|
| The evidence against these forms of care is not as firmly established as for those in Table 6
|
|
Chapter
|
|
|
Basic care
|
| Reliance on expert opinion instead of on good evidence for decisions about care |
|
2
|
| Routinely involving doctors in the care of all women during pregnancy and childbirth |
|
3
|
| Routinely involving obstetricians in the care of all women during pregnancy and childbirth |
|
3
|
| Not involving obstetricians in the care of women with serious risk factors |
|
3
|
| Fragmentation of care during pregnancy and childbirth |
|
3
|
| Social support for high-risk women to prevent preterm birth |
|
3, 24
|
| Antenatal breast or nipple care for women who plan to breastfeed |
|
46
|
| Advice to restrict sexual activity during pregnancy |
|
5
|
| Prohibition of all alcohol intake during pregnancy |
|
5
|
| Imposing dietary restrictions during pregnancy |
|
6
|
| Routine vitamin supplementation in late pregnancy in well nourished populations |
|
6
|
| Routine hematinic supplementation in pregnancy in well-nourished populations |
|
6
|
| High-protein dietary supplementation |
|
6, 16
|
| Restriction of salt intake to prevent pre-eclampsia |
|
6, 15
|
Screening and diagnosis
|
| Routine use of ultrasound for fetal measurement in late pregnancy |
|
8, 12
|
| Reliance on edema to screen for pre-eclampsia |
|
10
|
| Angiotensin-sensitivity test to screen for pre-eclampsia |
|
10
|
| Cold-pressor test to screen for pre-eclampsia |
|
10
|
| Roll-over test to screen for pre-eclampsia |
|
10
|
| Isometric exercise test to screen for pre-eclampsia |
|
10
|
| Measuring uric acid as a diagnostic test for pre-eclampsia |
|
10
|
| Screening for 'gestational diabetes' |
|
11
|
| Routine glucose challenge test during pregnancy |
|
11
|
| Routine measurement of blood glucose during pregnancy |
|
11
|
| Insulin plus diet treatment for 'gestational diabetes' |
|
11
|
| Diet treatment for 'gestational diabetes' |
|
11
|
| Routine fetal movement counting to improve perinatal outcome |
|
12
|
| Routine use of Doppler ultrasound screening in all pregnancies |
|
12
|
| Measurement of placental proteins or hormones (including estriol and human placental lactogen) |
|
12
|
| Routine cervical assessment for prevention of preterm birth |
|
24
|
Pregnancy Problems
|
| Calcium supplementation for leg cramps |
|
13
|
| Screening for, and treatment of, vaginal candidal colonization without symptoms |
|
13
|
| Screening for, and treatment of, vaginal trichomonas colonization without symptoms |
|
13
|
| Screening for, and treatment of, bacterial vaginosis without symptoms |
|
13
|
| Bed-rest for threatened miscarriage |
|
14
|
| Immunotherapy for recurrent miscarriage |
|
14
|
| Antithrombotic agents to prevent pre-eclampsia |
|
15
|
| Reducing salt intake to prevent pre-eclampsia |
|
15
|
| Diazoxide for pre-eclampsia or hypertension in pregnancy |
|
15
|
| Ketanserin for severe hypertension in pregnancy |
|
15
|
| Diuretics for pregnancy-induced hypertension |
|
15
|
| High protein dietary supplementation for impaired fetal growth |
|
16
|
| Hospitalization and bed-rest for uncomplicated twin pregnancy |
|
17
|
| Cervical cerclage for multiple pregnancy |
|
17
|
| Prophylactic betamimetics for multiple pregnancy |
|
17
|
| Routine cesarean section for multiple pregnancy |
|
17
|
| Routine screening for mycoplasmas during pregnancy |
|
19
|
| Screening for toxoplasmosis during pregnancy |
|
19
|
| Treatment of group B streptococcus colonization during pregnancy |
|
19
|
| Cesarean section for non-active herpes simplex before or at the onset of labor |
|
19
|
| Amniotomy in HIV-infected women |
|
19, 35
|
| Elective delivery before term in women with otherwise uncomplicated diabetes |
|
20
|
| Elective cesarean section for pregnant women with diabetes |
|
20
|
| Discouraging breastfeeding in women with diabetes |
|
20
|
| Vaginal or rectal examination when placenta praevia is suspected |
|
21
|
| Postural techniques for turning breech into cephalic presentation |
|
22
|
| External cephalic version before term to avoid breech presentation at birth |
|
22
|
| X-ray pelvimetry to diagnose cephalopelvic disproportion |
|
22
|
| Computer tomographic pelvimetry to predict cephalopelvic disproportion |
|
22
|
| Cesarean section for macrosomia without a trial of labor to prevent shoulder dystocia |
|
22
|
| Induction of labor to prevent cephalopelvic disproportion |
|
22
|
| Amniocentesis for prelabor rupture of the membranes preterm |
