Home > Search Results

Results: 1 to 20 of 291

Alternative packages of antenatal care for low‐risk pregnant women

A routine number of visits for pregnant women has developed as part of antenatal or prenatal care without evidence of how much care is necessary to optimise the health of mothers and babies, and is helpful for the women. These visits can include tests, education and other health checks. The review set out to compare studies where women receiving standard care were compared with women attending on a reduced number of occasions. We included seven randomised controlled trials involving more than 60,000 women. The trials were carried out in both high‐income (four trials) and low‐ and middle‐income countries (three trials). In high‐income countries the number of visits was reduced to around eight. In lower‐income countries many women in the reduced visits group attended for care on fewer than five occasions, although the content of visits was altered so as to focus on specific goals. In this review there was no strong evidence of differences between groups receiving a reduced number of antenatal visits compared with standard care on the number of preterm births or low birthweight babies. However, there was some evidence from these trials that in low‐ and middle‐income countries perinatal mortality may be increased with reduced visits. The number of inductions of labour and births by caesarean section were similar in women receiving reduced visits compared with standard care. There was evidence that women in all settings were less satisfied with the reduced schedule of visits; for some women the gap between visits was perceived as too long. Reduced visits may be associated with lower costs.

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

Version: 2011

Group versus conventional antenatal care for pregnant women

Antenatal care is one of the most important healthcare services provided for pregnant women around the world. In most Western countries, health care during pregnancy traditionally involves a schedule of one‐to‐one visits with a midwife, an obstetrician or a general practitioner (GP) in a hospital or clinic setting. A different way of providing pregnancy care involves use of a group model rather than a one‐to‐one approach. Group antenatal or pregnancy care has been developed in the USA in a model known as CenteringPregnancy. Care is provided by a midwife or an obstetrician to groups of eight to 12 women of similar gestational age. Groups meet eight to 10 times during pregnancy at the usual scheduled visits, with sessions running for 90 to 120 minutes. All pregnancy care is provided in this group setting by integrating the usual pregnancy health assessment with information, education and peer support.

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

Version: 2015

Specialised antenatal clinics for women with a pregnancy at high risk of preterm birth (excluding multiple pregnancy) to improve outcomes for women and babies

Women who have had a previous preterm birth are at increased risk of having another premature birth. Babies who are born before the 37th week of pregnancy, and particularly those born before the 34th week, are at greater risk of suffering problems at birth and of disability in childhood. 'Specialised' antenatal clinics have been suggested for women at high risk of a preterm birth as a way of improving health outcomes for the women and their infants. This review of three randomised controlled trials involving 3400 women in the USA found that there was no reduction in the number of preterm births in women attending specialised antenatal clinics. The results were difficult to interpret, as the trials were conducted in slightly different ways and offered slightly different care. The trials were all conducted in the 1980s, before the introduction of many of the screening tests currently offered in specialised antenatal clinics such as ultrasound assessment of cervical length. There was no information available on the effect of specialised antenatal care on maternal wellbeing or long‐term outcome.

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

Version: 2011

Breast examination during pregnancy for promoting breastfeeding

The rationale for breast examination during pregnancy is to determine whether any problems with breastfeeding can be anticipated and to use the opportunity for the healthcare provider and pregnant woman to discuss breastfeeding. Examination by a healthcare provider is recommended in some countries. Breast examination can also be performed by the pregnant woman herself. Furthermore, breast examination during pregnancy has been recommended as a screening method for breast cancer, although no evidence has been found to support breast examination by a doctor, nurse or the woman as a primary screening technique for breast cancer. A woman’s breasts are often tender and swollen during pregnancy. This makes examination difficult and potentially compounds a woman's feelings of discomfort or vulnerability. Some women may find a clinical breast examination during pregnancy intrusive, and identification of flat or inverted nipples may actually act as a deterrent to breastfeeding. No randomised controlled trials were identified to guide a decision on whether antenatal breast examination promotes breastfeeding. Ideally, policies that govern the care of pregnant women should be evidence based and impact on any disease outcomes.

