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UHL Clinical Librarian Service

Obstetrics & Gynaecology Evidence Update

12th October 2016

New and Updated Cochrane Systematic Reviews

Surgery for women with apical vaginal prolapse
Authors' conclusions: Sacral colpopexy is associated with lower risk of awareness of prolapse, recurrent prolapse on examination, repeat surgery for prolapse, postoperative SUI and dyspareunia than a variety of vaginal interventions.

The limited evidence does not support use of transvaginal mesh compared to native tissue repair for apical vaginal prolapse. Most of the evaluated transvaginal meshes are no longer available and new lighter meshes currently lack evidence of safety

The evidence was inconclusive when comparing access routes for sacral colpopexy.

No clear conclusion can be reached from the available data comparing uterine preserving surgery versus vaginal hysterectomy for uterine prolapse.

Cochrane Clinical Answers Pregnancy & Childbirth
UpToDate - What's new in Obstetrics & Gynaecology
  • Closed-loop insulin pump in pregnant women with type 1 diabetes (October 2016)
  • Safety of magnetic resonance imaging and gadolinium in pregnancy (September 2016)Oxytocin induction not associated with autism (August 2016)
  • Low-dose aspirin for preeclampsia prophylaxis (August 2016)
DynaMed Plus
Risk factors for preterm labor and premature birth
Untreated depression during pregnancy associated with increased risk of preterm birth and low birth weight (JAMA Psychiatry 2016 Aug 1).

Premenstrual syndrome

Review of premenstrual syndrome and premenstrual dysphoric disorder (Am Fam Physician 2016 Aug 1)
Leicester Publications

Severe spontaneous hemoperitoneum in pregnancy may be linked to in vitro fertilization in patients with endometriosis: a systematic review.
Fertility & Sterility 2016 Sep 1;106(3):692-703.
Brosens IA, Lier MC, Mijatovic V, Habiba M, Benagiano G

Prenatal invasive testing and karyotypic abnormalities in antenatally diagnosed congenital heart defects: impact on timing of diagnosis and termination of pregnancy.
Ultrasound in Obstetrics &  Gynecology 2016 Sep;48 Suppl 1:294.
Breslin E, Cresswell L, Bu'Lock F, Mousa H, Khare M.

Abstracts of the 26th World Congress on Ultrasound in Obstetrics and Gynecology, Rome, Italy, 24-28 September 2016.  
Ultrasound in Obstetrics & Gynecology 2016 Sep;48 Suppl 1:248 
Mousa H, Jones G, Vasudevan P, Navti OB, Richmond A.
NICE  National Institute for Health and Care Excellence

There were no new guidelines published this month.
Selected Systematic Reviews

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

A Systematic Review
 Group Prenatal Care Compared With Traditional Prenatal Care: A Systematic Review and Meta-analysis.

Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials.

Epigenetic dysregulation of Insulin-like growth factor (IGF)-related genes and adverse pregnancy outcomes: a systematic review.

Cushing's syndrome and pregnancy outcomes: a systematic review of published cases.

Elevated homocysteine levels in mothers with neural tube defects: a systematic review and meta-analysis.

Prevention of Spinal Anesthesia-Induced Hypotension During Cesarean Delivery by 5-Hydroxytryptamine-3 Receptor Antagonists: A Systematic Review and Meta-analysis and Meta-regression.

Anticoagulation Regimens During Pregnancy in Patients With Mechanical Heart Valves: ASystematic Review and Meta-analysis.

Fertility results and pregnancy outcomes after conservative treatment of cervical cancer: a systematic review of the literature.
Other Sources

Pregnancy loss and the death of a baby: guidelines
The new edition of Sands’ Pregnancy loss and the death of a baby: guidelines for professionals has been published.  The guidelines include four new chapters: ‘Termination of pregnancy for fetal anomaly or maternal medical conditions’; ‘Labour and birth when a baby has died’; ‘Mental health’; and ‘Receiving and responding to feedback: parent experiences’. 
Better care needed for disabled pregnant woman
Bournemouth University has published The human rights & dignity experience of disabled women during pregnancy, childbirth and early parenting.  Commissioned by the charity Birthrights this interim report highlights how maternity care services may not be meeting the needs of some pregnant disabled women. The report follows a survey of women with physical or sensory impairment or long term health conditions which highlighted how despite most women rating the support they received from maternity health carers positively only 19% of women thought that reasonable adjustments or accommodations had been made for them.
Female genital mutilation report
The House of Commons Home Affairs select committee has published Female genital mutilation: abuse unchecked.  The Committee reported that it was "beyond belief" that thirty years after female genital mutilation (FGM) was made illegal in the UK there has been not one successful prosecution. The Committee were also concerned by reports that some clinicians are ignoring the duty on frontline healthcare professionals, social care workers and teachers to record data on FGM incidence, and repeat’s its call for the Government to introduce stronger sanctions for failing to meet the mandatory reporting responsibility.
Female genital mutilation healthcare videos
The Department of Health has released three videos to help healthcare professionals understand, safeguard and care for women and girls affected by female genital mutilation (FGM). The videos show:  women talking about their personal experiences of FGM; NHS professionals discuss the mandatory reporting duty and how it applies to all health and social care professionals; and mental health specialists discussing the impact of FGM on the mental health of women and girls and how to support patients who have been affected.

Pregnancy and maternity discrimination
The House of Commons Women and Equalities Committee has published Pregnancy and maternity discrimination.  Following an increase in workplace pregnancy discrimination over the past decade, this report calls for UK women to have protections similar to those in Germany.  The report calls on the Government to publish a detailed plan within the next two years and recommends changes to health and safety practices, preventing discriminatory redundancies and an increase in protection for casual, agency and zero-hours workers.
To access full text you may have to log in to your NHS Athens account (click here to register for free). If full text is not available then please email us to request a copy.

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NHS behind the Headlines - Media Stories Explained

Cervical screening every 10 years for healthy women is 'safe'

Women taking the contraceptive pill 'more likely to be depressed'

Could fertility breakthrough lead to babies with no mothers?

C-section babies 'more likely' to grow up obese

Baby doll simulators may actually increase teen pregnancy rates

Combined HRT breast cancer risk 'may have been underestimated'
Table of Contents

American Journal of Obstetrics & Gynecology
Archives of Gynecology & Obstetrics
BJOG: An International Journal of Obstetrics and Gynaecology
Clinical Obstetrics and Gynecology
European Journal of Obstetrics & Gynecology and Reproductive Biology
Obstetrics & Gynecology
Prenatal diagnosis
Ultrasound in obstetrics and gynaecology
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