Care Supporting Normal Birth is Best for Mothers and Babies

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Findings from a two-year review of the science behind maternity care indicate that the common and costly use of many routine birth interventions, such as continuous electronic fetal monitoring, labor induction for low-risk women, and cesarean surgery, fail to improve health outcomes for mothers and their babies and may cause harm. The Coalition for Improving Maternity Services (CIMS) Expert Work Group study entitled, Evidence Basis for the Ten Steps to Mother-Friendly Care, reviewed the evidence in support of each of the Ten Steps of the Mother-Friendly Childbirth Initiative for Mother-Friendly Hospitals, Birth Centers, and Home Birth Services. Research findings include:
Ponte Vedra Beach, FL (PRWeb) March 1, 2007 -- Findings from a two-year review of the science behind maternity care indicate that the common and costly use of many routine birth interventions, such as continuous electronic fetal monitoring, labor induction for low-risk women, and cesarean surgery, fail to improve health outcomes for mothers and their babies and may cause harm. The Coalition for Improving Maternity Services (CIMS) Expert Work Group study entitled, Evidence Basis for the Ten Steps to Mother-Friendly Care, reviewed the evidence in support of each of the Ten Steps of the Mother-Friendly Childbirth Initiative for Mother-Friendly Hospitals, Birth Centers, and Home Birth Services. Research findings include:• Women whose labors are induced for non-medical reasons are more likely to suffer from intrapartum fever and more likely to end up needing forceps, vacuum extraction and a cesarean surgery. • Inductions add to the risk of poor outcomes for the health of the baby. Artificially induced labors increase the rate of fetal distress and a serious complication of labor called shoulder dystocia (when the baby's shoulders have difficulty passing through the mother's pelvic bones). Elective induction babies are also more likely to need phototherapy to treat jaundice after birth, and are at higher risk for breathing difficulties and admission to neonatal intensive care. • Use of electronic fetal monitors is over 85% on low-risk women. They fail to reduce the number of perinatal deaths, the incidence of cerebral palsy or the number of admissions to the neonatal intensive care unit. Continuous fetal monitoring puts women at increased risk for an instrumental delivery, cesarean section and infection. • Overall 1 in 3 US women give birth by cesarean surgery. The majority of the operations are repeat procedures with no medical indication. • When compared to women who have a vaginal birth, cesareans put women at risk for infections, hemorrhage requiring transfusion, surgical injuries, and complications from anesthesia, chronic pain, adhesions, hysterectomy, pulmonary embolism, placental problems with future pregnancies, and death. Babies born by cesarean are more likely to suffer from surgical lacerations, respiratory complications, and to require neonatal intensive care. • There are more than 4.1 million US births a year with a cesarean rate over 30%. The health and economic impact of high tech birth is significant. In 2004, hospital costs for deliveries totaled over $30 billion dollars. The record high cesarean rate contradicts the national goals of Healthy People 2010 to reduce cesareans for first time mothers to 15% and increase VBAC (Vaginal Birth After Cesarean) rates to 63%.The CIMS study found that harm is also caused by routine use of intravenous fluids (IVs), amniotomy (breaking the bag of waters), withholding food and water from women in labor, and episiotomy. CIMS recommends supporting normal birth for birthing women and limited use of many common and costly birth interventions. The CIMS Evidence Basis for the Ten Steps to Mother-Friendly Care will be published as a supplement to the Winter Issue of The Journal of Perinatal Education. The results will be premiered at the CIMS Forum on March 8th at the DoubleTree Atlanta-Buckhead in Atlanta, Georgia.Members of the CIMS Expert Work Group include: Henci Goer, BA, Project Director; Judith Lothian, RN, PhD, LCCE, FACCE, Project Coordinator; Mayri Sagady Leslie, CNM, MSN; Amy Romano, MSN, CNM; Katherine Shealey, MPH, IBCLC, RLC Sharon Storton, MA, CCHT, LMFT; Karen Salt, CEE, MA; Deborah Woolley, CNM, PhD, FACCEThe Coalition for Improving Maternity Services (CIMS), a United Nations recognized NGO, is a collaborative effort of numerous individuals, leading researchers, and more than 50 organizations representing over 90,000 members. Promoting a wellness model of maternity care that will improve birth outcomes and substantially reduce costs, CIMS developed the Mother-Friendly Childbirth Initiative in 1996. A consensus document that has been recognized as an important model for improving the healthcare and well being of children beginning at birth, the Mother-Friendly Childbirth Initiative has been translated into several languages and is gaining support around the world. For more information about CIMS and the Mother-Friendly Childbirth Initiative, visit www.motherfriendly.org.

