Evidence
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Decision aids including leaflets and computer programs help patients make treatment choices

Decision aids help patients choose between treatment options in obstetrics and gynaecology, and reduce uncertainty. A systematic review of trials of decision aids used for choices of contraception, caesarean section and menopause treatment found that patients who used them felt more confident in their ability to make the decision that was right for them, and …

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Surgery to fix the womb in position after prolapse is an alternative to hysterectomy

Women who have surgery that uses stitches to lift and keep their prolapsed womb in place (called hysteropexy) are less likely to have recurrent symptoms after five years than those who have their womb removed (vaginal hysterectomy). These results from a Dutch trial involving 204 women showed comparable outcomes for the two surgical options for other …

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Universal ultrasound in late pregnancy did not reduce serious harms to babies

Offering all women third trimester ultrasounds did not reduce the rate of serious illness or death in babies in the first week of life. Monitoring fetal growth is part of routine antenatal care, using regular tape measurements from the pubic bone to the top of the uterus. To date, it has been unclear whether also …

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Antenatal MRI can aid ultrasound when fetal brain abnormality is suspected

In utero magnetic resonance imaging (iuMRI) can provide a more accurate diagnosis when used after ultrasound in pregnancy. Adding iuMRI when a brain abnormality is suspected but unclear from ultrasound could help clinicians provide better prognostic advice and support to parents during pregnancy. This NIHR-funded cohort study compared ultrasound and iuMRI in 570 women at …

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Impact of a national quality improvement programme for hospital wards is unclear

The Productive Ward quality improvement programme has shown some procedural changes on hospital wards in England in the 10 years since it was introduced. But evidence to show any sustained changes to the experiences of staff or patients is hard to find. This NIHR-funded study used quantitative and qualitative methods to evaluate the programme in …

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Very small babies appear not to be affected by the rate of increasing milk feeds

A large-scale trial has found that the speed of increasing milk feed volumes in low birth weight or very low gestational age babies who are on intravenous feeding does not influence outcomes. This NIHR-funded study randomised preterm (below 32 weeks) or very low birth weight (less than 1,500g) babies to receive either daily milk feed …

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Planned earlier delivery for late pre-eclampsia may be better for mothers

If pregnant women develop late pre-eclampsia, after 34 but before 37 weeks of gestation, then planning to deliver their babies within 48 hours of the diagnosis reduces the risk of problems to the mother. This is compared with waiting until 37 weeks or delivering earlier if other problems arise (“expectant management”). However, this benefit needs …

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Keyhole hysterectomy is effective for women with heavy menstrual bleeding

When surgical treatment was needed, almost all women with heavy menstrual bleeding were satisfied and had a good quality of life following keyhole surgery to remove the uterus. Slightly fewer achieve this with ablation to remove the uterine lining. In a UK randomised trial, women given one or other treatment in NHS hospitals reported good …

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Enhanced communication and staff training could improve the experience of maternity services for asylum-seeking women

Pregnant asylum seekers experience significant barriers to accessing maternity services in the UK. A review found that these barriers often relate to language differences and practical challenges associated with their status. Provision of interpreter services and training for health care professionals could improve maternity support for these women. Pregnant women seeking asylum have often experienced …

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Antibiotics reduce complications after assisted vaginal delivery

Preventative antibiotics halve the risk of infection for women who have assisted vaginal delivery using forceps or suction-cup devices. About 10% of women receiving antibiotics develop an infection within six weeks of delivery compared with 20% of women who receive a placebo. Antibiotics are not routinely recommended for women undergoing assisted delivery as there hasn’t …

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