TrialPanorama/TrialPanorama-benchmark huggingface dataset:
Background: Plasma volume is reduced amongst women with pre-eclampsia. This association has led to the suggestion that expanding the plasma volume might improve maternal and uteroplacental circulation, and so potentially improve outcome for both the woman and her baby.
Objectives: The aim of this review was to assess the effects of plasma volume expansion for the treatment of women with pre-eclampsia.
Selection criteria: Randomised trials were included. Quasi-random designs were excluded. Participants were women with hypertension during pregnancy, with or without proteinuria. Women who were postpartum at trial entry were excluded. Interventions were any comparison of plasma volume expansion with no expansion, or of one plasma volume expander with another.
Background: In the past women have been advised that lowering their salt intake might reduce their risk of pre-eclampsia. Although this practice has largely ceased, it remains important to assess the evidence about possible effects of advice to alter dietary salt intake during pregnancy.
Objectives: The objective of this review was to assess the effects of dietary advice to alter salt intake compared to continuing a normal diet, on the risk of pre-eclampsia and its consequences.
Selection criteria: Studies were included if they were randomised trials of advice to either reduce or to increase dietary salt during pregnancy.
Background: Inotropes are widely used in preterm infants to treat systemic hypotension. The most commonly used drugs are dopamine and dobutamine. These agents have different modes of action which may result in different haemodynamic effects.
Objectives: To compare the effectiveness and safety of dopamine and dobutamine in the treatment of systemic hypotension in preterm infants.
Selection criteria: Randomised controlled trials where short and/or long term effects of treatment with dopamine and dobutamine for the treatment of systemic arterial hypotension were compared were selected for this review. Trials studying newborn infants born before 37 completed weeks gestation and less than 28 days of age were eligible for inclusion. Systemic arterial hypotension was not defined specifically, but accepted as defined in individual studies. Studies were not limited by birthweight, lower gestational age threshold or by route or duration of administration of inotropic agents. Study quality and eligibility were assessed independently by each reviewer.
Background: Inhibition of prostaglandin synthesis mediates closure of the ductus arteriosus and renal side effects after indomethacin administration. Because furosemide increases prostaglandin production, it could potentially help prevent indomethacin-related toxicity but also decrease ductal response to indomethacin.
Objectives: The primary objectives of this review were to assess (1) whether furosemide affects the incidence of failure of ductal closure after indomethacin and that of indomethacin-related toxicity and (2) the effect of furosemide on mid-term and long-term outcome. The secondary objective was to determine whether the effect of furosemide on renal function and water balance depends on prior extracellular volume (assessed by blood urea nitrogen [BUN]/creatinine ratio).
Selection criteria: We selected studies with (1) random allocation to either indomethacin alone or indomethacin and furosemide and (2) analysis of either short-term risk-benefit ratio of furosemide, mid- or long-term outcome, or the relationship between extracellular volume at study entry and changes in renal function.
Background: Circulating progesterone may be the cause of slower gastrointestinal movement in mid and late pregnancy.
Objectives: The objective of this review was to assess the effects of different methods for treating constipation in pregnancy.
Selection criteria: Randomised trials of any treatment for constipation in pregnancy.
Background: Failure of extubation and subsequent reintubation may result in additional stress and trauma to the premature infant. Testing infants about to be extubated with a period of endotracheal CPAP has been suggested as a method of demonstrating readiness for extubation. However, this process has been criticized as increasing the neonate's work of breathing and perhaps increasing the likelihood of extubation failure.
Objectives: In premature infants having their endotracheal tube removed, is direct extubation from low rate intermittent positive pressure ventilation (IPPV) more successful than that following a period of endotracheal continuous positive airway pressure (CPAP)?
Selection criteria: All trials using random or quasi-random allocation of premature infants to endotracheal CPAP or direct extubation following a period of IPPV were included.
Background: This section is under preparation and will be included in the next issue.
Objectives: In preterm or low birth weight infants, does early versus late weaning from supplementary oxygen influence mortality, retinopathy of prematurity, lung function, growth or development?
