New in RHL

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.

Antidepressant treatment for postnatal depression

Postnatal depression (PND) affects more than 10% of postnatal women worldwide. Limited evidence from randomized trials found that selective serotonin reuptake inhibitors (SSRIs) are effective in addressing PND in terms of short-term response and remission. There was little evidence about effects on breastfeeding babies.

Immunotherapy for recurrent miscarriage

Attempts to induce maternal antibodies with paternal cells, third party donor leukocytes, trophoblast membranes or intravenous immunoglobulins have not proven effective in improving the chance of a live birth for women with recurrent miscarriages.

Closure versus non-closure of the peritoneum at caesarean section

Randomized trials have challenged the convention of suturing both visceral and parietal peritoneal layers during caesarean section. This review found that non-suturing of one or both layers reduces operation time and postoperative complications, with no apparent adverse effects.

Interventions to reduce haemorrhage during myomectomy for fibroids

Interventions found to reduce blood loss from myomectomy for leiomyomata (fibroids) of the uterus include: pericervical Foley catheter tourniquet, uterine artery ligation, various vasopressins and uterotonics, local haemostatics, and tranexamic acid.

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