Methods: We conducted a systematic review of studies published from January 1, 1950, through November 31, 2008, using PubMed, EMBASE, Web of Knowledge, CINAHL, and all Evidence-Based Medicine Reviews. Randomized clinical trials and prospective studies of RRTs that reported data on changes in the primary outcome of hospital mortality or the secondary outcome of cardiopulmonary arrest cases were included.

/pdf/a-systematic-review-and-meta-analysis-32tp0h3hqr.pdf

A Systematic Review and Meta-analysis

ACOG practice bulletin: Clinical management guidelines for obstetrician-gynecologists

http://old.ssmu.ru/ofice/f6/ginfuv/information/rodi/f4.pdf

Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data

The difficult birth process of humans, often described as the "obstetric dilemma," is commonly assumed to reflect antagonistic selective pressures favoring neonatal encephalization and maternal bipedal locomotion. However, cephalo-pelvic disproportion is not exclusive to humans, and is present in some primate species of smaller body size. The fossil record indicates mosaic evolution of the obstetric dilemma, involving a number of different evolutionary processes, and it appears to have shifted in magnitude between Australopithecus, Pleistocene Homo, and recent human populations. Most attention to date has focused on its generic nature, rather than on its variability between populations. We re-evaluate the nature of the human obstetric dilemma using updated hominin and primate literature, and then consider the contribution of phenotypic plasticity to variability in its magnitude. Both maternal pelvic dimensions and fetal growth patterns are sensitive to ecological factors such as diet and the thermal environment. Neonatal head girth has low plasticity, whereas neonatal mass and maternal stature have higher plasticity. Secular trends in body size may therefore exacerbate or decrease the obstetric dilemma. The emergence of agriculture may have exacerbated the dilemma, by decreasing maternal stature and increasing neonatal growth and adiposity due to dietary shifts. Paleodemographic comparisons between foragers and agriculturalists suggest that foragers have considerably lower rates of perinatal mortality. In contemporary populations, maternal stature remains strongly associated with perinatal mortality in many populations. Long-term improvements in nutrition across future generations may relieve the dilemma, but in the meantime, variability in its magnitude is likely to persist.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/ajpa.22160

The obstetric dilemma: an ancient game of Russian roulette, or a variable dilemma sensitive to ecology?

Prognostic models in obstetrics : available, but far from applicable

Objective. To document predictors of success of emergency cervical cerclage.Methods. This is a retrospective cohort study of 8 years at a university hospital. Emergency cerclage was defined as when the membranes were at or beyond the external os and was only performed where evidence of infection or labour were absent. Outcomes used were interval between cerclage and delivery, gestation at delivery; a ‘good outcome’ was defined as delivery after 32 weeks and healthy at discharge. Predictive factors for a successful pregnancy outcome were analysed using odds ratios (OR) with 95% confidence intervals.Results. Forty-five emergency cerclages were performed, including 11 twin pregnancies. Twenty-one (47%) had a ‘good outcome’, including two twin pregnancies; 20 (44%) pregnancies reached 36 weeks. In 79.2% of ‘poor outcomes’ chorioamnionitis was found. Prolapsed membranes, advanced cervical dilatation, maternal symptoms and equivocal markers of infection were associated with a poor outcome, but not consistently ...

Manish Gupta

Papers

Emergency cervical cerclage: predictors of success.

A review of stroke and pregnancy: incidence, management and prevention.

Antenatal and intrapartum prediction of shoulder dystocia.