Selection criteria: All trials utilising random or quasi-random patient allocation, in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants, were eligible for inclusion.
Background: This section is under preparation and will be included in the next issue.
Objectives: In preterm or low birth weight infants, does gradual versus abrupt discontinuation of supplemental oxygen influence mortality, retinopathy of prematurity, lung function, growth or development?
Selection criteria: All trials utilising random or quasi-random patient allocation, in which gradual weaning was compared with abrupt discontinuation of supplemental oxygen in preterm or low birth weight infants, were eligible for inclusion.
Background: In many settings, symphysis-fundal height measurement has replaced clinical assessment of fetal size by abdominal palpation because the latter has been reported to perform poorly.
Objectives: The objective of this review was to assess the effects of routine use of symphysis-fundal height measurements (tape measurement of the distance from the pubic symphysis to the uterine fundus) during antenatal care on pregnancy outcome.
Selection criteria: Acceptably controlled trials comparing symphysis-fundal height measurement with assessment by abdominal palpation alone.
Background: Application of specific criteria for diagnosis of active labour as part of a labour assessment program aims to differentiate more accurately between latent and active phases of labour.
Objectives: The objective of this review was to assess the effects of the use of specific criteria by caregivers in diagnosing active labour in term pregnancy.
Selection criteria: Randomised trials comparing caregivers' application of strict diagnostic criteria for active labour with routine care.
Background: A specific program designed to teach women to recognise active labour may be beneficial through potentially decreasing the incidence of early admission to hospital, increasing women's confidence and decreasing their anxiety.
Objectives: The objective of this review was to assess the effects of teaching pregnant women specific criteria for self-diagnosis of active labour onset in term pregnancy.
Selection criteria: Randomised trials comparing a structured antenatal education intervention for the identification of symptoms for self-diagnosis of active labour with usual care.
Background: On the basis of evidence from non-randomised studies, it has been recommended that all babies born through thick meconium should have their tracheas intubated so that suctioning of their airways can be performed. The aim is to reduce the incidence and severity of meconium aspiration syndrome. However, for term babies who are vigorous at birth endotracheal intubation may be both difficult and unnecessary.
Objectives: To determine if endotracheal intubation and suction of the airways at birth in vigorous term meconium-stained babies is more beneficial than routine resuscitation including aspiration of the oro-pharynx.
Selection criteria: Randomised trials which compared a policy of routine vs no (or selective) use of endotracheal intubation and aspiration in the immediate management of vigorous term meconium-stained babies at birth.
Background: This section is under preparation and will be included in the next issue.
Objectives: Main question: in preterm infants with apnea, does the use of kinesthetic stimulation lead to clinically important reductions in clinical apnea and bradycardia (>50% reduction in number of episodes), use of mechanical ventilation (IPPV) or continuous positive airways pressure (CPAP), and neurodevelopmental disability, without clinically important side effects.
Selection criteria: All trials using random or quasi-random patient allocation in which kinesthetic stimulation in preterm infants was compared to placebo or no treatment for apnea of prematurity were included.
Background: Proponents of therapeutic ultrasound suggest it can decrease pain by resolution of inflammation processes and reducing the pressure on pain sensitive structures by haematoma and oedema.
Objectives: The objective of this review was to assess the effects of therapeutic ultrasound for treating acute perineal pain, persistent perineal pain and/or dyspareunia, following childbirth.
Selection criteria: Randomised and quasi-randomised trials comparing active therapeutic ultrasound with no treatment, placebo ultrasound, or any other 'standard' or active treatment for women with acute or persistent perineal pain and/or dyspareunia following childbirth.
Background: Necrotising enterocolitis continues to be a problem, particularly in preterm neonates. There have been reports published suggesting that the use of enteral antibiotics may be effective as prophylaxis. This systematic review was undertaken to clarify the issue.
Objectives: To evaluate the benefits and harms of enteral antibiotic prophylaxis for necrotising enterocolitis in low birth weight and preterm infants.
Selection criteria: All randomized or quasi-randomized controlled trials where enteral antibiotics were used as prophylaxis against NEC in LBW (<2500g) and/or preterm (<37 weeks gestation) infants.
