Abstract:
BACKGROUND:Breech presentation is associated with increased complications. Turning a breech baby to head first presentation using external cephalic version (ECV) attempts to reduce the chances of breech presentation at birth, and reduce the adverse effects of breech vaginal birth or caesarean section. Tocolytic drugs and other methods have been used in an attempt to facilitate ECV. OBJECTIVES:To assess interventions such as tocolysis, fetal acoustic stimulation, regional analgesia, transabdominal amnioinfusion or systemic opioids on ECV for a breech baby at term. SEARCH METHODS:We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011) and the reference lists of identified studies. SELECTION CRITERIA:Randomised and quasi-randomised trials comparing the above interventions with no intervention or other methods to facilitate ECV at term. DATA COLLECTION AND ANALYSIS:We assessed eligibility and trial quality. Two review authors independently assessed for inclusion all potential studies identified as a result of the search strategy and independently extracted the data using a designed data extraction form. MAIN RESULTS:We included 25 studies, providing data on 2548 women. We used the random-effects model for pooling data due to clinical heterogeneity in the included studies in the various comparisons. The overall quality of the evidence was reasonable, but a number of assessments had insufficient data to provide an answer with any degree of assurance.Tocolytic drugs, in particular betastimulants, were effective in increasing cephalic presentations in labour (average risk ratio (RR) 1.38, 95% confidence interval (CI) 1.03 to 1.85, eight studies, 993 women) and in reducing the number of caesarean sections (average RR 0.82, 95% CI 0.71 to 0.94, eight studies, 1177 women). No differences were identified in fetal bradycardias (average RR 0.95, 95% CI 0.48 to 1.89, three studies, 467 women) although the review is underpowered for assessing this outcome. We identified no difference in success, cephalic presentation in labour and caesarean sections between nulliparous and multiparous women. There were insufficient data comparing different groups of tocolytic drugs. Sensitivity analyses by study quality agreed with the overall findings.Regional analgesia in combination with a tocolytic was more effective than the tocolytic alone in terms of increasing successful versions (assessed by the rate of failed ECVs, average RR 0.67, 95% CI 0.51 to 0.89, six studies, 550 women) but there was no difference identified in cephalic presentation in labour (average RR 1.63, 95% CI 0.75 to 3.53, three studies, 279 women) nor in caesarean sections (average RR 0.74, 95% CI 0.40 to 1.37, three studies, 279 women) or fetal bradycardia (average RR 1.48, 95% CI 0.62 to 3.57, two studies, 210 women).There were insufficient data on the use of vibroacoustic stimulation, amnioinfusion or systemic opioids. AUTHORS' CONCLUSIONS:Betastimulants, to facilitate ECV, increased cephalic presentation in labour and birth, and reduced the caesarean section rate in both nulliparous and multiparous women, but there were insufficient data on adverse effects. Calcium channel blockers and nitric acid donors had insufficient data to provide good evidence. At present we recommend betamimetics for facilitating ECV.There is scope for further research. The possible benefits of tocolysis to reduce the force required for successful version and the possible risks of maternal cardiovascular side effects, need to be addressed further. Further trials are needed to compare the effectiveness of routine versus selective use of tocolysis, the role of regional analgesia, fetal acoustic stimulation, amnioinfusion and the effect of intravenous or oral hydration prior to ECV.Although randomised trials of nitroglycerine are small, the results are sufficiently negative to discourage further trials.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Cluver C,Hofmeyr GJ,Gyte GM,Sinclair Mdoi
10.1002/14651858.CD000184.pub3subject
Has Abstractpub_date
2012-01-18 00:00:00pages
CD000184issn
1469-493Xjournal_volume
1pub_type
杂志文章,meta分析,评审abstract:OBJECTIVES:To assess the safety and efficacy of IUD insertion immediately after spontaneous or induced abortion. SEARCH STRATEGY:We used Medline, Popline, and EMBASE computer searches, supplemented by review articles and contacts with investigators. SELECTION CRITERIA:We sought all randomized controlled trials that h...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001777
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Tears of the rotator cuff tendons, which surround the joints of the shoulder, are one of the most common causes of pain and disability in the upper extremity. OBJECTIVES:To review the efficacy and safety of common interventions for tears of the rotator cuff in adults. SEARCH STRATEGY:We searched the Cochra...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002758.pub3
更新日期:2009-01-21 00:00:00
abstract:BACKGROUND:Although pregnancy was once thought of as a time of emotional well-being for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006795.pub2
更新日期:2008-10-08 00:00:00
abstract:BACKGROUND:High altitude illness (HAI) is a term used to describe a group of cerebral and pulmonary syndromes that can occur during travel to elevations above 2500 metres (8202 feet). Acute hypoxia, acute mountain sickness (AMS), high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE) are reporte...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009761.pub2
