Odpověď na dotaz
Dobrý den,pokud hrdlo stále pro daný týden norma, není důvod ke znepokojení, za prvé, často vidíme chyby měření hrdla,pokud není prováděno správně, za druhé, 25 mm a více stále o.k., pak má smysl posoudit za dva týdny znovu,bolesti mohou být normální ,ale je vhodné učinit opatření viz zde:
http://www.porodnice.cz/tvrdnuti-bolesti-bricha-v-tehotenstvi
Pokud stále normální hrdlo, není důvod k omezením, ležení ani náhodou nezabrání předčasnému porodu - metaanalýza prací zabývající se tímto viz níže:
Bed rest in singleton pregnancies for preventing preterm birth
Reviewers:
Sosa, Claudio 1
Althabe, Fernando 2
Belizán, José M 2
Bergel, Eduardo 3
Informace o recenzní skupině:
Cochrane Pregnancy and Childbirth Group [Group Record]
Group subjects: Preterm labour; Prediction/prevention
Informace o dokumentu:
Cochrane Database of Systematic Reviews. This document is a Cochrane Review
Review first published in Issue 1, 2004.
Protocol first published in Issue 2, 2002.
This version first published online: 26 January 2004 in Issue 1, 2004.
Last published edit in Issue 1, 2010.
Informace o aktualizaci:
Publication Status: Edited (no change to conclusions) in Issue 1, 2010
The last edit or substantive update was made on 10 November 2009.
The record was last assessed up to date on 30 September 2003.
Contact:
Claudio Sosa 1; csosa@tulane.edu
Affiliations:
1 Hospital de Clínicas, Unidad de Investigación Perinatal/Perinatal Research Unit, Echevarriarza 3320 Apartment 701., Montevideo, Uruguay, 11300
2 Institute for Clinical Effectiveness and Health Policy (IECS), Department of Mother and Child Health Research, Buenos Aires, Argentina,
3 World Health Organization, Statistics and Informatics Services, Reproductive Health and Research, Geneva 27, Switzerland, 1211
Abstrakt:
BACKGROUND: Bed rest in hospital or at home is widely recommended for the prevention of preterm birth. This advice is based on the observation that hard work and hard physical activity during pregnancy could be associated with preterm birth and with the idea that bed rest could reduce uterine activity. However, bed rest may have some adverse effects on other outcomes.
OBJECTIVES: To evaluate the effect of prescription of bed rest in hospital or at home for preventing preterm birth in pregnant women at high risk of preterm birth.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (July 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003), MEDLINE (July 2003), LILACS (July 2003), EMBASE (July 2003), POPLINE (July 2003) and bibliographies of relevant papers. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 1 October 2009 and added the results to the awaiting classification section.
SELECTION CRITERIA: Randomized and quasi-randomized controlled trials with reported data that assess clinical outcomes in women at high risk of spontaneous preterm birth who were prescribed bed rest in hospital or at home for preventing preterm birth, and their babies.
Date new studies sought but none found: Information not supplied by reviewer.
Date new studies found but not yet included/excluded: Information not supplied by reviewer.
Date new studies found and included/excluded: Information not supplied by reviewer.
DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed eligibility, trial quality and extracted data.
MAIN RESULTS: One study met the inclusion criteria (1266 women). This trial has uncertain methodological quality due to lack of reporting. Four hundred and thirty-two women were prescribed bed rest at home and a total of 834 women received a placebo (412) or no intervention (422). Preterm birth before 37 weeks was similar in both groups (7.9% in the intervention group versus 8.5% in the control group), and the relative risk was 0.92 with a 95% confidence interval from 0.62 to 1.37. No other results were available.
AUTHORS' CONCLUSIONS: There is no evidence, either supporting or refuting the use of bed rest at home or in hospital, to prevent preterm birth. Although bed rest in hospital or at home is widely used as the first step of treatment, there is no evidence that this practice could be beneficial. Due to the potential adverse effects that bed rest could have on women and their families, and the increased costs for the healthcare system, clinicians should not routinely advise women to rest in bed to prevent preterm birth. Potential benefits and harms should be discussed with women facing an increased risk of preterm birth. Appropriate research is mandatory. Future trials should evaluate both the effectiveness of bed rest, and the effectiveness of the prescription of bed rest, to prevent preterm birth.
15. dubna, 9:42
