Abstract:
OBJECTIVE:To determine the effects of perineal massage in the second stage of labour on perineal outcomes. DESIGN:Randomised controlled trial. PARTICIPANTS:At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial. INTERVENTION:Massage and stretching of the perineum during the second stage of labour with a water soluble lubricant. MAIN OUTCOME MEASURES: PRIMARY OUTCOMES:rates of intact perineum, episiotomies, and first, second, third, and fourth degree tears. SECONDARY OUTCOMES:pain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum. RESULTS:Rates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points. CONCLUSIONS:The practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Stamp G,Kruzins G,Crowther Cdoi
10.1136/bmj.322.7297.1277keywords:
subject
Has Abstractpub_date
2001-05-26 00:00:00pages
1277-80issue
7297eissn
0959-8138issn
1756-1833journal_volume
322pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:To provide counter evidence to existing literature on healer shopping in Africa through a systematic analysis of illness practices by Ghanaians with diabetes; to outline approaches towards improving patient centred health care and policy development regarding diabetes in Ghana. DESIGN:Longitudinal qualitati...
journal_title:BMJ (Clinical research ed.)
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更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:To quantify the relative contribution of premorbid and episode specific factors in determining the long term persistence of disabling symptoms of low back pain. DESIGN:Prospective cohort study. SETTING:Two general practices in the south Manchester area. PARTICIPANTS:180 patients, who previously participat...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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abstract:OBJECTIVE:To evaluate the immunogenicity and reactogenicity of a new triple S recombinant hepatitis B vaccine in a cohort of healthy people in whom currently licensed hepatitis B vaccines had persistently not induced an immune response. DESIGN:Single centre, randomised, double blind, dose-response study. SETTING:Rese...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.314.7077.329
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To determine whether the variation in unadjusted rates of caesarean section derived from routine data in NHS trusts in England can be explained by maternal characteristics and clinical risk factors. DESIGN:A cross sectional analysis using routinely collected hospital episode statistics was performed. A multi...
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pub_type: 杂志文章,多中心研究
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更新日期:2010-10-06 00:00:00
abstract:OBJECTIVE:To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. DESIGN:Multicentre, three group, randomised, double blind, sham controlled ...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k2860
更新日期:2018-07-19 00:00:00
abstract:OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CR...
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pub_type: 杂志文章,meta分析,评审
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更新日期:2012-12-06 00:00:00
abstract:OBJECTIVES:To investigate the perspectives of patients with asthma on the use of an action plan and the implementation of this plan during an asthma attack that culminated in a visit to an emergency department. DESIGN:Qualitative study. SETTING:Tertiary teaching hospital, suburban hospital, and rural hospital. PARTI...
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7344.1003
更新日期:2002-04-27 00:00:00
abstract::The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research...
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pub_type: 杂志文章
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更新日期:2019-02-15 00:00:00
abstract:OBJECTIVES:To report the sensitivities of the faecal occult blood test, screening episode, and screening programme for colorectal cancer and the benefits of applying a randomised design at the implementation phase of a new public health policy. DESIGN:Experimental design incorporated in public health evaluation using ...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-11-20 00:00:00
abstract:OBJECTIVE:To determine the prevalence of sexually transmitted diseases in patients with normal and abnormal cervical smears. DESIGN:A prospective study of asymptomatic women with normal cervical smears attending their general practitioner and newly referred patients with abnormal smears attending a colposcopy clinic. ...
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pub_type: 杂志文章
doi:10.1136/bmj.302.6768.82
更新日期:1991-01-12 00:00:00
abstract:OBJECTIVE:To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. DESIGN:Population based case-control study with data abstracted from hospital records. SETTING:Scotland. SUBJECTS:Children aged 0-14 years resident in Scotland from 1991-4 and diagno...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7126.173
更新日期:1998-01-17 00:00:00
abstract:OBJECTIVE:To determine whether being overweight in childhood increases adult obesity and risk of disease. DESIGN:Prospective cohort study. SETTING:City of Newcastle upon Tyne. PARTICIPANTS:932 members of thousand families 1947 birth cohort, of whom 412 attended for clinical examination age 50. MAIN OUTCOME MEASURES...
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pub_type: 杂志文章
doi:10.1136/bmj.323.7324.1280
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
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pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract::An increase in the incidence of cardiovascular disease has generally been observed in postmenopausal women, but there have been few studies of the association between menopausal state and atherosclerosis. In this study 294 premenopausal and 319 postmenopausal women aged 45 to 55 were examined radiographically for calc...
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pub_type: 杂志文章
doi:10.1136/bmj.298.6674.642
更新日期:1989-03-11 00:00:00
abstract:OBJECTIVES:To identify the need for reproductive health care among a community affected by conflict, and to ascertain the priority given by the community to reproductive health issues. DESIGN:Rapid appraisal. This comprised interviews with key informants, in-depth interviews, and group discussions. Secondary data were...
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pub_type: 杂志文章
doi:10.1136/bmj.319.7212.743
更新日期:1999-09-18 00:00:00
abstract:OBJECTIVE:To examine period trends in the rate of suicide in the first 28 days after discharge from psychiatric hospital. DESIGN:Cohort study of patients discharged from psychiatric hospital. SETTING:Scotland. SUBJECTS:All patients aged 15-84 who were discharged from Scottish psychiatric hospitals during 1968 to 199...
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pub_type: 杂志文章
doi:10.1136/bmj.311.7001.357
更新日期:1995-08-05 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:1998-03-14 00:00:00
abstract:OBJECTIVE:To determine the contribution of inheritance to the incidence of squamous cell carcinoma of the head and neck. DESIGN:Historical cohort study. First degree relatives of cases with squamous cell carcinoma of the head and neck made up the exposed cohort and first degree relatives of spouses of cases made up th...
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abstract:OBJECTIVE:To assess the incidence and severity of physical and psychosexual symptoms in young women due to ovarian failure caused by total body irradiation for leukaemia and the women's response to hormone treatment. DESIGN:Postal questionnaire and interview. SETTING:Leukaemia unit of oncology hospital. PATIENTS:Con...
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更新日期:1997-10-11 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2010-01-14 00:00:00
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更新日期:2010-03-31 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2011-03-11 00:00:00
abstract:OBJECTIVE:To assess relative efficacy and toxicity of aminoglycosides given by single daily dose compared with multiple daily doses. DESIGN:Meta-analysis of 21 randomised trials identified through MEDLARS (1966 to January 1995). Data were overviewed with fixed effects and random effects models and with meta-regression...
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pub_type: 杂志文章,meta分析
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abstract:OBJECTIVES:To evaluate the effectiveness of a self help approach to smoking cessation in pregnancy. DESIGN:Pragmatic cluster randomised controlled trial with community midwife as the unit of randomisation. SETTING:Three NHS hospital trusts in England. PARTICIPANTS:1527 women who smoked at the start of pregnancy. IN...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.325.7377.1383
更新日期:2002-12-14 00:00:00
abstract:OBJECTIVE:To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. DESIGN:Cluster randomised controlled trial. SETTING:70 villages (clusters) in the Eastern Cape province of South Africa. PARTICIPANTS:1360 men and 1416 women aged...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-08-07 00:00:00
abstract:OBJECTIVE:To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN:Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING:Comprehensive cancer c...
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更新日期:1999-06-05 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of manipulative therapy, physiotherapy, treatment by the general practitioner, and placebo therapy in patients with persistent non-specific back and neck complaints. DESIGN:Randomised clinical trial. SETTING:Primary health care in the Netherlands. PATIENTS:256 patients with non...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-03-07 00:00:00
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更新日期:1994-03-12 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-05-07 00:00:00