Cochrane Pregnancy and Childbirth Group
Topics List
ROUND 1
Thank you for agreeing to help with our review title prioritisation process.
Attached is a list of review titles, organised by topic, which are either published, in
preparation or have been identified as a title of a review that we would like to have
prepared. This is a subset of our full topics list and represents review titles which our
international team of Editors identified as important topics at our Editors’ meeting in May
2012.
Please review this list of review titles and indicate in the column alongside the title if you
think this is an ‘Important’ or ‘Very important’ title from a UK maternity care perspective
by inserting ‘X’ to identify an important review and ‘XX’ to identify a very important
review (if you consider a topic to be neither important nor very important please leave the
box empty). If you have suggestions for other important topics/titles that are not on our
list, please add them to the end of this document.
Deadline for return of completed form: by 17 October 2012
If you have any questions, please contact Frances Kellie (f.kellie@liverpool.ac.uk; +44
(0)151 795 9571).
Participant’s Name:
Basic care during pregnancy
Routine pre-pregnancy health promotion for improving pregnancy outcome
Objective: To assess the effectiveness of routine pre-pregnancy health promotion for
improving pregnancy outcomes when compared with no pre-pregnancy care or usual care.
Antenatal Care
Antenatal versus standard packages of antenatal care for low-risk pregnancy
Objective: To compare the effects of antenatal care programmes providing a reduced
number of antenatal care visits for low-risk women with programmes providing the
standard schedule of visits, and to assess the views of the care providers and the women
receiving antenatal care.
Community-based intervention packages for reducing maternal and neonatal
morbidity and mortality and improving neonatal outcomes
Objective: To assess the effectiveness of community-based intervention packages in
reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes.
Behaviour/advice during pregnancy
Psychosocial interventions for promoting smoking cessation during pregnancy
Objective: The review evaluated the effect of psychosocial interventions designed to
promote smoking cessation in pregnant women.
Pharmacological interventions for promoting smoking cessation during pregnancy
Objective: To determine the efficacy and safety of smoking cessation pharmacotherapies,
including NRT, varenicline and bupropion (or any other medications) when used to support
smoking cessation in pregnancy.
Interventions for preventing or reducing domestic violence against pregnant women
Objective: To examine the effectiveness and safety of interventions in preventing or
reducing domestic violence against pregnant women.
Nutrition during pregnancy
Multiple-micronutrient supplementation for women during pregnancy
Objectives: To evaluate the benefits to mother and infant of multiple-micronutrient
supplements in pregnancy and to assess the risk of excess supplementation and potential
adverse interactions between micronutrients.
Supplementation with iodine for women during pregnancy and lactation
Objectives: To assess the benefits and harms of oral supplementation with iodine alone or
in combination with other vitamins and minerals to women during pregnancy and lactation
in both maternal and infant outcomes.
Vitamin D supplementation for women during pregnancy
Objective: To examine whether supplements of vitamin D alone or in combination with
calcium or other vitamins and minerals given to women during pregnancy can safely
improve maternal and neonatal outcomes.
Symptoms during pregnancy
Interventions for nausea and vomiting in early pregnancy
Objective: To assess the effectiveness and safety of all interventions for nausea, vomiting
and retching in early pregnancy, up to 20 weeks’ gestation.
Interventions for treating hyperemesis gravidarum
Objective: To assess the safety and effectiveness of all therapies for hyperemesis
gravidarum.
Interventions for treating constipation in pregnancy
Objectives: To assess the effectiveness of different methods for treating constipation in
pregnancy.
Miscarriage
Expectant care versus surgical treatment for miscarriage
Objectives: To compare the effectiveness and safety of expectant management versus
surgical treatment for early pregnancy failure.
Medical treatments for incomplete miscarriage (less than 24 weeks)
Objectives: To assess, from clinical trials, the effectiveness and safety of different medical
managements for incomplete miscarriage, in terms of success, death or serious
complications, additional unplanned surgical evacuation, blood transfusion, haemorrhage,
blood loss, anaemia, days of bleeding, pain relief, pelvic infection, cervical damage,
digestive disorders, hypertensive disorders, duration of stay in hospital, psychological
effects, subsequent fertility, women's views of treatment options, and costs.
Immunotherapy for recurrent miscarriage
Objectives: To determine whether immunologic treatments improve the chance of live
births in women with a history of recurrent miscarriage.
Oestrogen supplementation, mainly diethylstilbestrol, for preventing miscarriages
and other adverse pregnancy outcomes
Objectives: This review aims to determine the effects of antenatal administration of
oestrogens on pregnancy outcome. The specific objectives are to assess:
(1) whether oestrogen administration during pregnancy improves outcome (eg preeclampsia) for the mother;
(2) the long-term effect of oestrogen administration during pregnancy for the mother.
Anaesthesia for evacuation of incomplete miscarriage
Objectives: To assess the effects of general anaesthesia, sedation or analgesia, regional
or paracervical block anaesthetic techniques, or differing regimens of these, for surgical
evacuation of incomplete miscarriage.
Medical treatment for early fetal death
Objectives: To assess, from clinical trials, the effectiveness and safety of different medical
treatments for the termination of non-viable pregnancies, with reference to death or serious
complications, additional surgical evacuation, blood transfusion, haemorrhage, blood loss,
anaemia, days of bleeding, pain relief, pelvic infection, cervical damage, duration of stay in
hospital, psychological effects, subsequent fertility, women's satisfaction and costs.
Hypertension during pregnancy
Calcium supplementation during pregnancy for preventing hypertensive disorders
and related problems
Objectives: To determine, from the best available evidence, the effect of calcium
supplementation during pregnancy on the risk of high blood pressure and related maternal
and fetal or neonatal adverse outcomes. Subgroup analyses tested whether these effects
were influenced by whether:
1. women had low or adequate dietary calcium intake prior to trial entry;
2. women were at low or average risk of hypertensive disorders, or at high risk.
Antihypertensive drug therapy for mild to moderate hypertension during pregnancy
Objectives: To determine the possible benefits, risks and side-effects of antihypertensive
drug treatments for women with mild to moderate hypertension during pregnancy (defined
whenever possible as a systolic blood pressure of 140 to 169 mmHg or diastolic blood
pressure of 90 to 109 mmHg, or both). Also, to compare the differential effects of
alternative drug regimens.
Magnesium sulphate and other anticonvulsants for women with pre-eclampsia
Objectives: The primary aim was to assess the benefits and hazards for women and their
babies of magnesium sulphate, or other anticonvulsant drug, when used for women with
pre-eclampsia. If magnesium sulphate or other anticonvulsant therapy is beneficial,
secondary aims were to compare the differential effects of alternative agents, and to
assess whether the effects differed with different levels of severity of pre-eclampsia.