Background: Recurrent apnea is common in preterm infants, particularly at very early gestational ages. These episodes of loss of effective breathing can lead to hypoxemia and bradycardia, which may be severe enough to require resuscitation including use of positive pressure ventilation or other treatments. Physical stimulation is often used to restart breathing and it is possible that repeated stimulation, such as with an oscillating mattress (kinesthetic stimulation), might prevent apnea and its consequences.
Objectives: In preterm infants at risk for apnea, does prophylactic use of kinesthetic stimulation lead to a clinically important reduction in apnea and bradycardia, and use of intemittent positive preswsure ventilation (IPPV).
Selection criteria: All trials in preterm infants at risk of developing clinical apnea which utilised random or quasi-random allocation to treatment with an oscillating mattress or control, were eligible.
Background: This section is under preparation and will be included in the next issue.
Objectives: The objective of this review was to determine whether the elective (commencing soon after initiation of mechanical ventilation) use of high frequency jet ventilation (HFJV), as compared to conventional ventilation (CV) in preterm infants with respiratory distress syndrome (RDS), would decrease the incidence of chronic lung disease (CLD) without adverse effects.
Selection criteria: All randomized controlled trials of elective high frequency jet ventilation versus conventional ventilation in preterm infants born at less than 35 weeks GA or with a birth weight less than 2000 gms with respiratory distress were included in the systematic review. Trials which used HFJV to 'rescue' preterm infants due to severe respiratory distress usually beyond 24 hours, and trials that used HFJV for a mandatory time period and then switched back to CV, were not included in this review.
Background: Endotracheal tubes are foreign bodies that may injure the upper airway causing laryngeal edema. This in turn may result in failure of extubation in preterm infants. Corticosteroids have been used prophylactically to reduce upper airway obstruction and facilitate extubation.
Objectives: In newborn infants having their endotracheal tube removed following a period of intermittent positive pressure ventilation (IPPV), what are the effects of intravenous corticosteroids on the incidence of endotracheal reintubation, stridor, atelectasis and adverse side effects?
Selection criteria: Trials were included which used random or quasi-random patient allocation, and which compared intravenous steroids given immediately prior to a planned extubation with placebo.
Background: This section is under preparation and will be included in the next issue.
Objectives: To assess the effects of active chest physiotherapy on babies being extubated from mechanical ventilation for neonatal respiratory failure.
Selection criteria: All trials utilising random or quasi-random patient allocation, in which active chest physiotherapy was compared with non-active techniques (eg positioning and suction alone) or no intervention in the periextubation period. The methodological quality of each trial was assessed by two independent authors.
Background: Vaginal candidiasis (moniliasis or thrush) is a common and frequently distressing infection for many women. It is even more common in pregnancy.
Objectives: The objective of this review was to assess the effects of different methods of treating vaginal candidiasis in pregnancy.
Selection criteria: Randomised trials of any treatment for vaginal candidiasis in pregnancy.
Background: One way of attempting to improve fetal growth has been nutrient supplementation for the mother when fetal growth is impaired. Different nutrients such as carbohydrates and amino acids have been suggested as treatments for impaired fetal growth.
Objectives: The objective of this review was to assess the effects of nutrient administration for suspected fetal growth impairment on fetal growth and perinatal outcome.
Selection criteria: Acceptably controlled trials of nutrient administration for suspected impaired fetal growth compared to placebo or no treatment.
Background: Fetal hypoxaemia is often a feature of fetal growth impairment. It has been suggested that perinatal outcome after suspected impaired fetal growth might be improved by giving mothers continuous oxygen until delivery.
Objectives: The objective was to assess the effects of maternal oxygen therapy in suspected impaired fetal growth on fetal growth and perinatal outcome.
Selection criteria: Acceptably controlled trials comparing maternal oxygen therapy with no oxygen therapy in suspected impaired fetal growth.
Background: Oligohydramnios (reduced amniotic fluid) may be responsible for malpresentation problems, umbilical cord compression, concentration of meconium in the liquor, and difficult or failed external cephalic version. Simple maternal hydration has been suggested as a way of increasing amniotic fluid volume in order to reduce some of these problems.