Adhesion Medical Headlines ARD vark Blog

Company Agrees to Stop Making Endoscope Cleaners Until Compliance Problems Are Resolved

Blue Cross And Blue Shield Association Opposes Reduction In Reimbursements To Medicare MA Plans

AmeriHealth Expands Disease Management Program To Benefit Members With Crohn's Disease

2006 Procedural Survey Shows 3% Increase In Men Seeking Cosmetic Surgery

MRI Contrast Agent Linked To Complication In Renal Patients

Consumer Group Petitions FDA To Ban Some Contraceptive Pills

Operative Hysteroscopy For Intrauterine Adhesions Video

Operative Hysteroscopy For Intrauterine Adhesions Video The operative hysteroscopy for intrauterine adhesions video shows the procedure also known as adhesiolysis for treating Ashermann's syndrome. The surgeon is Dr Anjali Malpani.
The video first shows the uterine cavity as the the surgeon sees it on the video screen. This cavity is small and distorted because of the adhesion, due to a scar on the inside wall of the uterus. The adhesion divided the cavity into two parts. The surgeon cuts through the adhesion with a hysteroscopic cutting knife, which uses electricity. The goal is not only to resect the adhesion but to eliminate the scar itself.
Once the resection was done, the video shows how the uterine cavity opened up and normalized the uterus. This woman will undergo further IVF treatment, but now her chances of conceiving are greatly increased, since the uterus is almost normal now.
Click here to see UTube Video

Adhesion ARD Medical Headlines ARDvark Blog

Consumer Group Petitions FDA To Ban Some Contraceptive Pills
US consumer group Public Citizen is petitioning the Food and Drug Administration (FDA) to ban certain types of contraceptive pills...[read article]

Patients Should Take Steps To Prevent Medical Errors, Experts Say

Bacteria Fighter Goes Where Antibiotics Can't

Alliance Pharmaceutical Corp. Completes The Manufacture Of Oxygent (TM) For Clinical Trials

Baxter Receives Clearance From U.S. FDA For Ipump Pain Management System 510(k)

IVF Success May Be Increased With Use Of Ultrasound

Vitamin D Appears Effective In Reducing Colorectal Cancer Incidence

Senate Committee Investigation Finds Pharmaceutical Companies Improperly Used Exception In Medicaid Drug Rebate Program

Sexual History Should Be An Integral Component Of Medical Assessment

Pilot Study Shows Withdrawal Drug Offers Symptom Relief To Crohn's Sufferers

Study sounds alarm on surgery drug

By Carla K. Johnson
Associated Press
CHICAGO – A drug widely used to prevent excessive bleeding during heart surgery appears to raise the risk of dying in the five years afterward by nearly 50 percent, an international study found.
The researchers said replacing the drug – aprotinin, sold by Bayer AG under the brand name Trasylol – with other, cheaper medications for a year would prevent 10,000 deaths worldwide over the next five years.
The findings were more bad news for Trasylol: The same scientists found the drug raised the risk of kidney failure, heart attacks and strokes in a study published last year. Most of the deaths in the new study were related to those problems.
Bayer said in a statement that the findings are unreliable because Trasylol tends to be used in more complex operations and the researchers’ statistical analysis did not fully account for the complexity of the surgery cases.
Nevertheless, the drug company said it will “work with regulatory agencies and external experts in the field to further evaluate the findings.”
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Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations.