Drugs for treatment of very high blood pressure during pregnancy
Objectives: To compare the effects of different antihypertensive agents when used to
rapidly lower very high blood pressure during pregnancy on:
(i) substantive maternal morbidity;
(ii) morbidity and mortality for the baby;
(iii) side-effects for the woman.
Antioxidants for the preventing pre-eclampsia
Objectives: To determine the effectiveness and safety of any antioxidant supplementation
during pregnancy and the risk of developing pre-eclampsia and its related complications.
Alternative magnesium sulphate regimens for women with pre-eclampsia and
eclampsia
Objectives: T o assess the comparative effects of alternative regimens for the
administration of magnesium sulphate when used for the care of women with preeclampsia or eclampsia, or both.
Plasma volume expansion for treatment of pre-eclampsia
Objectives: To estimate the main effects for women and their babies of plasma volume
expansion when used for the treatment of pre-eclampsia during pregnancy and labour.
Anaemia during pregnancy
Daily oral iron supplementation during pregnancy
Objectives: To assess the effects of daily oral use of iron supplements by pregnant women,
either alone or in conjunction with folic acid or with other vitamins and minerals as a public
health intervention.
Intermittent oral iron supplementation during pregnancy
Objectives: To assess the benefits and harms of intermittent oral supplementation with iron
alone or in combination with folic acid or other vitamins and minerals to pregnant women
on neonatal and pregnancy outcomes.
Treatments for iron-deficiency anaemia in pregnancy
Objectives: To determine the overall effects of different forms of iron therapy given to
pregnant women diagnosed with anaemia attributed to iron-deficiency, measuring neonatal
and maternal morbidity and mortality, haematological parameters and side effects,
especially adverse effects of treatment. The review aimed to assess the effects of iron
treatments when delivered to women categorised in three groups (mild, moderate or
severe anaemia, as defined by trialists) at inception into the randomised controlled trial.
Folic acid supplementation during pregnancy for maternal health and pregnancy
outcomes
Objectives: To assess the effectiveness of oral folate supplementation alone during
pregnancy on haemotological and biochemical parameters during pregnancy and on
pregnancy outcomes.
Treatment for women with postpartum iron deficiency anaemia
Objectives: To evaluate the effects of treatments for postpartum anaemia, including oral,
intramuscular, intravenous or subcutaneous iron/folate supplementation and erythropoietin
administration, and blood transfusion.
Interventions for treating painful sickle cell crisis during pregnancy
Objectives: To assess the effectiveness and safety of different regimens of packed red cell
transfusion, oxygen therapy, fluid replacement therapy, analgesic drugs, and steroids for
the treatment of painful sickle cell crisis during pregnancy.
Glucose intolerance
Treatments for gestational diabetes
Objectives: To conduct a systematic review of randomised trials, comparing alternative
treatment options for women with gestational diabetes and their effect on maternal and
infant outcomes.
Thromboembolic disease
Prophylaxis for venous thromboembolic disease in pregnancy and the early
postnatal period
Objectives: To determine the effects of thromboprophylaxis during pregnancy and the early
postnatal period in women at increased risk of venous TED on the incidence of venous
TED and side effects.
Heparin for pregnant women with acquired or inherited thrombophilias
Objectives: The objective of this review was to determine whether or not heparin use in
pregnant women with a thrombophilia improved pregnancy outcome. Specifically, the
objective was to determine whether or not heparin decreased the incidence of the following
perinatal outcomes in women with a thrombophilia:
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stillbirth;
intrauterine growth restriction;
placental abruption;
pre-eclampsia.
Anticoagulant therapy for deep vein thrombosis (DVT) in pregnancy
Objectives: To compare the effectiveness of anticoagulant therapies for the treatment of
deep vein thrombosis in pregnancy. The anticoagulant drugs included are unfractionated
heparin, low molecular weight heparin and warfarin.
Haematological interventions for treating disseminated intravascular coagulation
during pregnancy and postpartum
Objectives: To assess the clinical effectiveness and safety of heparins (LMWH and UFH),
danaparoid sodium, synthetic protease inhibitor, antithrombin, human recombinant
activated protein C, recombinant human soluble thrombomodulin, recombinant tissue
factor pathway inhibitor, recombinant activated factor VIIa and any other types of
haematological interventions for treating disseminated intravascular coagulation during
pregnancy and postpartum.
Cardiac and renal disease
Interventions for treating peripartum cardiomyopathy
Objectives: To assess the effectiveness and safety of any intervention for the care of
women and/or their babies with a diagnosis of peripartum cardiomyopathy.
Other diseases in pregnancy
Interventions for clinical and subclinical hypothyroidism in pregnancy
Objectives: To identify interventions used in the management of women with
hypothyroidism and subclinical hypothyroidism in pregnancy and to ascertain the impact of
these interventions on important maternal, fetal, neonatal, childhood and later outcomes.
Interventions for preventing and treating hyperthyroidism in pregnancy
Objectives: To assess the effects of interventions for preventing or treating hyperthyroidism
in pregnant women.
Fetal assessment before labour
Fetal and umbilical Doppler ultrasound in high-risk pregnancies
Objectives: To assess whether the use of fetal and umbilical Doppler ultrasound in highrisk pregnancies improves subsequent obstetric care and fetal outcome.
Routine ultrasound in late pregnancy (after 24 weeks gestation)
Objectives: To assess the effects on obstetric practice and pregnancy outcome of routine
late pregnancy ultrasound, defined as greater than 24 weeks' gestation, in women with
either unselected or low-risk pregnancies.
Amniocentesis and chorionic villus sampling for prenatal diagnosis
Objectives: To compare the safety and accuracy of all types of amniocentesis (i.e. early
and late) and chorionic villus sampling (e.g. transabdominal, transcervical) for prenatal
diagnosis.
Antenatal cardiotocography for fetal assessment
Objectives: To assess the effectiveness of antenatal cardiotocograph (CTG) in improving
outcomes for babies and also how effective computerised CTG might be (both in women at
increased risk of problems and as a routine intervention for all pregnant women).
Customised versus population based growth charts for monitoring fetal growth in
pregnant women
Objectives: To assess the benefits and harms of using population-based growth charts
compared with customised growth charts as a screening tool for detection of fetal growth in
pregnant women.
Regimens of fetal surveillance for impaired fetal growth
Objectives: To assess the benefits and harms associated with different methods of
antenatal surveillance for the baby identified with impaired growth.
