Randomised Trial of Planned Caesarean Section Prior to Versus after 39 Weeks: Unscheduled Deliveries and Facility Logistics - A Secondary Analysis

Objectives To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. Methods This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia. Results At 28 weeks, median HOMA-IR was significantly lower in the metformin group. Logistic regression analysis demonstrated that there was a significant contribution in the prediction of preeclampsia from maternal history of chronic hypertension and gestational weight gain, but not HOMA-IR either at randomisation ( p = 0.514) or at 28 weeks ( p = 0.643). Conclusions Reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is unlikely to be due to changes in insulin resistance.

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Restenosis and risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study (ICSS): secondary analysis of a randomised trial

The Lancet Neurology ◽

10.1016/s1474-4422(18)30195-9 ◽

2018 ◽

Vol 17 (7) ◽

pp. 587-596 ◽

Cited By ~ 34

Author(s):

Leo H Bonati ◽

John Gregson ◽

Joanna Dobson ◽

Dominick J H McCabe ◽

Paul J Nederkoorn ◽

...

Keyword(s):

Carotid Stenosis ◽

Randomised Trial ◽

Secondary Analysis ◽

Carotid Stenting ◽

Symptomatic Carotid ◽

Symptomatic Carotid Stenosis

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Effects of tactile stimulation on spontaneous breathing during face mask ventilation

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2021-322989 ◽

2021 ◽

pp. fetalneonatal-2021-322989

Author(s):

Vincent D Gaertner ◽

Christoph Martin Rüegger ◽

Dirk Bassler ◽

Eoin O'Currain ◽

C Omar Farouk Kamlin ◽

...

Keyword(s):

Surface Area ◽

Tactile Stimulation ◽

Randomised Trial ◽

Secondary Analysis ◽

Newborn Infants ◽

Face Mask ◽

Positive Pressure ◽

Clinical Trial Registry ◽

Term Infants ◽

Prospective Randomised Trial

ObjectiveWe sought to determine the effect of stimulation during positive pressure ventilation (PPV) on the number of spontaneous breaths, exhaled tidal volume (VTe), mask leak and obstruction.DesignSecondary analysis of a prospective, randomised trial comparing two face masks.SettingSingle-centre delivery room study.PatientsNewborn infants ≥34 weeks’ gestation at birth.MethodsResuscitations were video recorded. Tactile stimulations during PPV were noted and the timing, duration and surface area of applied stimulus were recorded. Respiratory flow waveforms were evaluated to determine the number of spontaneous breaths, VTe, leak and obstruction. Variables were recorded throughout each tactile stimulation episode and compared with those recorded in the same time period immediately before stimulation.ResultsTwenty of 40 infants received tactile stimulation during PPV and we recorded 57 stimulations during PPV. During stimulation, the number of spontaneous breaths increased (median difference (IQR): 1 breath (0–3); padj<0.001) and VTe increased (0.5 mL/kg (−0.5 to 1.7), padj=0.028), whereas mask leak (0% (−20 to 1), padj=0.12) and percentage of obstructed inflations (0% (0–0), padj=0.14) did not change, compared with the period immediately prior to stimulation. Increased duration of stimulation (padj<0.001) and surface area of applied stimulus (padj=0.026) were associated with a larger increase in spontaneous breaths in response to tactile stimulation.ConclusionsTactile stimulation during PPV was associated with an increase in the number of spontaneous breaths compared with immediately before stimulation without a change in mask leak and obstruction. These data inform the discussion on continuing stimulation during PPV in term infants.Trial registration numberAustralian and New Zealand Clinical Trial Registry (ACTRN12616000768493).

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