“Before Midnight she had Miscarried” : Women, Men and Miscarriage in Early Modern England

Reproduction and Childbirth in the early modern era have sometimes been represented as a uniquely feminine experience. Similarly, studies of domestic medicine have in the past overlooked the role that men played in domestic health care practices. This article builds on recent work that resituates men within both of these discourses by considering the ways in which men understood, discussed and responded to the threat and occurrence of miscarriage in the women they knew. It considers a range of medical literature, spiritual diaries and letters to illustrate that men were a central feature of many women’s experiences of miscarriage.Peer reviewedSubmitted Versio

A randomized double-blind controlled trial of the use of dydrogesterone in women with threatened miscarriage in the first trimester: study protocol for a randomized controlled trial

BACKGROUND: Miscarriage is a common complication of pregnancy occurring in 15-20 % of all clinically recognized pregnancies. Currently, there is still no good scientific evidence to support the routine use of progestogens for the treatment of threatened miscarriage because the existing studies were not large enough to show a significant difference and some of them were not randomized or double-blind. METHODS: This is a double-blind, randomized controlled trial. A total of 400 patients presenting with first-trimester threatened miscarriage will be enrolled. They will be randomized to take dydrogesterone 40 mg per os, followed by 10 mg per os three times a day or placebo until twelve completed weeks of gestation or 1 week after the bleeding has stopped, whichever is longer. The primary outcome is the percentage of miscarriage before 20 weeks of gestation. DISCUSSION: We postulate that the dydrogesterone therapy will significantly reduce the risk of miscarriage in women with threatened miscarriage. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov, NCT02128685 . Registered on 29 April 2014.published_or_final_versio

Comparative study of dydrogesterone dosage of the duphaston 40mg daily and duphaston 20mg daily in the outcome of pregnancy with threatened miscarriage in husm.

Objective To evaluate the effectiveness and the adverse effect of Duphaston 40mg daily and Duphaston 20mg daily in threatened miscarriage. Methodology This is a prospective randomized controlled trial conducted at Hospital USM, Kubang Kerian Kelantan from 1st of March 2009 until 30th March 2010. A total of 130 patients were studied, 65 patients in Group A for those who is taking Duphaston 20mg daily and the other 65 patients in Group B on Duphaston 40mg daily. Besides the effectiveness, the side effect of the two different dosage of Duphaston is also evaluated. The successful of the pregnancy is measured by continuity of the pregnancy beyond 20weeks of gestation. Result was analysed with Chi-square and Fisher’s Exact test to determine the statistical significant. The test considered significant if p value 0.05). There were no significant differences in adverse effect of the two different dosage of Duphaston. Conclusion Duphaston 40mg daily was not associated with higher chances of successful pregnancy in threatened miscarriage (p = 0.50 in multivariate analysis). There were also no significant differences of adverse effect of the drugs in between the two groups

Randomized controlled trials are needed to close the evidence gap in the prevention of preterm birth

Pregnant women have been advised to avoid heavy lifting during pregnancy due to concerns of adverse pregnancy outcomes including premature delivery. To date there is no evidence on the effectiveness of advice in preventing preterm birth as found in a recent systematic search and appraisal of published literature. This letter employs the findings of the review to inform future studies

Oral Contraceptives

Cyclic oral contraceptive and continuous oral contraceptives have many similarities yet a few distinct differences. One of the major differences between cyclic and continuous oral contraceptives is that cyclic oral contraceptive pills have twenty one active pills and seven inactive pills versus the new continuous oral contraceptive pills which have 28 active pills and no inactive pills. However, though cyclic and continuous oral contraceptives do have a few differences, both types of oral contraceptives affect a woman’s body in similar ways. When choosing between cyclic and continuous oral contraceptives, it is important for women to be informed about the advantages and disadvantages of both continuous and cyclic oral contraceptive pills. Also, over the years, there have been debates between religious groups regarding oral contraceptives. The two religions that have prominent views on this topic are Catholic and Protestant. A few followers from each religion will be chosen to represent the religious group as a whole regarding the topic of oral contraceptives. The Bible will also be used as a source and cited for its writing related to oral contraceptives, marriage, sex, and children

Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.

Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012.To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome.We searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2016) and reference lists of identified studies.We included all randomised trials of cervical suturing in singleton pregnancies. Cervical stitch was carried out when the pregnancy was considered to be of sufficiently high risk due to a woman's history, a finding of short cervix on ultrasound or other indication determined by physical exam. We included any study that compared cerclage with either no treatment or any alternative intervention. We planned to include cluster-randomised studies but not cross-over trials. We excluded quasi-randomised studies. We included studies reported in abstract form only.Three review authors independently assessed trials for inclusion. Two review authors independently assessed risk of bias and extracted data. We resolved discrepancies by discussion. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach.This updated review includes a total of 15 trials (3490 women); three trials were added for this update (152 women). Cerclage versus no cerclageOverall, cerclage probably leads to a reduced risk of perinatal death when compared with no cerclage, although the confidence interval (CI) crosses the line of no effect (RR 0.82, 95% CI 0.65 to 1.04; 10 studies, 2927 women; moderate quality evidence). Considering stillbirths and neonatal deaths separately reduced the numbers of events and sample size. Although the relative effect of cerclage is similar, estimates were less reliable with fewer data and assessed as of low quality (stillbirths RR 0.89, 95% CI 0.45 to 1.75; 5 studies, 1803 women; low quality evidence; neonatal deaths before discharge RR 0.85, 95% CI 0.53 to 1.39; 6 studies, 1714 women; low quality evidence). Serious neonatal morbidity was similar with and without cerclage (RR 0.80, 95% CI 0.55 to 1.18; 6 studies, 883 women; low-quality evidence). Pregnant women with and without cerclage were equally likely to have a baby discharged home healthy (RR 1.02, 95% CI 0.97 to 1.06; 4 studies, 657 women; moderate quality evidence).Pregnant women with cerclage were less likely to have preterm births compared to controls before 37, 34 (average RR 0.77, 95% CI 0.66 to 0.89; 9 studies, 2415 women; high quality evidence) and 28 completed weeks of gestation.Five subgroups based on clinical indication provided data for analysis (history-indicated; short cervix based on one-off ultrasound in high risk women; short cervix found by serial scans in high risk women; physical exam-indicated; and short cervix found on scan in low risk or mixed populations). There were too few trials in these clinical subgroups to make meaningful conclusions and no evidence of differential effects. Cerclage versus progesteroneTwo trials (129 women) compared cerclage to prevention with vaginal progesterone in high risk women with short cervix on ultrasound; these trials were too small to detect reliable, clinically important differences for any review outcome. One included trial compared cerclage with intramuscular progesterone (75 women) which lacked power to detect group differences. History indicated cerclage versus ultrasound indicated cerclageEvidence from two trials (344 women) was too limited to establish differences for clinically important outcomes.Cervical cerclage reduces the risk of preterm birth in women at high-risk of preterm birth and probably reduces risk of perinatal deaths. There was no evidence of any differential effect of cerclage based on previous obstetric history or short cervix indications, but data were limited for all clinical groups. The question of whether cerclage is more or less effective than other preventative treatments, particularly vaginal progesterone, remains unanswered

Traditional Chinese Medicine and Its Role in Women’s Health

This paper is a literature review of traditional Chinese medicine and its role in women’s health. A search was performed and a group of 208 articles were initially found using the Liberty Summons search engine. Out of those 208 articles, only 16 were included based on various criteria. The articles were then read and analyzed and compiled into two main themes: maternal health and an “other” category. The findings resulted in strong evidence for some herbal treatments and acupuncture in a select few areas, with inconclusive evidence for other acupuncture treatments and a mixed review of the traditional “Doing a month.” Future research is needed in all areas as there is a noticeable lack of rigorous research on the topic