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Amnioinfusion can help when a baby is surrounded by too little fluid in the womb (oligohydramnios) and is showing distress, but is not needed otherwise.

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

Version: 2012

Babies born after preterm prelabour rupture of membranes (PPROM) between 16 and 26 weeks of pregnancy are prone to underdevelopment of the lungs. When the membranes containing the fluid that surrounds the baby (amniotic fluid) rupture, a shortage of this fluid can occur, a condition that is called oligohydramnios. Oligohydramnios is thought to interfere with normal lung development so that it is delayed, resulting in a condition that is called pulmonary hypoplasia.

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

Version: 2013

Pregnant women with too little fluid surrounding their babies can increase this by consuming liquid, although it is not known whether this improves outcomes.

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

Version: 2012

The accurate assessment of amniotic fluid volume by ultrasonography can be influenced by an inexperienced operator, fetal position, the probability of a transient change, and the different ultrasound diagnostic criteria of an abnormal volume.

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

Version: 2009

Infusing fluid into the uterus during labour may reduce fetal heart rate abnormalities and reduce caesarean sections.

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

Version: 2012

What care should be given to babies who are thought to be coping poorly towards the end of pregnancy (beyond 37 weeks)? A baby may be in this situation because the placenta is no longer functioning well and this means the baby may be short of nutrition or oxygen. We asked in this Cochrane review if it is better to induce labour or do a caesarean section (both ways of ensuring the baby is born earlier) rather than letting the pregnancy continue until labour starts by itself.

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

Version: 2016

OBJECTIVE: The management of isolated oligohydramnios (IO) in post/term pregnancies is controversial. The aim of this paper was to review outcomes of term and post-term pregnancies with IO versus normal amniotic fluid (AF) at labor assessment.

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

Version: 2013

Prediction of pulmonary hypoplasia after midtrimester preterm prelabour rupture of membranes (PPROM) is important for optimal management. We performed a systematic review to assess the capacity of clinical parameters to predict pulmonary hypoplasia. A systematic literature search in EMBASE and MEDLINE was performed to identify articles published on pulmonary hypoplasia in relation to midtrimester PPROM. Articles were selected when they reported on one of the following clinical parameters - gestational age at PPROM, latency period and degree of oligohydramnios - and when they allowed the construction of a two-by-two table comparing at least one of three clinical parameters to the occurrence of pulmonary hypoplasia. The selected studies were scored on methodological quality, and sensitivity and specificity of the tests in the prediction of pulmonary hypoplasia and lethal pulmonary hypoplasia were calculated. Overall performance was assessed by summary receiver operating characteristic (sROC) curves that were constructed with bivariate meta-analysis. We detected 28 studies that reported on the prediction of pulmonary hypoplasia. Prediction of lethal pulmonary hypoplasia could be analysed separately in 21 of these studies. The quality of the included studies was poor. The estimated sROC-curves showed that gestational age at PPROM performed significantly better than the two other parameters in the prediction of pulmonary hypoplasia. The accuracy in the prediction of lethal pulmonary hypoplasia was similar. In women with midtrimester PPROM, pulmonary hypoplasia can be predicted from the gestational age at PPROM. This information should be used in the management of women with early PPROM.

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

Version: 2010

This review assessed the risk of uterine rupture with amnioinfusion in women with a previous Caesarean section. The author concluded that there was insufficient evidence to draw definitive conclusions and that further studies are required. The author's conclusions appear to reflect the limitations of the evidence, but poor reporting of the review methods hinders an assessment of the reliability of the results.

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

Version: 2005

This review concluded that serial transabdominal amnioinfusion for pregnant women with preterm premature rupture of their membrane, could improve morbidity and mortality. The authors' cautious conclusions reflected the evidence presented, but they were based on small observational studies, and caution is advised when interpreting the results. Their recommendation for further research was appropriate.