Fetal movement counting for assessment of fetal wellbeing
Objectives: To compare the outcome of pregnancy when fetal movement counting is done
routinely, selectively, or not at all, and using various methods.
Management of reported decreased fetal movements for improving pregnancy
outcomes
Objectives: To determine the effect of various methods of managing reported DFM on
maternal, perinatal and childhood outcomes.
Fetal disease
Anti-D administration in pregnancy for preventing Rhesus alloimmunisation
Objectives: To assess the effects of administering anti-D immunoglobulin at 28 weeks or
more of pregnancy on the incidence of Rhesus D alloimmunisation during pregnancy when
given to Rhesus-negative women without anti-D antibodies.
Anti-D administration after spontaneous miscarriage for preventing Rhesus
alloimmunisation
Objectives: To assess the effects of anti-D administration to Rh-negative women with no
anti-D antibodies after a spontaneous miscarriage.
Anti-D administration after childbirth for preventing Rhesus alloimmunisation
Objectives: To assess the effects of giving anti-D after birth to Rhesus negative women,
with no anti-D antibodies, who had given birth to a Rhesus positive infant.
Prelabour rupture of membranes
Antibiotics for preterm rupture of membranes
Objectives: To assess the effects of administering antibiotics to women with preterm
rupture of membranes on fetal and neonatal morbidity and mortality, maternal infectious
morbidity and mortality, and long-term childhood development.
Tocolytics for preterm premature rupture of membranes
Objectives: To assess the potential benefits and harms of tocolysis in women with preterm
premature rupture of membranes.
Antibiotics for prelabour rupture of membranes at or near term
Objectives: To assess the effects of antibiotics administered prophylactically to women with
prelabour rupture of the membranes at 36 weeks or beyond, on maternal, fetal and
neonatal outcomes.
Preterm labour
Prenatal administration of progesterone for preventing preterm birth in women
considered to be at risk of preterm birth
Objectives: To assess the benefits and harms of progesterone administration for the
prevention of preterm birth in women and their infants.
Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of
preterm birth
Objectives: To assess the effects on fetal and neonatal morbidity and mortality, on
maternal mortality and morbidity, and on the child in later life of administering
corticosteroids to the mother prior to anticipated preterm birth. The review addresses
whether corticosteroids are more effective than placebo or 'no corticosteroids' in reducing
the risk of respiratory distress syndrome, neonatal death, intraventricular haemorrhage,
necrotising enterocolitis, chronic lung disease in survivors of neonatal intensive care, the
use of surfactant in the newborn, the cost of neonatal care, and the duration of neonatal
hospital care. The review will also address the effect of corticosteroids on the risk of
stillbirth, fetal or neonatal infection, maternal infection, and long-term abnormality in
survivors during childhood and adulthood.
Calcium channel blockers for inhibiting preterm labour
Objectives:
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To assess the effects on maternal, fetal and neonatal outcomes of calcium channel
blockers administered as a tocolytic agent to women in preterm labour when
compared with either placebo or no intervention.
To assess the effects on maternal, fetal and neonatal outcomes of calcium channel
blockers administered as a tocolytic agent to women in preterm labour when
compared with any other tocolytic agent.
Magnesium sulphate for women at risk of preterm birth for neuroprotection of the
fetus
Objectives: To assess the effectiveness and safety, using the best available evidence, of
magnesium sulphate as a neuroprotective agent when given to women considered to be at
risk of preterm birth.
Magnesium sulphate for preventing preterm birth in threatened preterm labour
Objectives: To assess the effectiveness and safety of magnesium sulphate therapy given
to women in threatened preterm labour with the primary aim of preventing preterm birth
and its sequelae.
Repeat doses of prenatal corticosteroids for women at risk of preterm birth for
improving neonatal health outcomes
Objectives: To assess the effectiveness and safety, using the best available evidence, of a
repeat dose(s) of prenatal corticosteroids, given to women who remain at risk of preterm
birth seven or more days after an initial course of prenatal corticosteroids with the primary
aim of reducing fetal, infant and childhood morbidity and mortality.
Betamimetics for inhibiting preterm labour
Objectives: To assess the effects of betamimetics in the treatment of preterm labour.
Oxytocin receptor antagonists for inhibiting preterm labour
Objectives:
 To assess the effects on maternal, fetal and neonatal outcomes of any oxytocin
receptor antagonist administered as a tocolytic agent to women in preterm labour when
compared with either placebo or no intervention.
 To assess the effects on maternal, fetal and neonatal outcomes of any oxytocin
receptor antagonist administered as a tocolytic agent to women in preterm labour when
compared with any other tocolytic agent.
Antibiotics for treating bacterial vaginosis in pregnancy
Objectives:
To determine whether the use of antibiotics for bacterial vaginosis in pregnancy can:
(a) improve maternal symptoms;
(b) decrease incidence of adverse perinatal outcomes.
To determine, if antibiotics are helpful, which antibiotic regimens are most effective.
Antenatal lower genital tract infection screening and treatment programs for
preventing preterm delivery
Objectives: To assess the effectiveness and complications of antenatal lower genital tract
infection screening and treatment programs in reducing preterm birth and subsequent
morbidity.
Fetal fibronectin testing for reducing the risk of preterm birth
Objectives: To assess the outcome of management based on knowledge of fetal
fibronectin testing results for preventing preterm birth.
Repeat digital cervical assessment in pregnancy for identifying women at risk of
preterm labour
Objectives: To assess the effect of repeat digital cervical assessment during pregnancy for
the risk of preterm birth and other adverse effects for mother and baby.
Vitamin K prior to preterm birth for preventing neonatal periventricular haemorrhage
Objectives: To assess the benefits and harms of vitamin K administered to women at risk
of imminent very preterm birth with the primary aims of preventing neonatal mortality,
periventricular haemorrhage and the associated neurological injury in the infant.
Cyclo-oxygenase (COX) inhibitors for treating preterm labour
Objectives:
 To assess the effects on maternal, fetal and neonatal outcomes of cyclo-oxygenase
(COX) inhibitors administered as a tocolytic agent to women in preterm labour when
compared with either placebo or no intervention.
 To assess the effects on maternal, fetal and neonatal outcomes of COX inhibitors
administered as a tocolytic agent to women in preterm labour when compared with
other tocolytic agents.
 To assess the effects on maternal, fetal and neonatal outcomes of non-selective COX
inhibitors administered as a tocolytic agent to women in preterm labour when
compared with COX-2 selective inhibitors.