|
23
|
| Prophylactic tocolytics with prelabor rupture of the membranes preterm |
|
23
|
| Regular leucocyte counts for surveillance in prelabor rupture of the membranes |
|
23
|
| Home uterine activity monitoring for prevention of preterm birth |
|
24
|
| Magnesium sulphate to stop preterm labor |
|
24
|
| Betamimetics for preterm labor in women with heart disease or diabetes |
|
24
|
| Hydration to arrest preterm labor |
|
24
|
| Diazoxide to stop preterm labor |
|
24
|
| Adding thyrotrophin releasing hormone (TRH) to corticosteroids to promote fetal maturation |
|
25
|
Childbirth
|
| Withholding food and drink from women in labor |
|
29
|
| Routine intravenous infusion in labor |
|
29
|
| Routine measurement of intra-uterine pressure during oxytocin administration |
|
31, 35
|
| Wearing face masks during labor or for vaginal examinations |
|
31
|
| Frequent scheduled vaginal examinations in labor |
|
31
|
| Routine directed pushing during the second stage of labor |
|
32
|
| Pushing by sustained bearing down during the second stage of labor |
|
32
|
| Breath holding during the second stage of labor |
|
32
|
| Early bearing down during the second stage of labor |
|
32
|
| Arbitrary limitation of the duration of the second stage of labor |
|
32
|
| 'Ironing out' or massaging the perineum during the second stage of labor |
|
32
|
| Routine manual exploration of the uterus after vaginal birth |
|
32
|
| Injectable prostaglandins in the third stage of labor |
|
33
|
| Encouraging early suckling to prevent postpartum hemorrhage |
|
33
|
Problems during childbirth
|
| Injecting saline into the umbilical vein for retained placenta |
|
33
|
| Biofeedback to relieve pain in labor |
|
34
|
| Sedatives and tranquilizers to relieve pain in labor |
|
34
|
| Caudal block to relieve pain in labor |
|
34
|
| Paracervical block to relieve pain in labor |
|
34
|
| Intrapartum X-ray to diagnose cephalopelvic disproportion |
|
35
|
| Diagnosing cephalopelvic disproportion without ensuring adequate uterine contractions |
|
35
|
| Relaxin for slow or prolonged labor |
|
35
|
| Hyaluronidase for slow or prolonged labor |
|
35
|
| Vitamin K to the mother to prevent intraventricular hemorrhage in the very preterm infant |
|
37
|
| Phenobarbitone to the mother to prevent intraventricular hemorrhage in the very preterm infant |
|
37
|
| Delivery of a very preterm infant without adequate facilities to care for a very preterm baby |
|
37
|
| Elective forceps delivery for preterm birth |
|
37 , 41
|
| Routine use of episiotomy for preterm birth |
|
37
|
| Trial of labor after previous classical cesarean section |
|
38
|
| Routine manual exploration of the uterus to assess a previous cesarean section scar |
|
38
|
Techniques of induction and operative delivery
|
| Relaxin for cervical ripening before induction of labor |
|
39
|
| Nipple stimulation for cervical ripening before induction of labor |
|
39
|
| Extra-amniotic instead of other prostaglandin regimens for cervical ripening |
|
39
|
| Instrumental vaginal delivery to shorten the second stage of labor |
|
41
|
| Routine exteriorization of the uterus for repair of the uterine incision at cesarean section |
|
42
|
Care after childbirth
|
| Silver nitrate to prevent eye infection in newborn babies |
|
44
|
| Elective tracheal intubation for very low-birthweight infants who are not depressed |
|
44
|
| Routine suctioning of newborn babies |
|
44
|
| Medicated bathing of babies to reduce infection |
|
45
|
| Wearing hospital gowns in newborn nurseries |
|
45
|
| Restricting sibling visits to babies in hospital |
|
45
|
| Routine measurements of temperature, pulse, blood pressure, and fundal height postpartum |
|
45
|
| Limiting use of women's own non-prescription drugs postpartum in hospital |
|
45
|
| Administering non-prescription symptom-relieving drugs at regularly set intervals |
|
45
|
| Prohibition of oral contraceptives for diabetic women |
|
20
|
| Nipple shields for breastfeeding mothers |
|
46
|
| Switching breasts before babies spontaneously terminate the feed |
|
46
|
| Oxytocin for breast engorgement in breastfeeding mothers |
|
46
|
| Antibiotics for localized breast engorgement (milk stasis) |
|
46
|
| Discontinuing breastfeeding for localized breast engorgement (milk stasis) |
|
46
|
| Combinations of local anesthetics and topical steroids for relief of perineal pain |
|
47
|
| Relying on these tables without referring to the rest of the book |
|
50
|
|
|