Yilmaz O,
Genc A,
Taneli F,
Demireli P,
Deliaga H,
Taneli C.
Celal Bayar University, Medical Faculty, Department of Pediatric Surgery, 45010 Manisa, Turkey.
OBJECTIVE: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate (Seprafilm((R)); Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed((R)); Johnson&Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. METHODS: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm((R)), and in group 2 with Interceed((R)). But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. RESULTS: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p=0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p=0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. CONCLUSION: Seprafilm((R)) and Interceed((R)) had no effect on esophagus dissection. Although Seprafilm((R)) had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed((R)) in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa.
PMID: 17161874 [PubMed - in process]

Lichen Sclerosis:

A Guide for Teens
Lichen sclerosis is a skin condition that usually affects the vulva area (the outside parts of the female genitalia) and the anal area in young girls, adolescents, and adults. Similar to other skin conditions, there are treatments available to help the symptoms.

What is lichen sclerosis and what does it look like?
Lichen sclerosis (LS) is a skin condition that makes the vulva look white, slightly shiny, and smooth. The skin's surface becomes thin and delicate so that it tears easily. This can cause bleeding under the skin. In severe cases of lichen sclerosis of the genital area, scarring can occur. This causes the inner lips of the vulva to get smaller. The clitoris can become covered in scar tissue.

What causes lichen sclerosis?
We do not know the exact cause of lichen sclerosis. Scientists have different theories to try to explain the cause. Some scientists think that an overactive immune system may play a role in causing the disease. Some people may also develop lichen sclerosis due to their genes or to changes in hormones. Since lichen sclerosis is not caused by an infection, it cannot be spread and is not contagious.

What are the symptoms of lichen sclerosis?
Symptoms of lichen sclerosis may be different from one person to another and can be mild to severe. Girls and young women who have this disease may experience some or all of the following symptoms in the vulvar area:
mild to severe itching in the vulvar area
skin that appears fragile, pale, and/or white
bruised skin with broken blood vessels or "blood blisters"
small tears or fissures in the skin
scar tissue covering the labia or clitoris
bleeding or tearing of skin when having bowel movements
How is lichen sclerosis diagnosed?
Lichen sclerosis can be a difficult diagnosis to make. It is not unusual for someone to see more than one doctor before the disease is finally diagnosed. This can be very frustrating for you if the treatment you are receiving isn't working. Most of the time, doctors who see a lot of patients with lichen sclerosis can often make the diagnosis just by looking at the skin, but still may need to do a biopsy. If you are in the early stages of lichen sclerosis, the doctor may have to do a biopsy (removal and examination of a small sample of affected skin) to identify the cause of your symptoms.

Will I need treatment?
Even if you do not have symptoms such as itching or pain, it is important for you to receive medical treatment for lichen sclerosis. Treatment to genital skin is necessary to try to prevent scarring of the vulva. Without treatment, there can be scarring that causes parts of the vulva to narrow and cause problems with passing urine or pain with sexual activity. Severe scarring can cause the opening to the vagina to narrow. Intercourse may be painful if the vagina narrows too much.

Are there medicines to treat lichen sclerosis?
Yes. Medications are available to help with the symptoms of lichen sclerosis. They are only available by a prescription from your doctor. If you have lichen sclerosis, your doctor will most likely prescribe a strong topical corticosteriod, which is a type of ointment that reduces swelling and itching on your skin. This medicine also decreases the body's immune response. Your doctor will probably tell you to apply this drug every day so that your skin can return to its normal surface and strength. The amount of time it takes for this to happen is different from patient to patient. It is important to realize that the treatment may not undo the scarring that may have already occurred.
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