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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Birth 9 (1982), S. 0 
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : A review of the medical literature shows that episiotomy is done in about two-thirds of births in the US, and routinely in many settings, especially in primiparas. While episiotomy can be clinically justified in specific circumstances such as impending laceration of the perineum, the literature does not support its routine use, since it is associated with significant risks of pain and infection, and the benefits claimed for routine episiotomy have not been subjected to randomized controlled trials.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Birth 6 (1979), S. 0 
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : Electronic fetal monitoring (EFM) of the fetal heart rate during labor and delivery has become a cornerstone of the new technology of obstetrics. Its routine use has been advocated, and the majority of labors in the U.S. are now monitored electronically. Recently, questions have been raised about the benefits of EFM. Review of the literature shows that only 4 randomized controlled clinical trials (RCTs) of EFM have been carried out. These show little if any benefit from the use of EFM in comparison to monitoring by stethoscope (fetoscope). The lack of diagnostic precision of EFM is reflected in high false positive and false negative rates of identification of fetuses in distress. Although many retrospective studies of EFM attempt to correlate use of EFM with declines in perinatal mortality in specific hospitals, the 4 RCTs showed no difference in mortality between babies monitored by auscultation and those who were electronically monitored. No differences have been found in morbidity, including neurologic status, between infants in the two groups. Electronic fetal monitoring has been associated with a significant increase in the cesarean section rate in most retrospective studies and all the RCTs.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Birth 13 (1986), S. 0 
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : The results of controlled clinical trials assessing the routine use of ultrasound in obstetrics have not provided convincing evidence of benefit but do provide important data on the need for further clinical research. This report recommends research related to the efficacy, safety, and cost of routine ultrasound methods in clinical obstetrics, including the psychosocial and ethical implications of these applications.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Birth 9 (1982), S. 0 
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Birth 13 (1986), S. 0 
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : The results of controlled clinical trials assessing the routine use of ultrasound in obstetrics have not provided convincing evidence of benefit but do provide important data on the need for further clinical research. This report recommends research related to the efficacy, safety, and cost of routine ultrasound methods in clinical obstetrics, including the psychosocial and ethical implications of these applications.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 93 (1986), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 92 (1985), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Randomized controlled trials are increasingly used t o assess clinical practices in obstetrics and gynaecology. The strength of these studies is that they usually address the issue of selection bias satisfactorily. Yet, as with any form of scientific investigation, the randomized controlled trial has inherent limitations and is subject to flaws in its conduct. Using basic methodological criteria, this report assesses the quality of the four published controlled trials in which a policy of routine imaging ultrasonography in pregnancy was compared with a more restrictive policy. In addition, a pooled analysis using data from all four trials was conducted to illustrate how increasing the sample size may reveal differences between the two policies which remain undetected in trials using small samples. The researchers in these studies reached different conclusions as to the effectiveness of routine ultrasound screening. Taken together, these four trials provide valuable information about routine ultrasound screening but fail to demonstrate adequately the usefulness of imaging ultrasound as a screening procedure for all pregnant women. The assessment criteria presented here could be used by investigators, editors, referees and other readers as a guideline for assessing the quality of therapeutic studies upon which clinical practice should be based.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1573-3610
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We combine two standard approaches to analyze power and influence in health policy formulation within a moderately large county in the south. Intrinsic methodologic weaknesses are discussed and several conclusions are drawn regarding power in the health care sector of that community. The most significant finding is the shift in power over time, away from the individuals to committees and health care organizations. The ignorance of most physicians about the broader health care issues that affect the community was reflected in their lack of recognition by others in the community as influential decision makers. The insular relationship of the university to the rest of the community was also noted. Past racial politics had a continuing effect on later health policy formulation. These findings are discussed in light of current and past issues. Because we had promised confidentiality to the persons we interviewed, fictitious names were given to the county, the institutions, and the interviewees.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of community health 8 (1982), S. 50-52 
    ISSN: 1573-3610
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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