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Biomedical subjects
M Malnory
Publications and source records attributed to M Malnory.
A randomized trial comparing prostaglandin E(2) vaginal insert (Cervidil) to vaginal gel for cervical ripening before induction of labor.
Objective: To compare the efficacy and safety of a controlled release vaginal insert (Cervidil) with hospital compounded prostaglandin E(2) vaginal gel for cervical ripening before labor induction.Methods: A prospective randomized study was performed between July 1996 and August 1997 on 200 patients undergoing cervical ripening before induction of labor. The efficacy and safety of a 12-hour controlled release 10-mg vaginal insert (Cervidil, Forest Pharmaceuticals) was compared with two 4-mg doses of prostaglandin E(2) gel.Results: The study groups did not differ by parity, estimated gestational age, indications for induction, and initial Bishop scores. No differences were noted in Bishop score at 12 hours or change in Bishop score. No statistically significant differences were noted in the successful inductions, additional days of induction, and the number of patients discharged undelivered. There were no differences in mean time to active labor, cesarean section, meconium staining, 1 and 5 minute Apgar scores, cord pH values, NICU admissions, and incidence of hyperstimulation.Conclusions: Two 4-mg doses of prostaglandin vaginal gels are equally effective to a Cervidil vaginal insert for preinduction cervical ripening.
Journal Article↗
Mother-infant home care drives quality in a managed care environment.
Advocates of inpatient managed care employing clinical pathways are confident that this patient management strategy reduces cost while promoting equivalent patient outcomes. Other health care professionals are concerned that cost reductions place patients at higher risk for adverse health events. Research is needed to demonstrate the true impact of cost-containment strategies on clinical outcomes. The article describes a study in progress comparing patients conventionally managed by their physicians with similar patients whose overall management involved a nurse case manager. This study explores the issue of resource costs that can be linked to clinical and financial outcome measures.
Adolescent↗