Routine ultrasound in early pregnancy increased the rate of detection of multiple pregnancies and fetal abnormalities before 24 weeks’ gestation. It seemed to be associated with a reduction in induction of labour for ’post-term’ pregnancy. No significant reduction in perinatal death, adverse outcomes for babies or in health service use was found. No adverse effects were demonstrated in long-term follow-up of children exposed to scan in utero.
This review compared primary overlap and end-to-end repair techniques in the management of obstetric anal sphincter injury (OASIS). There were no differences in perineal pain, dyspareunia, flatus incontinence and fecal incontinence. Overlap technique showed significantly lower risk of fecal urgency, lower anal incontinence score and deterioration of anal incontinence symptoms. However, there is insufficient evidence to make a strong recommendation regarding the best repair technique.
Parenteral beta sympathomimetics significantly increase the rate of successful external cephalic version (ECV) and vaginal birth, and significantly reduce the rate of caesarean section resulting from breech position, however information about adverse effects, and the effectiveness of other drugs is limited.
The use of calcium supplementation in pregnancy reduces the risk of pre-eclampsia, maternal death or severe morbidity and reduces the risk of preterm birth, especially in women with low dietary calcium intake or high risk of preeclampsia.
Antihypertensive therapy for mild to moderate hypertension during pregnancy reduces the risk of severe hypertensive episodes; however the clinical significance of this reduction for the mother and fetus is not clear. A significant effect on rates of pre-eclampsia has not been observed.
Giving prophylactic antibiotics to women with prelabour rupture of membranes (PROM) at or near term have shown no reduction in maternal infectious morbidity, early-onset neonatal sepsis, stillbirth, neonatal or perinatal mortality when compared to placebo or no treatment
Prophylactic administration of betamethasone to women undergoing elective caesarean section between 37 and 39 weeks of gestation seems to reduce the risk of admission to special and to intensive neonatal care units for respiratory distress.