更新日期:2017-06-27 00:00:00
abstract:BACKGROUND:Bed rest used to be widely advised for women with a multiple pregnancy. OBJECTIVES:The objective was to assess the effect of bed rest in hospital for women with a multiple pregnancy for prevention of preterm birth and other fetal, neonatal and maternal outcomes. SEARCH STRATEGY:We searched the Cochrane Pre...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000110.pub2
更新日期:2010-07-07 00:00:00
abstract:BACKGROUND:Etoricoxib is a selective cyclo-oxygenase-2 (COX-2) inhibitor prescribed for the relief of chronic pain in osteoarthritis and rheumatoid arthritis, and acute pain. The drug is believed to be associated with fewer upper gastrointestinal adverse effects than conventional non-steroidal anti-inflammatory drugs (...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004309.pub2
更新日期:2009-04-15 00:00:00
abstract:BACKGROUND:Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. OBJECTIVES:To assess the effectiveness and safety of using an opiate compared to a sedative or non-pharmacological...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002059.pub3
更新日期:2010-10-06 00:00:00
abstract:BACKGROUND:Palatal canines are upper permanent canine (eye) teeth that have become displaced in the roof of the mouth. They are a frequently occurring anomaly, present in 2% to 3% of the population. Management of this problem is both time consuming and expensive and involves surgical exposure (uncovering) followed by f...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006966.pub2
更新日期:2008-10-08 00:00:00
abstract:BACKGROUND:Chronic severe infection with Pseudomonas aeruginosa, affects many people with cystic fibrosis (CF). There is evidence from the laboratory and from other disease processes that macrolide antibiotics, whilst not directly active against Pseudomonas aeruginosa, may have indirect actions against this organism. ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002203.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Motor control exercise (MCE) is used by healthcare professionals worldwide as a common treatment for low back pain (LBP). However, the effectiveness of this intervention for acute LBP remains unclear. OBJECTIVES:To evaluate the effectiveness of MCE for patients with acute non-specific LBP. SEARCH METHODS:W...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD012085
更新日期:2016-02-10 00:00:00
abstract:BACKGROUND:Delirium occurs in 30% of hospitalised patients and is associated with prolonged hospital stay and increased morbidity and mortality. The results of uncontrolled studies have been unclear, with some suggesting that benzodiazepines may be useful in controlling non-alcohol related delirium. OBJECTIVES:To dete...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006379.pub2
更新日期:2009-01-21 00:00:00
abstract:BACKGROUND:The common cold is considered to be caused by viruses and it has long been believed that antibiotics have no role in treating this condition. In many countries doctors will often prescribe antibiotics for the common cold in the belief that they may prevent secondary bacterial infection and in some cases to r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000247
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:In response to criticism that epilepsy care for children has little impact, healthcare professionals and administrators have developed various service models and strategies to address perceived inadequacies. OBJECTIVES:To assess the effects of any specialised or dedicated intervention for epilepsy versus us...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006245.pub4
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:This is an update of the Cochrane review published in 2002.Colorectal cancer (CRC) is a major cause of morbidity and mortality in industrialised countries. Experimental evidence has supported the hypothesis that dietary fibre may protect against the development of CRC, although epidemiologic data have been i...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003430.pub2
更新日期:2017-01-08 00:00:00
abstract:BACKGROUND:The method of delivering a diagnosis of breast cancer to women has the potential to impact on their level of interpretation, patient recall and satisfaction. OBJECTIVES:To assess the effectiveness of different methods when used to communicate a primary diagnosis of breast cancer to women. SEARCH STRATEGY:W...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006011.pub2
更新日期:2007-07-18 00:00:00
abstract:BACKGROUND:Because spontaneous (non-traumatic) intracerebral haemorrhage (ICH) volume influences its outcome and a third of ICHs enlarge by a third within 24 hours of onset, early haemostatic drug therapy might improve outcome. This is an update of a Cochrane review first published in 2006. OBJECTIVES:To examine the c...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005951.pub3
更新日期:2009-10-07 00:00:00
abstract:BACKGROUND:Randomised controlled trials (RCTs) evaluating the clinical effect of proton pump inhibitors (PPIs) in peptic ulcer (PU) bleeding yield conflicting results. OBJECTIVES:To evaluate the efficacy of PPIs in acute bleeding from PU using evidence from RCTs. SEARCH STRATEGY:We searched CENTRAL, The Cochrane Libr...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002094.pub4