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

Version: 2008

Support during pregnancy for women at increased risk of low birthweight babies

Programs offering additional support during pregnancy were not effective in reducing number of babies born too early and babies with low birthweights.

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

Version: 2010

Giving women their own case notes to carry during pregnancy

Women carrying their own case notes improves their sense of control and satisfaction and the availability of antenatal records, but insufficient evidence of additional effects.

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

Version: 2011

Specialised antenatal clinics for women with a multiple pregnancy for improving maternal and infant outcomes

'Specialised' antenatal clinics versus 'standard' antenatal care for women with a multiple pregnancy.

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

Version: 2012

Trials of interventions for pregnant women who are obese to lose weight and improve pregnancy outcomes.

Pregnant women who are obese risk serious complications for themselves and their children. The mother is more likely to develop diabetes or high blood pressure or pre‐eclampsia during pregnancy, and the pregnancy may end in a miscarriage or stillbirth. The baby could have serious anomalies at birth, including spina bifida, cardiovascular anomalies, cleft lip and palate, or limb reduction anomalies. Some obese women have premature births. At birth, the labour may be longer and other complications can lead to a caesarean birth. The baby may also be bigger at birth than is normal, and there is evidence that the children of obese mothers go on to be obese. The advice for obese women in managing their weight during pregnancy is that weight loss should be avoided, and weight gain should be between 5.0 and 9.1 kg. Yet observational studies of large numbers of pregnant women indicate that some obese women, especially those who are heavier, lose weight during pregnancy. We do not have any clear results that indicate that losing weight when pregnant is safe for a mother who is obese, or for her baby. This Cochrane review aimed to evaluate trials that were designed for obese pregnant women to lose weight. No randomised controlled trials were found. We recommend that further research is conducted to evaluate the safety of interventions for weight loss when a woman is pregnant and obese for the mother and her baby.

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

Version: 2013

Home visits during pregnancy and after birth for women with an alcohol or drug problem

Not enough information on home visiting in pregnancy and after the birth for women with an alcohol or drug problem.

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

Version: 2012

Mobile phone messaging for preventive health care

Many costly and disabling conditions such as cardiovascular diseases, cancer or diabetes are linked by common preventable risk factors like tobacco use, unhealthy nutrition, physical inactivity and excessive alcohol use. However, prevention still plays a secondary role in many health systems as all too often, healthcare workers fail to seize interactions with patient as opportunities to inform them about health promotion and disease prevention strategies. This review examined whether mobile phone applications such as Short Message Service (SMS) and Multimedia Message Service (MMS) can support and enhance primary preventive health interventions.

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

Version: 2012

Effect of high feedback versus low feedback of prenatal ultrasound on maternal anxiety and health behaviour in pregnancy

Ultrasound is a routine part of prenatal care offered to pregnant women in most countries with developed health services. It is used during prenatal care to help achieve a healthy mother and child. Pregnant women want reassurance and to check that all is normal by verifying fetal life and growth and to exclude fetal abnormalities. The parents are given immediate access to the images of the fetus, which may promote maternal attachment and positive attitudes toward health during the pregnancy. The obstetricians can identify high‐risk conditions including multiple pregnancy, abnormalities of amniotic fluid volume and the placenta, fetal anomalies and growth restriction. During high feedback ultrasound scans, women can see the screen and they receive detailed explanations of the images. In low feedback ultrasound scans, only the operator can see the screen and the women are told the results at the end of the scan. High feedback might reduce pregnancy anxiety but it can impact both ways, not only adding excessive stress on the pregnant women and their partners but also on the physicians, especially when there is the possibility of an abnormal finding. We carried out this systematic review to compare high feedback versus low feedback during prenatal ultrasound for reducing maternal anxiety and improving maternal health behaviour and other pregnancy outcomes.