Different magnesium sulphate regimens for neuroprotection of the fetus for women
at risk of preterm birth
Objectives: To assess the comparative effectiveness and adverse effects of different
magnesium sulphate regimens for neuroprotection of the fetus in women considered at risk
of preterm birth.
Prophylactic antibiotics for inhibiting preterm labour with intact membranes
Objectives: To assess the effects on maternal and neonatal outcomes, of prophylactic
antibiotics administered to women in preterm labour with intact membranes.
Progestational agents for treating threatened or established preterm labour
Objectives: To determine if the use of progestational agents is effective as a form of
treatment or co-treatment for women with threatened or established preterm labour with
intact membranes.
Nitric oxide donors for the treatment of preterm labour
Objectives: To determine the efficacy and safety of nitric oxide donors administered as
tocolytics.
Oral betamimetics for maintenance therapy after threatened preterm labour
Objectives: To assess the effects of oral betamimetic maintenance therapy after
threatened preterm labour for preventing preterm birth.
Terbutaline pump maintenance therapy after threatened preterm labor for preventing
preterm birth
Objectives: To determine the effectiveness and safety of terbutaline pump maintenance
therapy after threatened preterm labor in preventing preterm birth and its complications.
Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after
threatened preterm labour
Objectives: To assess the efficacy and safety of maintenance treatment with oxytocin
antagonists after an episode of threatened or actual preterm labour, in preventing preterm
birth and other adverse outcomes.
Multiple pregnancy
Planned caesarean section for women with a twin pregnancy
Objectives: To assess, from the best available evidence, the effects on mortality and
morbidity for mother and baby, of a policy of planned caesarean section versus planned
vaginal birth for twin pregnancy.
Reduction of the number of fetuses for women with a multiple pregnancy
Objectives: To assess a policy of expectant management of women with a multiple
pregnancy with a policy of pregnancy reduction. The primary outcomes relate to the risk of
preterm birth and its immediate and late complications, maternal and other neonatal
morbidity and maternal, fetal and neonatal mortality.
Infection during pregnancy and childbirth
Intrapartum antibiotics for known maternal Group B streptococcal colonization
Objectives:
Primary objective: To assess the effect of intrapartum antibiotics for maternal Group B
haemolytic streptococci (GBS) colonization on mortality from any cause, from GBS
infection and from organisms other than GBS.
Secondary objectives:
 To assess the effect of intrapartum antibiotics for maternal GBS colonization on
neonatal morbidity from early onset neonatal GBS infection.
 To assess the effect of intrapartum antibiotics for maternal GBS colonization on
probable early (postnatal age less than seven days) neonatal GBS infection.
 To assess the effect of intrapartum antibiotics for maternal GBS colonization on late
onset GBS sepsis (sepsis due to GBS in an infant at least seven days old).
 To assess the effect of intrapartum antibiotics for maternal GBS colonization on longterm child development (motor and cognitive).
 To assess the effect of intrapartum antibiotics for maternal GBS colonization on
maternal outcomes including; chorioamnionitis, sepsis, urinary tract infection, hospital
stay and allergic reactions to antibiotics.
Vaccines for women to prevent neonatal tetanus
Objectives:
 To identify, retrieve and assess all studies evaluating the effects of tetanus toxoid
vaccination administered to women of childbearing age, or pregnant women, on
neonatal tetanus.
 To assess the effectiveness of vaccination administered to women of childbearing age,
or pregnant women, in preventing cases of neonatal tetanus.
 To assess the effectiveness of vaccines in avoiding deaths from neonatal tetanus.
 To estimate the frequency of adverse effects associated with tetanus toxoid
vaccination in pregnancy or in women of childbearing age.
Prophylactic antibiotic administration during second and third trimester in
pregnancy for preventing infectious morbidity and mortality
Objectives: To determine whether the routine administration of prophylactic antibiotics in
the second or third trimester of pregnancy reduces adverse pregnancy outcomes.
Topical treatment for vaginal candidiasis (thrush) in pregnancy
Objectives: To assess the effects of different topical treatments on vaginal candidiasis in
pregnancy.
Antibiotics for asymptomatic bacteriuria in pregnancy
Objectives: To evaluate the effect of antibiotic treatment for asymptomatic bacteriuria in
pregnancy on:
(i) persistent bacteriuria during pregnancy and after delivery;
(ii) the development of symptomatic infection (pyelonephritis);
(iii) the risk of preterm delivery and low birthweight.
Treatments for symptomatic urinary tract infections during pregnancy
Objectives: To determine, from the best available evidence from randomised controlled
trials (RCTs), which treatment is most effective for symptomatic UTIs during pregnancy in
terms of cure rates, recurrent infection, preterm delivery, premature rupture of membranes,
admission to neonatal intensive care unit, need for change of antibiotic and incidence of
prolonged pyrexia.
Antenatal interventions for preventing the transmission of cytomegalovirus (CMV)
from the mother to fetus during pregnancy and adverse outcomes in the
congenitally infected infant
Objectives: To assess the risks and benefits of interventions used during pregnancy to
prevent mother to fetus transmission of cytomegalovirus (CMV) infection. The secondary
aim is to assess the efficacy of these interventions in reducing adverse outcomes in the
congenitally infected neonate or infant. This review does not consider interventions to
prevent primary maternal infection in non-pregnant women, nor postnatal interventions to
prevent sequelae from congenital CMV infection.
Effect of administration of antihelminthics for soil transmitted helminths during
pregnancy
Objectives: To determine the effects of administration of antihelminthics for soil transmitted
helminths during the second or third trimester of pregnancy on maternal anaemia and
pregnancy outcomes.
Treatments for toxoplasmosis in pregnancy
Objectives: To assess whether or not treating toxoplasmosis in pregnancy reduces the risk
of congenital toxoplasma infection.
Fetal malpresentation/malposition
External cephalic version for breech presentation at term
Objectives: To assess, using the best available evidence, the effects of external cephalic
version (ECV) at or near term for breech presentation on: presentation at and method of
delivery; and perinatal and maternal morbidity and mortality.
External cephalic version for breech presentation before term
Objectives: To assess the effectiveness of a policy of beginning external cephalic version
before term for breech presentation on the presentation at and method of delivery, preterm
birth, and perinatal morbidity, stillbirth and neonatal mortality, using the best available
evidence.
Care during childbirth
Continuous support for women during childbirth
Objectives: The primary objective was to assess the effects, on mothers and their babies,
of continuous, one-to-one intrapartum support compared with usual care, in any setting.
Secondary objectives were to determine whether the effects of continuous support are
influenced by the following.