Objectives: The objective of this review was to assess the effects of maternal hydration on amniotic fluid volume and measures of pregnancy outcome.
Selection criteria: Randomised trials comparing maternal hydration with no hydration in pregnant women with reduced or normal amniotic fluid volume.
Background: Many women experience leg cramps in the second half of pregnancy.
Objectives: The objective of this review was to assess the effects of treatments for leg cramps in pregnancy.
Selection criteria: Randomised trials of treatments for leg cramps, persisting for at least two weeks, in pregnancy.
Background: At the end of 1998 over 33 million people were infected with the human immunodeficiency virus (HIV) and over one million children had been infected from their mothers.
Objectives: The objective of this review was to assess what interventions may be effective in decreasing the risk of mother-to-child transmission of HIV infection as well as their effect on neonatal and maternal mortality and morbidity.
Selection criteria: Randomised trials comparing any intervention aimed at decreasing the risk of mother-to-child transmission of HIV infection compared with placebo or no treatment, or any two or more interventions aimed at decreasing the risk of mother-to-child transmission of HIV infection.
Background: Neisseria gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth and can cause gonococcal opthalmia neonatorum.
Objectives: The objective of this review was to assess the effects of antibiotic regimens in the treatment of genital infection with gonorrhoea during pregnancy with respect to neonatal and maternal morbidity.
Selection criteria: Randomised trials of one regimen of antibiotic versus another in pregnant women with culture confirmed genital gonococcal infection.
Background: Chlamydia trachomatis is a sexually transmitted infection. Mother-to-child transmission can occur at the time of birth and may result in ophthalmia neonatorum or pneumonitis in the newborn.
Objectives: The objective of this review was to assess the effects of antibiotics in the treatment of genital infection with Chlamydia trachomatis during pregnancy with respect to neonatal and maternal morbidity.
Selection criteria: Randomised trials of any antibiotic regimen compared with placebo or no treatment or alternative antibiotic regimens in pregnant women with genital Chlamydia trachomatis infection.
Background: Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects.
Objectives: The objective of this review was to assess the effects of prophylactic betamimetic therapy during the second stage of labour on perinatal outcome.
Selection criteria: Randomised trials comparing prophylactic intravenous betamimetic therapy during the second stage of labour with placebo or no treatment in uncomplicated pregnancies.
Background: Betamimetic drugs may promote fetal growth by increasing the availability of nutrients and by decreasing vascular resistance. They may also induce adverse effects via their effects on carbohydrate metabolism.
Objectives: The objective of this review was to assess the effects of betamimetic therapy for suspected impaired fetal growth on fetal growth and perinatal outcome.
Selection criteria: Randomised trials of betamimetic therapy compared with no betamimetic therapy or placebo in women with suspected impaired fetal growth.
Background: Bed rest in hospital or at home is widely advised for many complications of pregnancy. The increased clinical supervision needs to be balanced with the risk of thrombosis, the stress on the pregnant women, as well as the costs to families and health services.
Objectives: The objective of this review was to assess the effects of bed rest in hospital for women with suspected impaired fetal growth.
Selection criteria: Randomised trials comparing a policy of bed rest in hospital with ambulatory management for women with suspected impaired fetal growth.
Background: The development of Rh immunisation and its prophylactic use since the 1970s has meant that severe Rhesus D (RhD) alloimmunisation is now rarely seen.
Objectives: The objective of this systematic review was to assess the effects of giving anti-D to Rhesus negative women, with no anti-D antibodies, who had given birth to a Rhesus positive infant.
Selection criteria: Randomised trials in Rhesus negative women without antibodies who were given anti-D immunoglobulin postpartum compared with no treatment or placebo.
Background: Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia.
Objectives: The objective of this review was to assess the effects of absorbable synthetic suture material as compared with catgut on the amount of short and long term pain experienced by mothers following perineal repair.
Selection criteria: Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic catgut suture for perineal repair in mothers after vaginal delivery.