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

Version: 2010

Midwife‐led continuity models versus other models of care for childbearing women

In many parts of the world, midwives are the main providers of care for childbearing women. Elsewhere, it may be obstetricians or family physicians that have the main responsibility for care; or the responsibility may be shared. The philosophy behind midwife‐led continuity models is normality, continuity of care and being cared for by a known, trusted midwife during labour. The emphasis is on the natural ability of women to experience birth with minimum intervention. Midwife‐led continuity of care can be provided through a team of midwives who share the caseload, often called 'team' midwifery. Another model is 'caseload midwifery', which aims to ensure that the woman receives all her care from one midwife or her or his practice partner. Midwife‐led continuity of care is provided in a multi‐disciplinary network of consultation and referral with other care providers. This contrasts with medical‐led models of care where an obstetrician or family physician is primarily responsible for care. In shared‐care models, responsibility is shared between different healthcare professionals.

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

Version: 2014

Individual or group antenatal education for childbirth or parenthood, or both

Benefits of antenatal education for childbirth, and the best educational approaches to use, remain unclear.

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

Version: 2011

Antenatal education for self‐diagnosis of the onset of active labour at term

Not enough evidence to prove the benefit of a specific set of criteria to self‐diagnose active labour.

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

Version: 2013

Antenatal breastfeeding education for increasing breastfeeding duration

Breastfeeding is well recognised as the best food for infants and the World Health Organization recommends that all infants should have exclusive breastfeeding for at least six months after birth. Complementary foods offered before six months of age tend to displace breast milk and do not give any health advantage. Breastfeeding (BF) can improve the child's health, the mother's health and mother‐infant bonding. Infants with BF have lower rates of gastrointestinal and respiratory diseases, otitis media and allergies, better visual acuity, and speech and cognitive development. The impact of educational interventions during pregnancy on breastfeeding duration has not yet been evaluated.

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

Version: 2012

Corticosteroids for preventing respiratory complications in the newborn after caesarean section at term

Babies born at term (at or after 37 weeks) by planned (elective) caesarean section and before onset of labour are more likely to develop respiratory complications than babies born vaginally. The giving of injections called "corticosteroids" to the mother has been shown to reduce the risk of newborn babies having breathing problems in babies born before 34 weeks, but it is not clear if they are useful after this stage. The risk of respiratory complications, mostly respiratory distress syndrome and transient tachypnoea, decreases from 37 weeks to 39 weeks of gestation, at which stage it is low. The aim of this review was to investigate if corticosteroids can reduce the rates of respiratory problems and the need for admission into special care units when given before planned (not emergency) caesarean section at term.

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

Version: 2011

Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth

Corticosteroids given to women in early labour help the babies' lungs to mature and so reduce the number of babies who die or suffer breathing problems at birth.

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

Version: 2013

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in pregnant women and women who have recently given birth

About a third of women leak urine and up to a 10th of women leak stool (faeces) after giving birth. Pelvic floor muscle training is commonly recommended both during pregnancy and after the birth to prevent and treat incontinence. The training involves exercises that women can do several times a day to strengthen their pelvic floor muscles. They are usually taught by a health professional such as a physiotherapist. There is little evidence that doing antenatal pelvic floor exercises makes labour more difficult. Instead, there is mounting evidence to suggest that they may help. This review shows that even women who did not leak urine while pregnant could reduce the possibility of leaking for the first six months after childbirth by doing the exercises during and  after their pregnancy. The exercises may also be helpful for women who are at higher risk of suffering urine leakage, like those having a large baby or those who are anticipating a forceps delivery. The exercises can also help women who start to leak after giving birth, and may help them leak less stool. However, there is not enough evidence to say if these effects last after the first year, although there is some evidence to suggest that exercising rates diminish over time.

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

Version: 2012

Reduced salt intake compared to normal dietary salt, or high intake, in pregnancy

To be prepared.

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

Version: 2009

Antenatal perineal massage for reducing perineal trauma

Antenatal perineal massage helps reduce both perineal trauma during birth and pain afterwards.

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

Version: 2013

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...