更新日期:2010-05-12 00:00:00
abstract:BACKGROUND:Heat and cold therapy are often used as adjuncts in the treatment of rheumatoid arthritis by rehabilitation specialists. OBJECTIVES:To evaluate the effects of heat and cold on objective and subjective measures of disease activity in patients with rheumatoid arthritis. SEARCH STRATEGY:We searched Medline, E...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002826
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The number of surgical techniques for decompression and solid interbody fusion as a treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques is unclear. OBJECTIVES:The goal of this study was to determine which method of anterior cervical interbo...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004958
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Breastfeeding is known to be the biological norm. Despite this, many women wean their babies because of perceived insufficient breast milk production. Mothers are sometimes advised to increase their fluid intake in the hope that this could improve breast milk production. The effect of extra fluid on human br...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008758.pub2
更新日期:2014-06-11 00:00:00
abstract:BACKGROUND:Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is sometimes used to treat chronic neuropathic pain and fibromyalgia. OBJECTIVES:To evaluate the analgesic efficacy and adverse effects of milnacipran in the management of chronic neuropathic pain or fibromyalgia. SEARCH METHODS:We se...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008244.pub2
更新日期:2012-03-14 00:00:00
abstract:BACKGROUND:A variety of body positions other than the standard supine position have been used in patients undergoing intensive care with hopes of reducing the incidence of pressure ulcers of the skin, contractures or ankylosis and improving the patients' well being. In patients from different age groups undergoing mech...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003668.pub3
更新日期:2013-03-28 00:00:00
abstract:BACKGROUND:The morbidity and treatment costs associated with skin and soft tissue infections (SSTIs) are high. Linezolid and vancomycin are antibiotics that are commonly used in treating skin and soft-tissue infections, specifically those infections due to methicillin-resistant Staphylococcus aureus (MRSA). OBJECTIVES...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008056.pub2
更新日期:2013-07-12 00:00:00
abstract:BACKGROUND:Autologous platelet-rich plasma (PRP) is a treatment that contains fibrin and high concentrations of growth factors with the potential to improve the healing of chronic wounds. This is the first update of a review first published in 2012. OBJECTIVES:To determine whether autologous PRP promotes the healing o...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006899.pub3
更新日期:2016-05-25 00:00:00
abstract:BACKGROUND:For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies. OBJECTIVES:To assess the benefits and risks of the use of different positions during the second stage of labour (i.e. from ful...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002006.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Hip fracture is a major cause of morbidity in older people and its impact, both on the individual and to society, is substantial. OBJECTIVES:To examine the effects of co-ordinated multidisciplinary inpatient rehabilitation, compared with usual orthopaedic care, for older patients with hip fracture. SEARCH ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000106
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The prevalence of recurrent miscarriage in women with a septate uterus has increased. Restoration of the morphology of the uterus can hypothetically increase live birth rate and subsequent pregnancies in women with a septate uterus and recurrent miscarriage. OBJECTIVES:To determine whether hysteroscopic met...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008576.pub3
更新日期:2011-06-15 00:00:00
abstract:BACKGROUND:Systemic cytostatic therapies for advanced, metastatic thyroid carcinomas have been poorly effective. Tumor growth and metastasis depend on blood supply and blood vessel formation (angiogenesis). Therefore, inhibition of angiogenesis may represent a promising target for cancer therapy. OBJECTIVES:To evaluat...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD007958.pub2
更新日期:2010-03-17 00:00:00
abstract:BACKGROUND:Tuberculous (TB) pericarditis is becoming more common. The infection can result in fluid around the heart, which can be fatal. OBJECTIVES:To evaluate evidence from trials about the effects of medical and surgical treatments for TB pericarditis on death and life-threatening conditions. SEARCH STRATEGY:The C...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000526
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Postnatal psychosis is a worldwide life-threatening condition that affects one to two in every 1000 new mothers. It has an abrupt onset within a month of childbirth. Affected new mothers rapidly develop frank psychosis, cognitive impairment, and disorganised behaviours. Factors that increase the risk of post...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD009991.pub2
更新日期:2013-06-06 00:00:00