 Routine practices and policies in the birth environment that may affect a woman's
autonomy, freedom of movement and ability to cope with labour, including:
 policies about the presence of support people of the woman's own choosing;
 epidural analgesia; and
 continuous electronic fetal monitoring.
 Whether the provider is:
 a member of the staff of the institution (and thus has additional loyalties or
responsibilities);
 not a staff member but not part of the woman's social network and present solely
for the purpose of providing continuous support; or
 a person chosen by the woman from family members and friends.
 Whether the continuous support begins early or later in labour.
Immersion in water in labour and birth
Objectives: To assess the effects of water immersion during labour and/or birth (labour
stages one, two and three) on maternal, fetal, neonatal and caregiver wellbeing. For the
purpose of this review wellbeing is defined as outcomes measuring physical and
psychological health. This review addresses the benefits and risks of immersion in water
versus no immersion during each stage of labour. In addition, the review compares early
(cervical dilation less than 5 cm) with late (cervical dilation more than 5 cm) immersion,
different pool designs, still versus moving water, and water with or without additives.
Maternal positions and mobility during first stage labour
Objectives: to assess the effects of different upright and recumbent positions and
mobilisation for women in the first stage of labour on length of labour, type of delivery and
other important outcomes for mothers and babies.
The primary objective: To compare the effects of upright (defined as walking and upright
non-walking, e.g. sitting, standing, kneeling, squatting and all fours) positions with
recumbent positions (supine, semi-recumbent and lateral) assumed by women in the first
stage of labour on maternal, fetal and neonatal outcomes.
The secondary objectives:
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to compare the effects of semi-recumbent and supine positions with lateral positions
assumed by women in the first stage of labour on maternal, fetal and neonatal
outcomes;
to compare the effects of walking with upright non-walking positions (sitting, standing,
kneeling, squatting, all fours) assumed by women in the first stage of labour on
maternal, fetal and neonatal outcomes;
to compare the effects of walking with recumbent positions (supine, semi-recumbent
and lateral) assumed by women in the first stage of labour on maternal, fetal and
neonatal outcomes;
to compare allowing women to assume the position/s they choose with recumbent
positions (supine, semi-recumbent and lateral) assumed by women in the first stage of
labour on maternal, fetal and neonatal outcomes.
Effect of partogram use on outcomes for women in spontaneous labour at term
Objectives: 1) to determine the effect of use of partogram on perinatal and maternal
morbidity and mortality. 2) to determine the effect of partogram design on perinatal and
maternal morbidity and mortality.
Episiotomy for vaginal birth
Objectives: To determine the possible benefits and risks of the use of restrictive episiotomy
versus routine episiotomy during delivery. We will also determine the beneficial and
detrimental effects of the using midline episiotomy compared with mediolateral episiotomy.
Comparisons will be made in the following categories.
1. Restrictive episiotomy versus routine episiotomy (all).
2. Restrictive episiotomy versus routine episiotomy (mediolateral).
3. Restrictive episiotomy versus routine episiotomy (midline).
4. Midline episiotomy versus mediolateral episiotomy.
Effect of timing of umbilical cord clamping and other strategies to influence
placental transfusion at preterm birth on maternal and infant outcomes
Objectives: To assess the short- and long-term effects of early rather than delayed
clamping of the umbilical cord for births before 37 completed weeks' gestation. A
secondary objective is to assess the effect of positioning the baby above or below the
introitus at birth, and the effect of milking the umbilical cord.
Active versus expectant management for women in the third stage of labour
Objectives: To compare the effects of active versus expectant management of the third
stage of labour on severe primary PPH and other maternal and infant outcomes. To
compare variations in the packages of active and expectant management of the third stage
of labour on severe primary PPH and other maternal and infant outcomes.
Advance misoprostol distribution for preventing and treating postpartum
haemorrhage
Objectives: To assess the effectiveness and safety of a strategy of advance misoprostol
provision for postpartum haemorrhage prevention and treatment in non-facility births.
Prophylactic ergometrine-oxytocin versus oxytocin for the third stage of labour
Objectives: To compare the effects of routine prophylactic administration of ergometrineoxytocin with administration of 5 international units (iu) and 10 iu oxytocin as part of the
active management of the third stage of labour in respect of risk reduction for postpartum
haemorrhage and other pre-specified maternal and neonatal outcomes.
Controlled cord traction for the third stage of labour
Objectives: To evaluate the effectiveness of controlled cord traction during the third stage
of labour, either with or without conventional active management.
Umbilical cord antiseptics for preventing sepsis and death among newborns
Objectives:
 To determine the effect of topical 70% alcohol versus other topical antiseptics (triple
dye, povidone iodine, chlorhexidine, hexachlorophene, benzene, soap and water, etc)
on the incidence of mortality, tetanus, sepsis or omphalitis among newborns.
 To determine the effect of no treatment (dry care) versus topical antiseptics (70%
alcohol, triple dye, povidone iodine, chlorhexidine, hexachlorophene, benzene, soap
and water, etc) on the incidence of mortality, tetanus, sepsis or omphalitis among
newborns.
Prostaglandins for preventing postpartum haemorrhage
Objectives: To determine the effectiveness of prophylactic prostaglandin use compared
with placebo or conventional uterotonics as part of the routine management of the third
stage of labour.
Routine perineal shaving on admission in labour
Objectives: The objective of this review is to determine the effects of perineal shaving
compared with no shaving prior to birth. The scientific evidence provided by this review will
enable purchasers, providers and consumers of health care to decide the most appropriate
form of care in terms of both health gain and cost.
Enemas during labour
Objectives: To determine the effects of enemas used during the first stage of labour on
maternal and neonatal morbidity.
Routine prophylactic drugs in normal labour for reducing gastric aspiration and its
effects
Objectives: To assess the effectiveness and safety, for women and babies, of routine
prophylactic drugs given to women during normal labour to reduce the incidence of gastric
aspiration and the effects of inhaling stomach contents (gastric aspiration/Mendelsohn's
syndrome). The review considered those interventions given routinely to all women in
labour compared with no interventions/placebo, compared with other drugs for this
purpose, and compared with combinations of drugs for this purpose.
Package of care for active management in labour for reducing caesarean section
rates in low-risk women
Objectives: To determine whether a predefined package of interventions during childbirth
such as 'active management of labour' can reduce the CS rate in low-risk women and
improve women's satisfaction.
Interventions for ketosis during labour
Objectives:
 To assess the effects on maternal, fetal and neonatal outcomes of intravenous fluids
with or without additional oral intake (fluids and food) administered to women in labour
for the treatment of ketosis compared with no intervention (defined as no oral intake,
ice chips only or oral intake on demand).
