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Fetal intrapartum pulse oximetry for fetal assessment in labour

Cardiotocography (CTG) for fetal monitoring during labour reduces short-term neonatal adverse outcomes, but is expensive and over-diagnoses fetal distress. Adding fetal pulse oxymetry (PO) to CTG did not help to reduce unnecessary caesarean sections (CS). Fetal assessment in low-resource settings depends mainly on a Pinard stethoscope or hand-held doptone ‘auscultation’, and simplified clinical fetal arousal tests.

Antibiotic prophylaxis versus no prophylaxis for preventing infection after caesarean section

Routine prophylactic antibiotics for caesarean section reduced the risk of wound infection, endometritis and severe infection by 60% or more, whether given before or after cord clamping. Single dose prophylactic antibiotics after cord clamping can be used for all caesarean sections.

Antibiotic prophylaxis for operative vaginal delivery

The evidence to support routine antibiotic prophylaxis for operative vaginal delivery is insufficient both in quantity and in quality.

Accuracy of urinary human papillomavirus testing for presence of cervical HPV

There is not yet sufficient evidence to support the adoption of urinary HPV testing for the presence of cervical HPV into routine clinical practice. It is a potentially accurate and non-invasive option, however this method requires further validation and standardization.

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth

There are no randomized controlled trials evaluating the effectiveness of prophylactic antibiotics for manual removal of retained placenta in vaginal birth.

Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth

The evidence to support the use of prophylactic antibiotics for third- and fourth- degree perineal tear after vaginal birth should be treated with caution.

Individual and contextual factors affecting antiretroviral treatment initiation, adherence, and retention for HIV-infected pregnant and postpartum women

Individual, interpersonal, community and structural factors can act as both enablers and barriers to the initiation, adherence and retention of antiretroviral treatment (ART) for HIV-infected pregnant women. Addressing these factors is crucial to implementing acceptable and effective ART programs that respond to women’s needs and perspectives.

Interventions for managing asthma in pregnancy

Evidence on the use of pharmacological and non-pharmacological interventions for the management of asthma during pregnancy is limited and further research is needed.

Ambroxol for women at risk of preterm birth for preventing neonatal respiratory distress syndrome

There is insufficient evidence to support or refute the role of ambroxol in preventing neonatal respiratory distress syndrome in women at risk of pre-term birth. Further information is required regarding the benefits and risks of treatment.

Minimally invasive surgical techniques versus open myomectomy for uterine fibroids

Laparoscopic myomectomy is associated with lower pain scores and lower risk of postoperative fever than open myomectomy, with no significant difference in other post-operative adverse events.

High-dose versus low-dose oxytocin infusion regimens for induction of labour at term

There is no clear evidence to support either high-dose or low-dose oxytocin infusion regimens, and further trials are needed.

Resources


Guidelines

Health-care practice guidance from WHO and other institutions

Methodological resources

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

Videos
 

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

RHL on iPad

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WHO