New in RHL

Traditional birth attendant (TBA) training for improving health behaviours and pregnancy outcomes

There is significant reduction in stillbirth, perinatal and neonatal mortality in the trained versus untrained TBA clusters. However, no clear benefit could be demonstrated with additional or advanced TBA training though, overall neonatal death rate may be lower. The results may be encouraging but more evidence is needed to establish any concrete inference.

Specialized antenatal care clinics for women with a pregnancy at high risk of preterm birth (excluding multiple pregnancy) to improve maternal and infant outcomes

There is no clear evidence that specialized antenatal clinics improve maternal and infant outcomes. However, the included trials lacked sufficient statistical power to detect any possible difference between groups.

Surgical approach to hysterectomy for benign gynecological disease

This review assessed the effectiveness and safety of different surgical approaches to hysterectomy for women with benign gynecological conditions. There is insufficient evidence to make a strong recommendation regarding the optimal surgical management of benign gynecological conditions.

In vitro fertilization for unexplained subfertility

Unexplained subfertility is common, peaking at 26% in women above 35 years. Although in vitro fertilization (IVF) is widely accepted, it is invasive, expensive and associated with risks.

Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes

Repeat doses of corticosteroids should be offered to women at risk of preterm birth who remain undelivered seven or more days after initial course of corticosteroids to reduce the risk of respiratory distress syndrome and serious neonatal health problems.

Alternative versus standard packages of antenatal care for low-risk pregnancy

Reduced visits programmes of antenatal care are associated with an increase in perinatal mortality compared to standard care. Women are less satisfied with the reduced visits schedule and gaps between visits. Reduced visits schedule may be associated with lower costs.

Vaccines for women for preventing neonatal tetanus

This review found a reduction in neonatal tetanus cases with a single dose of tetanus toxoid injection, and protection against death due to neonatal tetanus with the administration of two or more tetanus toxoid doses.

Antenatal cardiotocography for fetal assessment

This systematic review of evidence on the effectiveness of antenatal cardiotocography (CTG) found no clear benefit of CTG for mothers or their babies in the included studies. However, the included studies have limitations with regard to implications for current practice.

Combined Oral Contraceptives and venous thrombosis

Combined Oral Contraceptives can increase the risk of venous thrombosis in healthy premenopausal women.

Surfactant for meconium aspiration syndrome in term and late preterm infants

Intratracheal surfactant administration to term and late preterm infants with meconium aspiration syndrome (MAS) can reduce the need for ECMO and their length of hospital stay, however there is no clear impact on infant mortality.

Medical methods for first trimester abortion

Safe and effective methods of medical abortion are available for use. Combined methods, such as mifepristone with prostaglandins appear more effective then single methods.

Antibiotics for asymptomatic bacteriuria in pregnancy

Antibiotic treatment for women with asymptomatic bacteriuria during pregnancy appears to have some benefit, however only low-quality evidence is available.

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