 To assess the effects on maternal, fetal and neonatal outcomes of additional oral
intake alone (fluids and food) for women in labour in the treatment of ketosis compared
with no intervention (defined as no oral intake, ice chips only or oral intake on
demand).
 To assess the effects on maternal, fetal and neonatal outcomes of different types of
intravenous fluids with or without additional oral intake (fluids and food) administered to
women in labour for the treatment of ketosis.
Restricting oral fluid and food intake during labour
Objectives: To determine the benefits and harms of oral fluid and food restriction during
labour, with or without intravenous hydration.
Perineal techniques during the second stage of labour for reducing perineal trauma
Objectives: to assess the effect of perineal techniques during the second stage of labour
on the incidence and morbidity associated with perineal trauma.
Position in the second stage of labour for women without epidural anaesthesia
Objectives: To determine the possible benefits and risks of the use of different birth
positions during the second stage of labour on maternal, fetal, neonatal and caregiver
outcomes without epidural anaesthesia. The various positions can be broadly categorised
as being either neutral or upright. Comparisons between any upright position during the
second stage of labour compared with supine positions may be included.
Pushing/bearing down methods for the second stage of labour
Objectives: To determine, using the best level of evidence available, the benefits and
possible disadvantages of different kinds of techniques regarding maternal
pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes.
Position in the second stage of labour for women with epidural anaesthesia
Objectives: To assess the effects of different birthing positions during the second stage of
labour, on important maternal and fetal outcomes for women with epidural analgesia.
Fundal pressure during the second stage of labour
Objectives: To determine if fundal pressure is effective in achieving spontaneous vaginal
birth, and preventing prolonged second stage or the need for operative delivery. To explore
maternal and neonatal adverse effects related to fundal pressure.
Oxytocin bolus versus continuous infusion for reducing blood loss in the third stage
of labour
Objectives: To determine, from the best available evidence, the effects of Oxytocin bolus
versus continuous infusion in the third stage of labour.
Tranexamic acid for preventing postpartum haemorrhage
Objectives: To determine, from the best available evidence, whether tranexamic acid is
effective for preventing postpartum haemorrhage.
Postpartum misoprostol for preventing maternal mortality and morbidity
Objectives: To review maternal deaths and severe morbidity in all randomised trials of
misoprostol for prevention or treatment of postpartum haemorrhage.
Timing of prophylactic uterotonics for the third stage of labour after vaginal birth
Objectives: To assess the effect of administration of prophylactic uterotonics before
compared to after placental expulsion, as part of the active management, on the outcomes
related to the third stage of labour.
Uterine massage for preventing postpartum haemorrhage
Objectives: To determine the effectiveness of uterine massage after birth and before or
after delivery of the placenta, or both, to reduce postpartum blood loss and associated
morbidity and mortality.
Postpartum haemorrhage/retained placenta
Treatment for primary postpartum haemorrhage
Objectives: To determine the effectiveness and safety of pharmacological, surgical and
radiological interventions used for the treatment of primary postpartum haemorrhage.
Treatments for secondary postpartum haemorrhage
Objectives: To evaluate the relative effectiveness and safety of the treatments used for
secondary postpartum haemorrhage.
Prophylactic antibiotics for manual removal of retained placenta in vaginal birth
Objectives:
 To compare the effectiveness and side-effects of routine antibiotic use for manual
removal of placenta in vaginal birth in women who received antibiotic prophylaxis and
those who did not.
 To identify the appropriate regimen of antibiotic prophylaxis for this procedure by
comparing the incidence of postpartum endometritis after manual removal of placenta
in vaginal birth in women who received different antibiotic regimens (if antibiotic
prophylaxis is found to be effective).
Induction of labour
Induction of labour for improving birth outcomes for women at or beyond term
Objectives: To assess the effects of a policy of labour induction at or beyond term
compared with a policy of awaiting spontaneous labour indefinitely (until a later gestational
age or until a maternal or fetal indication for induction of labour is identified) on pregnancy
outcomes for the infant and the mother.
Induction of labour for suspected fetal macrosomia
Objectives:


To evaluate a policy of labour induction for suspected fetal macrosomia on the risk of
caesarean section, instrumental delivery and perineal trauma.
To evaluate a policy of labour induction for suspected fetal macrosomia on the risk of
perinatal trauma or asphyxia.
Vaginal prostaglandins PGE2 and PGF2a for induction of labour at term
Objectives: To determine the effectiveness and safety of vaginal prostaglandin E2 and F2a
for third trimester cervical ripening and induction of labour in comparison with placebo/no
treatment or other vaginal prostaglandins (except misoprostol).
Vaginal misoprostol for cervical ripening and induction of labour
Objectives: To determine, from the best available evidence, the effectiveness and safety of
misoprostol administered vaginally for third trimester cervical ripening and induction of
labour.
Elective delivery in diabetic pregnant women
Objectives: To evaluate the effect of a policy of elective delivery at or near term, as
compared to expectant management, in diabetic pregnant women, on maternal and
perinatal mortality and morbidity.
Elective delivery of women with a twin pregnancy from 37 weeks’ gestation
Objectives: To assess a policy of elective delivery from 37 weeks' gestation compared with
an expectant approach for women with an otherwise uncomplicated twin pregnancy. The
primary outcomes relate to caesarean section, maternal and neonatal morbidity, and
maternal and perinatal mortality.
Induction of labour versus expectant management for preeclampsia at term
Objectives: To assess the benefits and risks of a policy of planned delivery in comparison
to a policy of expectant management of women with pre-eclampsia at term.
Elective repeat caesarean section versus induction of labour for women with a
previous caesarean birth
Objectives: To assess, using the best available evidence, the benefits and harms of a
policy of planned elective repeat caesarean section with a policy of induction of labour for
women with a previous caesarean birth, who require induction of labour in a subsequent
pregnancy. The primary outcomes related to success of induction of labour, need for
caesarean section, maternal and neonatal mortality, and maternal and neonatal morbidity.
Planned early birth versus expectant management (waiting) for prelabour rupture of
membranes at term (37 weeks or more)
Objectives: To assess the effects of planned early birth (immediate intervention or
intervention within 24 hours) when compared with expectant management (no planned
intervention within 24 hours) for women with term prelabour rupture of membranes on fetal,
infant and maternal wellbeing.