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

Version: 2012

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

In a 2003 evidence report, the United States Preventive Services Task Force (USPSTF) concluded that the scientific evidence was insufficient to advise for or against routine screening for gestational diabetes mellitus (GDM) in all pregnant women. The 2003 review did not include evidence pertaining to GDM screening prior to 24 weeks gestation. As the prevalence of women at high risk for type 2 diabetes and GDM has continued to increase dramatically over the intervening years, the issue of early screening has taken on greater importance.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: May 2008

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

Labour before full term in pregnancy can lead to preterm birth of the baby. Preterm labour describes frequent uterine contractions (at least four in 20 minutes or eight in 60 minutes) and progressive changes in the cervix. If preterm labour is not managed properly, active labour can occur and result in preterm birth, before 37 completed weeks' gestation. Preterm birth is the leading cause of low birthweight, illness and death for newborn babies. Substances called prostaglandins play an important role in the contraction of the muscle of the womb and are important during labour and birth. They are produced by cyclo‐oxygenase (COX), which is an enzyme that increases the level of prostaglandins. Giving COX inhibitors to pregnant women at risk of preterm labour might stop contraction of the womb and allow them to reach full term. We included one small randomised trial (involving 98 women) that involved the drug rofecoxib, which is one type of COX inhibitor. The included study did not report any information about prevention of labour before full‐term pregnancy. However, use of this COX inhibitor was associated with an increased risk of the baby being born before full term. We found insufficient data to make any recommendation about using COX inhibitors for preventing preterm labour. Future research should include the follow‐up of babies to examine the short‐ and longer‐term effects associated with using COX inhibitors during pregnancy.

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

Version: 2012

Breast cancer is the most common cancer in pregnant women and can be hard to detect because of changes in the breast that occur with pregnancy. Learn about the incidence, diagnosis, and treatment of breast cancer during pregnancy, as well as the effect a history of breast cancer can have on future pregnancies and children.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 29, 2017

This guide summarizes clinical evidence comparing the safety of elective induction of labor (induction at term without a medical indication) with expectant management (waiting for spontaneous labor in a term pregnancy). This guide offers information about maternal and fetal outcomes when elective induction of labor is used. It does not address induction of labor for medical indications, such as preeclampsia, postdates pregnancy, or oligohydramnios. It also does not cover labor augmentation. This guide does not compare the effectiveness of different labor induction methods.

Comparative Effectiveness Review Summary Guides for Clinicians [Internet] - Agency for Healthcare Research and Quality (US).

Version: November 30, 2009

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

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

Version: March 2008

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This clinical guideline concerns the management of diabetes and its complications from preconception to the postnatal period. It has been developed with the aim of providing guidance on:

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

Version: February 2015

The guideline is intended to cover the care of healthy women with uncomplicated pregnancies entering labour at low risk of developing intrapartum complications. In addition, recommendations are included that address the care of women who start labour as ‘low risk’ but who go on to develop complications. These include the care of women with prelabour rupture of membranes at term, care of the woman and baby when meconium is present, indications for continuous cardiotocography, interpretation of cardiotocography traces, and management of retained placenta and postpartum haemorrhage. Aspects of intrapartum care for women at risk of developing intrapartum complications are covered by a range of guidelines on specific conditions (see section 1.8) and a further guideline is planned on intrapartum care of women ‘at high risk’ of complications during pregnancy and the intrapartum period.

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

Version: December 2014

This guideline contains recommendations specific to twin and triplet pregnancies and covers the following clinical areas: optimal methods to determine gestational age and chorionicity; maternal and fetal screening programmes to identify structural abnormalities, chromosomal abnormalities and feto-fetal transfusion syndrome (FFTS), and to detect intrauterine growth restriction (IUGR); the effectiveness of interventions to prevent spontaneous preterm birth; and routine (elective) antenatal corticosteroid prophylaxis for reducing perinatal morbidity. The guideline also advises how to give accurate, relevant and useful information to women with twin and triplet pregnancies and their families, and how best to support them.

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

Version: September 2011

Systematic Reviews in PubMed

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