Stopping smoking in pregnancy: effect of a self-help manual in controlled trial

Article Abstract:

Many clinical studies have reported that smoking can cause birth defects and retarded growth, and that these factors are important causes of infant illness and mortality. Other studies have reported that smoking is associated with an increased risk of miscarriage and fetal death. It is estimated that 30 percent of the pregnant women in Sweden, Great Britain, and the US are smokers, and that 20 percent of these women stop smoking when they find out that they are pregnant. In an attempt to find a method that may be useful in helping pregnant women to stop smoking, a self-help manual with instructions on how to quit smoking was prepared. The manual was designed especially for pregnant women and included information on how to recognize smoking situations, how to relax, how to cope with withdrawal symptoms, and basic facts about smoking during pregnancy. Of all the pregnant smokers who were included in the study, 492 (treatment group) were given the self-help manual, and 231 women (control group) were not. In the treatment group, 85 percent (417 women) read the manual; 10 percent of these subjects stopped smoking, while only 5 percent of those who did not receive the manual stopped smoking on their own. The women who read the manual but did not stop smoking reduced their average daily cigarette consumption from 16 to 10 cigarettes per day during the second and third trimesters of pregnancy. The same pattern of reducing the number of cigarettes smoked per day was observed in the smokers in the control group. Those in the treatment group who quit smoking during pregnancy were still not smoking eight weeks after delivery. It is concluded that the self-help manual was well received and helped achieve twice the success rate in stopping smoking for the experimental group compared with the control group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Pregnant women, Smoking cessation programs, Smoking cessation, Smokers

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Pretreatment of the primigravid uterine cervix with mifepristone 30 h prior to termination of pregnancy: a double blind study

Article Abstract:

Before a pregnancy is terminated, the cervix may be dilated with fatty acid compounds called prostaglandins or by special medical devices called intracervical tents. However, prostaglandins may cause pain in the pelvis, bleeding, and gastrointestinal complications, while cervical tents can cause pain and are difficult to use. Mifepristone, or RU 486, is a drug that counteracts the actions of the hormone progesterone, and may be capable of dilating the cervix. The effect of mifepristone on the cervix was assessed in 80 women in their first pregnancy. Mifepristone was given in one dose of 600 milligrams 30 hours before the termination of pregnancy in the first three months. The women were older than 18 years of age and were to undergo termination of pregnancy between 7 and 13 weeks of pregnancy. Treatment with mifepristone reduced the force needed to dilate the cervix from 4 to 10 millimeters. The required amount of force was decreased from 84.3 newtons (N) in untreated patients to 46.0 N in mifepristone-treated patients. Mifepristone treatment caused a greater incidence of pelvic pain and vaginal bleeding before the operation but less pain after surgery. These findings show that the antiprogesterone mifepristone reduces the resistance of the cervix in the first three months of pregnancy and causes few adverse side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Cervix uteri, Mifepristone, Incompetent cervix, Abortion, Therapeutic, Therapeutic abortion

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A randomized controlled trial of extra-amniotic ethinyloestradiol in ripening the cervix at term

Article Abstract:

At the end of a pregnancy, some labors require artificial induction to complete the delivery process. However, successful induction is difficult to achieve if the cervix is not ripe (has not begun to efface and dilate) and such efforts to induce labor are associated with additional procedures and complications such as cesarean section and fetal infection. Previous research has explored methods of cervical ripening using the hormone ethinyloestradiol (estradiol) outside of the amniotic membranes. A study of first pregnancies which required induction despite an unripe cervix was designed to compare the effects of applying a gel to the cervix with a narrow tube (Foley catheter); in twenty-five patients the gel contained estradiol and in twenty-four patients it did not. The tube was inserted through the cervix and remained in place overnight before induction was attempted. There was no difference in the labor outcomes of the two groups, including the time period from induction to delivery and the rate of cesarean section. Researchers concluded that the cervix ripened due to the tube insertion which probably promotes the release of prostaglandins from fetal membranes. The low complication and failure rates, and the low cost associated with this method make it a desirable alternative to other methods to promote of cervical ripening.

Health aspects, Care and treatment, Complications and side effects, Labor, Induced (Obstetrics), Induced labor, Estradiol, Labor, Complicated, Labor complications

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