Misoprostol for induction of labour to terminate pregnancy in the second or third
trimester for women with a fetal anomaly or after intrauterine fetal death
Objectives: To compare, using the best available evidence, the benefits and harms of
misoprostol to induce labour to terminate pregnancy in the second and third trimester for
women with a fetal anomaly or after intrauterine fetal death when compared with other
methods of induction of labour.
Planned early birth versus expectant management for women with preterm
prelabour rupture of membranes prior to 37 weeks' gestation for improving
pregnancy outcome
Objectives: To assess the effect of planned early birth versus expectant management for
women with preterm prelabour rupture of the membranes between 24 and 37 weeks'
gestation for fetal, infant and maternal well being.
Oral misoprostol for induction of labour
Objectives: To determine, from randomised controlled trials, the effectiveness and safety of
oral misoprostol for third trimester induction of labour.
Methods of term labour induction for women with a previous caesarean section
Objectives: This review will assess the benefits and harms associated with different
methods used to induce labour in women who have had a previous caesarean birth and
require induction of labour in a subsequent pregnancy.
Mechanical methods for induction of labour
Objectives: To determine, from the best available evidence, the effectiveness and safety of
mechanical methods for third trimester cervical ripening and induction of labour in
comparison with placebo/no treatment, prostaglandins (vaginal and intracervical (PGE2),
vaginal and oral misoprostol) and oxytocin.
Membrane sweeping for induction of labour
Objectives: To determine, from the best available evidence, the effectiveness and safety of
membrane sweeping for third trimester cervical ripening and induction of labour.
Pain during labour
Intracutaneous or subcutaneous sterile water injection compared with blinded
controls for pain management in labour
Objectives: To determine the efficacy of sterile water injections for relief of pain (both
typical contraction pain and intractable back pain) during labour compared to placebo
(isotonic saline injections) or non-pharmacological interventions, and to identify any
relevant effects on mode and timing of delivery, or safety of both mother and baby.
Early versus late initiation of epidural analgesia for labour
Objectives: To compare the effects of early initiation, rather than late initiation, of epidural
analgesia for women on their experiences during labour, on other maternal outcomes, and
on neonatal and infant outcome.
Discontinuation of epidural analgesia late in labour for reducing the adverse delivery
outcomes associated with epidural analgesia
Objectives:
 To assess the effectiveness of discontinuing epidural analgesia late in labour in
reducing instrumental deliveries and other adverse delivery outcomes associated with
epidural analgesia.
 To assess the impact of discontinuing epidural analgesia late in labour on analgesia
and satisfaction with labour care.
Dystocia
Symphysiotomy for feto-pelvic disproportion
Objectives: To determine, from the best available evidence, the relative benefits and risks
of symphysiotomy in defined clinical situations, compared with alternative management;
and the relative benefits and risks of alternative symphysiotomy techniques.
Fetal compromise during labour
Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM)
for fetal assessment during labour
Objectives: The objective of this review is to evaluate the effectiveness and safety of
continuous cardiotocography when used as a method to monitor fetal well-being during
labour.
Fetal electrocardiogram (ECG) for fetal monitoring during labour
Objectives: To compare the effects of analysis of fetal electrocardiogram waveforms during
labour with alternative methods of fetal monitoring.
Cardiotocography versus intermittent auscultation of fetal heart on admission to
labour ward for assessment of fetal wellbeing
Objectives: To compare the effects of admission cardiotocograph with intermittent
auscultation of the FHR on maternal and infant outcomes for pregnant women without risk
factors for intrapartum hypoxia on their admission to the labour ward.
Expert systems for fetal assessment in labour
Objectives: To evaluate the effectiveness of expert decision support systems for fetal heart
rate assessment during labour on maternal and fetal wellbeing.
Acute tocolysis for uterine tachysystole or suspected fetal distress
Objectives: To assess the effects of the use of acute tocolysis during labour for uterine
tachysystole or suspected fetal distress, or both on fetal, maternal and neonatal outcomes.
Amnioinfusion for meconium-stained liquor in labour
Objectives: To assess the effects of amnioinfusion for meconium-stained liquor in labour
on maternal and perinatal morbidity and mortality.
Amnioinfusion for potential or suspected umbilical cord compression in labour
Objectives: To determine, from the best available evidence, the effects of amnioinfusion for
potential or suspected umbilical cord compression in labour on FHR characteristics and
perinatal and maternal mortality and morbidity.
Maternal oxygen administration for fetal distress
Objectives: To assess, from the best available evidence, the effects of maternal oxygen
therapy for fetal distress (part 1), and prophylactic maternal oxygen therapy (part 2), on
intervention rates and neonatal outcome.
Perineal trauma
Interventions for women in subsequent pregnancies following obstetric anal
sphincter injury for improving health
Objectives: To assess the effects of antenatal and intrapartum interventions for women in
subsequent pregnancies following a previous obstetric anal sphincter injury to improve
health.
Antenatal perineal massage for reducing perineal trauma
Objectives: To assess the effect of antenatal perineal massage on the incidence of
perineal trauma at birth and subsequent morbidity.
Interventions for improving outcomes for women who have experienced genital
cutting
Objectives: To critically assess the impact of interventions to improve all outcomes in
pregnant women or women planning a pregnancy who have undergone female genital
cutting (FGC). The comparison group will consist of those who have undergone FGC but
have not received any intervention.
Secondary suturing compared to non-suturing for broken down perineal wounds
following childbirth
Objectives: To evaluate the therapeutic effectiveness of re-suturing of dehisced perineal
wounds compared to non-suturing (healing by secondary intention).
Methods of repair for obstetric anal sphincter injury
Objectives: To compare the effectiveness of overlap repair versus end-to-end repair
following obstetric anal sphincter injuries in terms of preventing subsequent anal
incontinence, perineal pain, dyspareunia and general improvement in the quality of life.
Operative vaginal delivery
Trial of instrumental delivery in theatre versus immediate caesarean section for
anticipated difficult assisted births
Objectives: To determine differences in maternal and neonatal morbidity for women where
a trial of anticipated difficult instrumental vaginal delivery is conducted in theatre, compared
to women who have immediate caesarean section for failure to progress in the second
stage.
Analgesia for forceps delivery
Objectives: To assess the effects of different analgesic agents and methods available for
forceps delivery, including safety for women and their babies.
Choice of instruments for assisted vaginal delivery
Objectives: The objective of this review is to answer the overall question: 'When assisted
vaginal birth is needed, which instrument would be best?'. We will review individual
vacuum devices or forceps used for assisted vaginal delivery in terms of maternal
outcome, neonatal outcome and training requirements. The main questions concerning
choice of instrument will therefore fall into three categories, namely:
 should forceps or ventouse be used;
 if it were forceps, which type would be best;
 if it were ventouse, which type would be best?
