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  • 1
    Electronic Resource
    Electronic Resource
    Prostaglandin E2 vaginal gel to treat dystocia in spontaneous labour: a multicentre randomised placebo-controlled trial (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  To test the safety and efficacy of prostaglandin E2 (PgE2) as a treatment for dystocia in spontaneous labour.Design  Randomised, double-blind, placebo-controlled trial.Setting  Multicentre study in nine university-affiliated hospitals in Canada.Population  Three hundred and thiry-two nulliparous women with spontaneous labour at term.Methods  Women who had progressed 〈2 cm of cervical dilation in the 4 hours following the diagnosis of labour were randomly assigned to receive a single dose of either 1 mg (n= 112) or 2 mg (n= 111) PgE2 vaginal gel or placebo gel (n= 109).Main outcome measures  The primary outcome was resolution of dystocia, defined as a change in cervical dilatation of 〉0.5 cm per hour in the 6 hours following gel administration. Secondary outcomes were progress of labour, uterine hyperstimulation (more than five contractions in 10 minutes or a contraction lasting more than 2 minutes), use of oxytocin, method of delivery, maternal and neonatal morbidity.Results  Dystocia resolved more often after PgE2 1 mg (49%), RR 1.53 (95% CI 1.1, 2.1) and PgE2 2 mg (49%), RR 1.5 (CI 1.1, 2.1), compared with placebo (32%). Hyperstimulation was increased after PgE2 2 mg treatment (15%), RR 5.6 (95% CI 1.7, 18), but not after PgE2 1 mg (5.4%), RR 1.9 (CI 0.50, 7.6) when compared with placebo (2.8%). There was an increase in caesarean sections performed in the second stage of labour in the PgE2 groups versus placebo. There were no differences in measures of maternal or neonatal morbidity.Conclusion  A single 1-mg dose of PgE2 vaginal gel is more effective than placebo in resolving dystocia, without increasing uterine hyperstimulation, but may be associated with an increase in the incidence of second stage caesarean section.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00484.x
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  • 2
    Electronic Resource
    Electronic Resource
    Prevention of Perineal Trauma by Perineal Massage During Pregnancy: A Pilot Study (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Birth 21 (1994), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : Although the performance of perineal massage by a woman or her partner during the last weeks of pregnancy may help to prevent perineal trauma at delivery, the technique has never been evaluated rigorously. This study examined the feasibility of a randomized, controlled trial, and more specifically assessed the participation rate, the acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. The pilot study was a single-blinded, randomized, controlled trial. Nulliparous women, 32 to 34 weeks pregnant, were recruited from June 8 to July 31, 1992, at the offices of family physicians and obstetricians who practice at the Hôpital du Saint-Sacrement in Quebec City. Women assigned to the intervention group practiced daily 10-minute perineal massage and completed a diary, and those in the control group had standard care. Women and attending physicians completed a questionnaire about the aspect of blindness. Among the 174 women who delivered during the study period, 104 (59.8%) were approached by a midwife and 46 (26.4%) were randomized. Twenty (91.0%) of the 22 women in the massage group returned their perineal massage diaries. Based on the postpartum questionnaire, 20 women practiced the technique at least four times a week for three weeks or longer. No woman in the control group practiced massage. The attending physician was aware of the woman's group in only three instances (6.7%). Based on the results of this pilot study, a randomized, controlled trial to evaluate the efficacy of perineal massage in preventing perineal trauma at birth appears feasible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-536X.1994.tb00911.x
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  • 3
    Electronic Resource
    Electronic Resource
    Women's views on the practice of prenatal perineal massage (2001)
    Oxford, UK : Blackwell Science Ltd
    BJOG 108 (2001), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine how women who practised perineal massage during pregnancy assessed the technique.Design Observational study within one arm of a randomised controlled trial.Setting Five secondary and tertiary care hospitals in the Province of Quebec, Canada.Participants Among 763 women randomised to the massage arm of a clinical trial of perineal massage during pregnancy, 684 (90%) who completed a questionnaire after delivery.Main outcome measures A 20-item questionnaire completed a few days after birth. The first 18 questions elicited opinions using a 6-point Likert scale. Based on a factor analysis, 17 of these questions were classified into four categories: acceptability of perineal massage (8 items); preparation for birth (4 items); relationship with the partner (2 items); and effect of massage on delivery (3 items). Scores of each scale varied between 1 (highly negative assessment) to 6 (highly positive assessment). The last two questions asked whether women would perform the massage in their next pregnancy and whether they would recommend perineal massage to another pregnant woman. In addition, 262 also provided comments about their experience in the daily diary provided to record compliance during the trial.Results On average, perineal massage was felt to be quite acceptable [mean (standard deviation) 4.09 (0.93)]. Pain and technical problems reported during the first week or two of massage tended to disappear after a few weeks. Women's assessment of the effect of massage on preparation for birth [4.34 (1.08)] and on delivery [4.18 (1.37)] was positive. Women's views about the effect on their relationship with their partner were either positive or negative [3.54 (1.74)] and were proportional to the partner's participation with the massage. Most women said they would massage again if they were to have another pregnancy (79%; 95% CI, 76%–82%) and would recommend it to another pregnant woman (87%; 95% CI 84%–90%).Conclusion Overall, women's assessment of prenatal perineal massage is positive.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2001.00111.x
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  • 4
    Electronic Resource
    Electronic Resource
    Effect of wastewater sludge on growth and heavy metal bioaccumulation of two Salix species (1995)
    Springer
    Plant and soil 171 (1995), S. 303-316 
    Details
    ISSN: 1573-5036
    Keywords: bioavailability ; fertilization ; heavy metals ; productivity ; Salix ; wastewater sludge
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Abstract Fast-growing tree species, such as willows, can benefit from sludge application. While sludges are good fertilizers, they may contain heavy metals which could reduce productivity and cause environment risks. The aims of the present research were to: i) determine the biomass production of Salix discolor Mühl. and Salix viminalis L. when supplied with various amounts of dried and pelleted sludge and ii) assess the uptake and accumulation of heavy metals. Trials were carried out using unrooted cuttings that were planted in large plastic pots containing sandy soil and grown outdoors for a 20-week period. Five doses of sludge were applied: the equivalents of 0 (T0), 40 (T1), 80 (T2), 120 (T3), 160 (T4) and 200 (T5) kg “available” N ha-1. Trees which received the highest dosage of sludge showed the best growth. Stem biomass was significantly greater for S. viminalis which had received sludge treatments. The relationship between the total biomass yield Y (g) and the rate of fertilization X (equivalent to kg of “available” nitrogen provided per hectare) is linear. Regression equations of predicted biomass production were established as follows: S. discolor, Y=28.36+0.56X and S. viminalis, Y=39.95+0.64X. For both species, the greatest stem biomass per g of N applied was produced with treatment 4 and 5. Amounts of nitrogen per leaf area (N/LA) and per dry leaf mass (N/DL) were higher for S. viminalis. The metal transfer coefficient did not vary between the species but was significantly different for Cd and Zn. Plants were able to absorb Cd and Zn, but were less able to absorb Ni, Hg, Cu, and Pb. It was concluded that the dried and pelleted sludge is a good fertilizer. S. discolor and particularly S. viminalis can be used as filters for the purification of wastewater sludge as well as for biomass production purposes. R F Huettl Section editor
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00010286
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