Bladder drainage during labor: a randomized controlled trial.

AIM: To compare two bladder draining methods during labor on time to delivery, cost and nursing preference. MATERIAL AND METHODS: This trial randomized 139 women with singleton pregnancies in active labor or undergoing induction of labor. Eligibility required an anticipated vaginal delivery with a clinical indication for bladder catheterization (epidural). Participants were randomly assigned to either indwelling or intermittent catheterization. The primary outcome was time to delivery; secondary outcomes were nurse preference, cost and route of delivery. A sample size of 138 women would be needed for 80% power to detect a 30 min difference in the time to delivery interval with a 0.05 alpha error. RESULTS: Outcome data was available for 138 patients (72 indwelling and 66 intermittent). The time to delivery was similar among the two groups (13.8 h for indwelling and 14.4 h for intermittent). Route of delivery and cost estimate was similar in both groups; however, nurses preferred the indwelling method. CONCLUSION: Indwelling catheterization is recommended as the standard method for bladder drainage in laboring women with epidural.

Cryopreservation in assisted reproductive technology: new trends.

During the last few years, cryopreservation has become a relevant addition to therapeutic concepts in reproductive medicine. New data and publications have made it difficult to maintain an overview of all of the new developments and their results. The focus of interest more recently, especially with the cryopreservation of human oocytes and human ovarian tissue, has been vitrification as an interesting alternative to slow freezing methods. Even though studies investigating the slow freezing of human mature oocytes have resulted in very different survival rates, it could be an option for donor oocyte programs, in the case of threatened ovarian loss or when there is an objection to embryo freezing. An optimal freezing protocol and later use of thawed human ovarian tissue is still a point of discussion. There are encouraging results regarding different kinds of autotransplantation, and recently the first birth after orthotopic autotransplantation of cryopreserved/thawed human ovarian tissue was described in the literature. Independent of any objections to cryopreservation in general, vitrification is a potential and effective alternative to conventional slow cryopreservation, especially for oocytes and embryos. Vitrification might be also be an option for human ovarian tissue; however this is only in its infancy and requires much additional investigation. Our article discusses new trends and results of actual studies regarding these issues.

Ambulation of hospitalized gynecologic surgical patients: a randomized controlled trial.

OBJECTIVE: To estimate whether specific ambulation goals affect the adequacy or perceived barriers to ambulation in hospitalized surgical patients after major gynecologic surgery. METHODS: One hundred forty-six surgical inpatients were randomized to specific ambulation goals or routine care. We assessed the number of pedometer-recorded steps in the 24 hours preceding discharge as well as patient-identified barriers to ambulation. Groups were compared using the Mann-Whitney U test. RESULTS: Of the 129 participants with outcome data, 12% were discharged without any pedometer-recorded steps. We did not detect an effect of specific ambulation goals by group (routine care: 87 compared with ambulation goals: 80, P=.7). The three main barriers to ambulation from a patient perspective were indwelling catheters (38.5%), intravenous poles (28%), and pain (12.5%) The median number of postoperative steps was higher after minimally invasive surgery (143) compared with laparotomy (27) (P=.035). CONCLUSION: Approximately 12% of gynecologic surgical patients do not walk while hospitalized despite formal encouragement to ambulate. Ambulation is easily quantified and may improve with attention to modifiable barriers, potentially improving postoperative recovery.