Tag Archives: Labour

NIHR Signal: Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

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Image Source: Wikimedia

Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started within 24 hours and was compared to waiting for labour to start on its own.

Waters breaking at full term without the onset of labour is called pre-labour rupture of membranes. This can increase risks of maternal and neonatal infection and the need for caesarean section. As most women deliver spontaneously within a day, NICE recommend that women are offered an informed choice of either induction 24 hours after premature rupture of membranes or to watch and wait.

This updated Cochrane review included new evidence and suggests that induction before 24 hours may reduce infections without increasing caesarean sections, but there remains some uncertainty. This is due to low study quality, lack of longer term outcomes, and too few participants in trials to compare the numbers of any rare serious events.

These findings may help inform shared decisions about induction by providing more information to help women understand the risks.

Read the full Signal here

Management of Breech Presentation (RCOG Green-top Guideline No. 20b)

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Image Source: NHS Photobank

This guideline provides up-to-date information on methods of delivery for women with breech presentation, this is the fourth edition of this guideline, first published in 1999 and revised in 2001 and 2006 under the same title.

The aim of this guideline is to aid decision making regarding the route of delivery and choice of various techniques used during delivery. It does not include antenatal or postnatal care. Information regarding external cephalic version is the topic of the separate Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20a External Cephalic Version and Reducing the Incidence of Term Breech Presentation.

To access the full guideline click here

External Cephalic Version and Reducing the Incidence of Term Breech Presentation (RCOG Green-top Guideline No. 20a)

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Image source: NHS Photobank

This guideline summarises the evidence regarding the routine use of external cephalic version (ECV) for breech presentation, and is the second edition of this guideline, first published in 2006 under the title External Cephalic Version (ECV) and Reducing the Incidence of Breech Presentation.

It presents the best evidence concerning methods to prevent noncephalic presentation at delivery and therefore caesarean section and its sequalae. The mode and technique of delivering a breech presentation is summarised in the Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20b Management of Breech Presentation.

For the full guidance click here

Support overdue: women’s experiences of maternity services 2017

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The National Federation of Women’s Institutes (NFWI) and National Childbirth Trust have published Support overdue: women’s experiences of maternity services 2017.  This report presents the findings of the NFWI’s and NCT’s second survey of women’s experiences of maternity care, providing insights into key aspects of the experiences of 2,500 women.  Women are generally positive about the maternity care they receive and many praised the professionalism of the staff who cared for them but some findings gave cause for concern.

Read the full report here

Additional Link to RCM press release here

RCOG Greentop 52: Postpartum haemorrhage, prevention and management

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Source: NHS Photo Library

 

The Royal College of Obstetrics and Gynaecologists has updated their guideline Postpartum haemorrhage, prevention and management (Green-top Guideline No. 52). This provides information about the prevention and management of postpartum haemorrhage, primarily for clinicians working in obstetric-led units in the UK.

Link to Greentop Guideline here

Intrapartum care for healthy women and babies

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NICE has updated its clinical guideline Intrapartum care for healthy women and babies (CG190). This guideline covers the care of healthy women and their babies during labour and immediately after the birth.  NICE has reviewed the evidence on the effectiveness of midwife-led continuity models and other models of care and deleted a recommendation about team midwifery.