: Newer Drugs for Insomnia: Final Report Update 2 [Internet]

Insomnia is a serious health problem that affects millions of people. Population surveys have estimated the prevalence of insomnia to be about 30% to 50% of the general population. About three-fourths of people who have trouble sleeping say that the problem is "occasional," averaging about 6 nights per month, with one-fourth having frequent or chronic insomnia, averaging about 16 nights per month. Individuals with insomnia most often report a combination of difficulty falling asleep and intermittent wakefulness during sleep. Treatment of insomnia involves behavioral changes, such as minimizing habits that interfere with sleep (for example, drinking coffee or engaging in stressful activities in the evening), and pharmacotherapy with sedating antidepressants (for example, trazodone), sedating antihistamines, anticholinergics, benzodiazepines, or nonbenzodiazepine hypnotics. The benzodiazepines and the newer sedative hypnotics zolpidem, zaleplon, zopiclone, and eszopiclone work through gamma-aminobutyric acid receptors. Ramelteon, a hypnotic approved by the United States Food and Drug Administration (FDA) in July 2005, is a selective melatonin receptor (MT1 and MT2) agonist. New nonbenzodiazepine drugs have been sought for multiple reasons, including reduction of the risk of tolerance, dependence, and abuse associated with benzodiazepines. The purpose of this review is to evaluate the comparative evidence on benefits and harms of these medications in people with insomnia to help policymakers and clinicians make informed choices about the use of newer drugs for insomnia.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008

Induction of labour in women with normal pregnancies at or beyond term

A normal pregnancy lasts about 40 weeks from the start of the woman's last menstrual period, but anything from 37 to 42 weeks is considered as being within the normal range. Births before 37 weeks are considered preterm because these babies often have breathing difficulties and other problems as some of their organs are not yet fully matured. Births after 42 weeks seem to carry a slightly increased risk for the baby and are associated with a greater number of deaths. No tests can tell if a baby would be better to be left in the womb or labour induced and the baby be born, so arbitrary time limits have been suggested. This review set out to determine if induction of labour at a prespecified time could reduce the risks for the baby. The review found 22 trials involving over 9000 women given induction of labour at various times from 37 weeks to over 42 weeks' gestation; some were quite old trials and the quality was variable. The review grouped the trials by a policy of induction at (1) 37 to 39 weeks, (2) 39 to 40 weeks, (3) < 41 weeks, (4) 41 weeks, and (5) > 41 weeks, compared with a policy of waiting to a later date. There were fewer baby deaths when a labour induction policy was implemented. Such deaths were rare with either policy. Signficantly fewer babies developed meconium aspiration syndrome and fewer caesarean sections were required in the induction group compared with the expectant management group. Women's experiences and opinions about these choices have not been adequately evaluated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Induction of labor versus expectant management for post-date pregnancy: is there sufficient evidence for a change in clinical practice?

This generally well-conducted review concluded that elective induction of labour was associated with a lower rate of meconium aspiration syndrome and caesarean section, but not a lower risk of perinatal mortality, when compared with expectant management for post-date pregnancy. Some caution might be required in interpreting these conclusions because of the poor quality of most of the included trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

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