Management of Labor

More documents

Recommendations

Info

Brief Description of Evidence Grading System Individual research reports are assigned a letter indicating the class of report based on design type: A, B, C, D, M, R, X. A full explanation of these designators is found in the Foreword of the guideline. II. CONCLUSION GRADES Key conclusions (as determined by the work group) are supported by a conclusion grading worksheet that summarizes the important studies pertaining to the conclusion. Individual studies are classed according to the system defined in the Foreword and are assigned a designator of +, -, or ø to reflect the study quality. Conclusion grades are determined by the work group based on the following definitions: Grade I: The evidence consists of results from studies of strong design for answering the question addressed. The results are both clinically important and consistent with minor exceptions at most. The results are free of any significant doubts about generalizability, bias, and flaws in research design. Studies with negative results have sufficiently large samples to have adequate statistical power. Grade II: The evidence consists of results from studies of strong design for answering the question addressed, but there is some uncertainty attached to the conclusion because of inconsistencies among the results from the studies or because of minor doubts about generalizability, bias, research design flaws, or adequacy of sample size. Alternatively, the evidence consists solely of results from weaker designs for the question addressed, but the results have been confirmed in separate studies and are consistent with minor exceptions at most. Grade III: The evidence consists of results from studies of strong design for answering the question addressed, but there is substantial uncertainty attached to the conclusion because of inconsistencies among the results from different studies or because of serious doubts about generalizability, bias, research design flaws, or adequacy of sample size. Alternatively, the evidence consists solely of results from a limited number of studies of weak design for answering the question addressed. Grade Not Assignable: There is no evidence available that directly supports or refutes the conclusion. The symbols +, –, ø, and N/A found on the conclusion grading worksheets are used to designate the quality of the primary research reports and systematic reviews: + indicates that the report or review has clearly addressed issues of inclusion/exclusion, bias, generalizability, and data collection and analysis; – indicates that these issues have not been adequately addressed; ø indicates that the report or review is neither exceptionally strong or exceptionally weak; Institute for Clinical Systems Improvement Management of Labor Third Edition/May 2009 N/A indicates that the report is not a primary reference or a systematic review and therefore the quality has not been assessed. www.icsi.org 31
References Agency for HealthCare Research and Quality. Management of preterm labor. Evidence Report/Technology Assessment: Number 18. Publication (No. 01-E021), October 2000. (Class M) Alfirevic Z, Devane D, Gyte GML. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour (review). The Cochrane Library 2009, Issue 1. (Class M) Allbert JR, Johnson C, Roberts WE, et al. Tocolysis for recurrent preterm labor using a continuous subcutaneous infusion pump. J Reprod Med 1994;39:614-18. (Class C) American College of Clinical Pharmacy. Preterm Labor. Pharmacotherapy self-assessment program. 3 rd ed. Module 11: Women's Health, Kansas City: American College of Clinical Pharmacy, 2000. (Class R) American College of Obstetricians and Gynecologists, The. Induction of labor for vaginal birth after Cesarean delivery. Obstet Gynecol 2006;108:465-67. (Class R) American College of Obstetricians and Gynecologists, The. Preterm labor. American College of Obstetricians and Gynecologists, The Technical Bulletin; 1989;133:1-6. (Class R) American College of Obstetricians and Gynecologists, The, and American Academy of Pediatrics. In Guidelines for Perinatal Care, 6th ed. Washington DC: American College of Obstetricians and Gynecologists, The and AAP. 2008;139-59. (Class R) American College of Obstetricians and Gynecologists, The, Committee on Obstetric Practice. Antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol 2002a;99:871-73. (Class R) American College of Obstetricians and Gynecologists, The, Committee Opinion. Induction of labor for vaginal birth after Caesarean delivery. Obstet Gynecol 2002b;99:679-80. (Class R) American College of Obstetricians and Gynecologists, The, Practice Bulletin. Dystocia and augmentation of labor. Number 49, December 2003. (Class R) American College of Obstetricians and Gynecologists, The, Practice Bulletin. Intrapartum fetal heart rate monitoring. 2005;106:1453-61. (Class R) American College of Obstetricians and Gynecologists, The, Practice Bulletin. Vaginal birth after previous Caesarean delivery. 2004;104:203-12. (Class R) Andrews WW, Goldenberg RL, Mercer B, et al. The preterm prediction study: association of secondtrimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol 2000;183:662-68. (Class C) Anotayanonth S, Subhedar NV, Neilson JP, Harigopal S. Betamimetics for inhibiting preterm labour (review). The Cochrane Library 2009, Issue 1. (Class M) Association of Women's Health Obstetrics and Neonatal Nurses. In Fetal Heart Monitoring Principles and Practices. 3rd Ed. Dubuque: Kendall/Hunt Publishing Co., 2003. (Class R) Bar J, Maayan-Metsger A, Hod M, et al. Effect of antibiotic therapy in preterm premature rupture of the membranes on neonatal mortality and morbidity. Am J Perinatology 2000;17:237-41. (Class C) Beazley D, Lewis R. The evaluation of infection and pulmonary maturity in women with premature rupture of the membranes. Seminars in Perinatology 1996;20:409-17. (Class R) Blanchette H, Blanchette M, McCabe J, Vincent S. Is vaginal birth after Caesarean safe? Experience at a community hospital. Obstet Gynecol 2001;184:1478-87. (Class C) www.icsi.org Institute for Clinical Systems Improvement Management of Labor Third Edition/May 2009 32
Page 1 and 2: I CSI I NSTITUTE FOR CLINICAL S YST
Page 3 and 4: Management of Signs/Symptoms of Pre
Page 5 and 6: Vaginal Birth After Caesarean (VBAC
Page 7 and 8: Intrapartum Fetal Heart Rate (FHR)
Page 9 and 10: Foreword Scope and Target Populatio
Page 11 and 12: Management of Labor Foreword Third
Page 13 and 14: Management of Labor Algorithm Annot
Page 29 and 30: Appendix A - Patient Education Hand
Page 31: I CSI I NSTITUTE FOR CLINICAL S YST
Page 35 and 36: Management of Labor References Thir
Page 41 and 42: Conclusion Grading Worksheet A - An
Page 43 and 44: Conclusion Grading Worksheet A - Ma
Page 45 and 46: Conclusion Grading Worksheet B - An
Page 53 and 54: I CSI I NSTITUTE FOR CLINICAL S YST
Page 55 and 56: Management of Labor Priority Aims a
Page 61: Resources Available * Author/Organi

Management of Labor

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?