Caesarean section
Timing of prophylactic antibiotics for preventing postpartum infectious
morbidity in women undergoing cesarean delivery
Objectives: To assess the effects of antibiotics given prior to skin incision compared with
administration after cord clamping in newborns and women undergoing caesarean section.
Antibiotic prophylaxis versus no prophylaxis for preventing infection after
caesarean section
Objectives: To determine, from the best evidence available, the effectiveness of
prophylactic antibiotics compared with placebo, or no treatment, given to women when
undergoing a cesarean section for reducing the incidence of febrile morbidity, wound
infection, endometritis, urinary tract infection or any serious infectious complication, and to
assess potential adverse effects and any impact on the infant, either short term or long
term.
Local anaesthetic wound infiltration and abdominal nerves block during caesarean
section for postoperative pain relief
Objectives: To assess the effects of local anaesthetic agent wound infiltration/irrigation
and/or abdominal nerve blocks on postcaesarean section pain relief; to assess the effect
on the mother's physical, social and mental well being; and to assess the effect on the
mother's ability to meet the physical, psychological and nutritional needs of the baby.
Techniques for caesarean section
Objectives:
 To compare, using the best available evidence, the effects of complete methods of
caesarean section not covered in the reviews of individual aspects of caesarean
section technique.
 To summarise the findings of reviews of individual aspects of caesarean section
technique.
 This will provide a holistic review of techniques of caesarean section with ready crossreference to the detailed individual aspect reviews.
Planned elective repeat caesarean section versus planned vaginal birth for women
with a previous caesarean section
Objectives: To assess, using the best available evidence, the benefits and harms of a
policy of planned elective repeat caesarean section with a policy of planned vaginal birth
after caesarean section for women with a previous caesarean birth. The primary outcomes
relate to success of trial of labour, need for caesarean section, maternal and neonatal
mortality, and maternal and neonatal morbidity.
Abdominal surgical incisions for caesarean section
Objectives: To determine, from the best available evidence, the benefits and risks of
alternative methods of abdominal surgical incisions for caesarean section.
Closure versus non-closure of the peritoneum at caesarean section
Objectives: To determine whether dispensing with closure of the peritoneum at caesarean
section affects the postoperative course and long-term outcomes, and the duration of
operation.
Extra-abdominal versus intra-abdominal repair of the uterine incision at caesarean
section
Objectives: To evaluate the effects of extra-abdominal repair of the uterine incision,
compared to intra-abdominal repair.
Surgical techniques for uterine incision and uterine closure at the time of caesarean
section
Objectives: To compare, using the best available evidence, the effects of:
 different types of uterine incision;
 different methods of performing the uterine incision;
 different materials and techniques for closure of the uterine incision; and
 single versus double layer closure of the uterine incision on maternal or infant health,
or both, and health care resource use.
Care after childbirth
Early skin-to-skin contact for mothers and their healthy newborn infants
Objectives: To assess the effects of early skin-to-skin contact for healthy newborn infants
compared to standard contact (infants held swaddled or dressed in their mothers arms,
placed in open cribs or under radiant warmers).
The three main outcome categories include:
 establishment and maintenance of breastfeeding/lactation;
 infant physiology - thermoregulation, respiratory, cardiac, metabolic function,
neurobehavior;
 maternal-infant bonding/attachment.
Oestrogens and progestins for preventing and treating postpartum depression
Objectives: To assess the effects of oestrogens and progestins, including natural
progesterone and synthetic progestogens, compared with placebo or usual antepartum,
intrapartum, or postpartum care in the prevention and treatment of postpartum depression.
Lactation
Antenatal breastmilk expression by women with diabetes for improving infant
outcomes
Objectives: To evaluate the benefits and harms of antenatal breast milk expression.
Interventions for promoting the initiation of breastfeeding
Objectives:
 To identify and describe health promotion activity intended to increase the rate of
initiation of breastfeeding.
 To evaluate the effectiveness of different types of health promotion activity, in terms of
changing the number of women who initiate breastfeeding.
 To compare the effectiveness of different types of health promotion interventions as
appropriate.
 To assess the impact of these interventions on secondary outcomes, namely, duration
of any or exclusive breastfeeding and any adverse outcomes as a result of the
intervention.
Antenatal breastfeeding education for increasing breastfeeding duration
Objectives:
 To assess the effectiveness of antenatal breastfeeding (BF) education for increasing
BF initiation and duration.
 To compare the effectiveness of various forms of education; for example, peer support,
educational programme, didactic teaching session, workshop, booklets, etc, or a
combination of these interventions for increasing BF initiation and duration.
 To assess the effects of antenatal BF education on other maternal and infant
outcomes, e.g. BF complications, maternal satisfaction and neonatal sepsis.
Interventions in the workplace to support breastfeeding for women in employment
Objectives:
 To assess the effectiveness of workplace interventions in assisting with the initiation,
continuation, duration and exclusiveness of breastfeeding.
 To evaluate the impact of workplace interventions on process outcomes pertinent to
employees and employers.
Interventions for treating painful nipples among breastfeeding women
Objectives: The primary objective of this review is to assess the effects of all interventions
in the resolution or reduction of nipple pain. The secondary objective is to assess the
impact of the interventions on other outcomes such as nipple trauma, nipple infections,
breast mastitis, breastfeeding duration, breastfeeding exclusivity, and maternal
satisfaction.
Treatments for breast engorgement during lactation
Objectives: To identify the best forms of treatment for women who experience breast
engorgement.
Interventions for preventing mastitis after childbirth
Objectives: To assess the effectiveness of preventive strategies (for example,
breastfeeding education, pharmacological treatments and alternative therapies) on the
occurrence or recurrence of non-infective or infective mastitis in breastfeeding women post
childbirth. To evaluate the effects of interventions to prevent mastitis on breastfeeding
duration and exclusivity.
Management of breast abscesses in breastfeeding women
Objectives: To assess the effects of different treatment strategies for management of
breast abscesses in breastfeeding women.
Treatments for suppression of lactation
Objectives: to evaluate the effectiveness and safety of interventions used for suppression
of lactation in postpartum women (who have not breastfed or expressed breastmilk) to
determine which approach has the greatest comparative benefits with least risk.
Supplementation with micronutrients (excluding vitamin A) for breastfeeding women
for improving outcomes for the mother and baby
Objectives: To critically evaluate the effect of micronutrient supplementation (excluding
Vitamin A) in postpartum breastfeeding mothers on maternal and infant outcomes.
Important topics missing from this list