Early extrusion of bilateral Filshie clips after laparoscopic sterilisation.
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Adult↗
Biomedical subjects
Meghana Pandit
Publications and source records attributed to Meghana Pandit.
Tocolysis for repeat external cephalic version in breech presentation at term: a randomised, double-blinded, placebo-controlled trial.
BACKGROUND: External cephalic version (ECV) reduces the incidence of breech presentation at term and caesarean section for non-cephalic births. Tocolytics may improve success rates, but are time consuming, may cause side effects and have not been proven to alter caesarean section rates. The aim of this trial was to determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. OBJECTIVE: To determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. DESIGN: Randomised, double-blinded, placebo-controlled trial. SETTING: UK teaching hospital. POPULATION: One hundred and twenty-four women with a breech presentation at term who had undergone an unsuccessful attempt at ECV. METHODS: Relative risks with 95% confidence intervals for categorical variables and a t test for continuous variables. Analysis was by intention to treat. MAIN OUTCOME MEASURES: Incidence of cephalic presentation at delivery. Secondary outcomes were caesarean section and measures of neonatal and maternal morbidity. RESULTS: The use of tocolysis for a repeat attempt at ECV significantly increases the incidence of cephalic presentation at delivery (RR 3.21; 95% CI 1.23-8.39) and reduces the incidence of caesarean section (RR 0.33; 95% CI 0.14-0.80). The effects were most marked in multiparous women (RR for cephalic presentation at delivery 9.38; 95% CI 1.64-53.62). Maternal and neonatal morbidity remain unchanged. CONCLUSIONS: The use of tocolysis increases the success rate of repeat ECV and reduces the incidence of caesarean section. A policy of only using tocolysis where an initial attempt has failed leads to a relatively high success rate with minimum usage of tocolysis.
Adult↗
National survey for intrapartum and postpartum bladder care: assessing the need for guidelines.
Variation in the practice of intrapartum and postpartum bladder care reported by 189 maternity units in England and Wales hospitals was evaluated by analysing the data obtained from a postal questionnaire completed by labour ward managers or heads of midwifery. The survey revealed that there was no consensus of opinion about the diagnostic criteria for postpartum urinary retention and therefore the optimum management for voiding dysfunction remains controversial. In spite of the increasing awareness of the risk management issues involved, the majority of the units were found to be non-compliant with the limited RCOG recommendations currently available. Although further research is needed to develop evidence-based guidelines, all units should be timing and measuring the voided volume and ideally checking the first post-void residual volume to ensure that retention does not go unrecognised.
Catheters, Indwelling↗