New in RHL

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity

There is insufficient evidence to support the routine use of antibiotics in the second and third trimesters to prevent infectious complications. However their use may reduce the risk of preterm delivery in selected patients, and may reduce the risk of postpartum infections.

Controlled cord traction for the third stage of labour

Controlled cord traction in the third stage of labour reduces mean blood loss and reduces the risk of the need for manual removal of the placenta.

Induction of labour in women with gestational diabetes

WHO does not recommend induction of labour before 41 weeks gestation when gestational diabetes is the only abnormality.

Tocolysis for management of retained placenta

This review found only one small trial of nitroglycerine in retained placenta to reduce the need of manual removal and blood loss in the third stage of labour. More trials are needed.

Interventions for preventing or reducing domestic violence against pregnant women

There is insufficient evidence on specific interventions for preventing or reducing violence against women during pregnancy.

Routine perineal shaving on admission in labour

There is not enough evidence to support routine perineal shaving in women admitted in labour for reducing infection.

Imiquimod for anogenital warts in non-immunocompromised adults

The available research comparing imiquimod to placebo or other treatments for the treatment of anogenital warts is of very low quality. Further research is required to guide practice in this area.

Packages of care as active management to prevent delays in active labour

WHO does not recommend packages of care to prevent delays in active labour as clinical benefits do not clearly outweigh other considerations.

Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants

Delaying the introduction of progressive enteral feeds for very low birth weight infants does not affect the risk of NEC or death. It delays the time until full enteral feeding is achieved; however, the clinical importance of this is not yet clear.

Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery

Early postoperative feeding after major abdominal gynaecologic surgery produced faster recovery of bowel function, lower rates of infectious complications, shorter hospital stay, and better patient satisfaction. It appears safe and did not result in any significant increase in complications.

Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection

Chlorhexidine vaginal washing during labour effectively reduces the bacterial load in the vagina, but has no effect on the risk of early-onset GBS illness. Further evaluation of its effectiveness is needed.

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Methodological and education resources for improved understanding of the concepts and discussions related to generation of best evidence


A set of training videos to help clinicians master details of manual or surgical procedures

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RHL endorses the Core Outcomes in Women’s health (CROWN) initiative to harmonise outcome reporting in women’s health research.