Objective: This study aimed to perform a systematic review to describe the achievements made by the researchers, summarizing findings that have been found by previous researchers in feature extraction and CTG classification, to determine criteria and evaluation methods to the taxonomies of the proposed literature in the CTG field and to distinguish aspects from relevant research in the field of CTG.
Methods: Article search was done systematically using three databases: IEEE Xplore digital library, Science Direct, and Web of Science over a period of 5 years. The literature in the medical sciences and engineering was included in the search selection to provide a broader understanding for researchers.
Results: After screening 372 articles, and based on our protocol of exclusion and inclusion criteria, for the final set of articles, 50 articles were obtained. The research literature taxonomy was divided into four stages. The first stage discussed the proposed method which presented steps and algorithms in the pre-processing stage, feature extraction and classification as well as their use in CTG (20/50 papers). The second stage included the development of a system specifically on automatic feature extraction and CTG classification (7/50 papers). The third stage consisted of reviews and survey articles on automatic feature extraction and CTG classification (3/50 papers). The last stage discussed evaluation and comparative studies to determine the best method for extracting and classifying features with comparisons based on a set of criteria (20/50 articles).
Discussion: This study focused more on literature compared to techniques or methods. Also, this study conducts research and identification of various types of datasets used in surveys from publicly available, private, and commercial datasets. To analyze the results, researchers evaluated independent datasets using different techniques.
Conclusions: This systematic review contributes to understand and have insight into the relevant research in the field of CTG by surveying and classifying pertinent research efforts. This review will help to address the current research opportunities, problems and challenges, motivations, recommendations related to feature extraction and CTG classification, as well as the measurement of various performance and various data sets used by other researchers.
METHODS: This was an open-label, prospective, multicentre, randomized trial. Three hospitals where the current protocol was to administer prophylactic amoxycillin-clavulanic acid served as the sites of recruitment. Women who delivered vaginally beyond 24+ 0 weeks of gestation with ragged membranes were invited to participate in the trial and randomized into prophylaxis or expectant management with medical advice by blocks of 10, at a 1:1 ratio. A medication adherence diary was provided and patients followed up at 2 weeks and 6 weeks postpartum.
RESULTS: A total of 6569 women gave birth vaginally in three centres during the trial period, of which 10.9% had ragged membranes. The incidence of endometritis was not significantly raised in women with or without prophylaxis (0.90% vs 0.29%; p = 0.60). All cases of endometritis presented within the first 2 weeks and preventive use of antibiotics did not ameliorate the severity of endometritis since rates of ICU admission, surgical evacuation and transfusion were comparable.
CONCLUSION: Preventive use of antibiotics after vaginal delivery in women with ragged placental membranes did not result in a reduction of endometritis. Educating women on the signs and symptoms of endometritis would suffice. Based on the reported incidence of ragged membranes, a change in practice would result in 1500 less prescriptions of antibiotics per annum in these three centres.
TRIAL REGISTRATION: NCT03459599 (Retrospectively registered on 9 March 2018).
DESIGN: A quasi-experimental study comparing 2 groups: (1) integrated maternal health care (MHC) program (with preconception care) and (2) standard MHC program (without preconception care).
SETTING: Maternal health-care clinics in Alvand and Qazvin cities in Qazvin Province, Iran.
PARTICIPANTS: A total of 152 and 247 Iranian women aged 16 to 35 years were enrolled in the integrated MHC and standard MHC program, respectively.
MEASURES: The birth outcomes measured included low birth weight, preterm birth, maternal and neonatal complications, and mode of delivery (normal vaginal delivery and cesarean delivery).
ANALYSIS: Multiple logistic regression was performed to determine the impact of preconception care and risk of adverse birth outcomes with adjusted odds ratios (ORs) as effect sizes.
RESULTS: One hundred forty-seven women in integrated MHC and 218 women in standard MHC completed this study. Preconception care was associated with reduced risk of preterm birth (OR = 0.298; 95% confidence interval [CI] = 0.120-0.743; P = .009), low birth weight (OR = 0.406; 95% CI = 0.169-0.971; P = .043), maternal complication (OR = 0.399; 95% CI = 0.241-0.663; P < .001), and neonatal complications (OR = 0.460; 95% CI = 0.275-0.771; P = .003).
CONCLUSION: The findings of the present study revealed advantages of preconception care with reduced adverse birth outcomes.
METHODS: This retrospective observational study involved 1296 women seen in a urogynaecological centre. All had undergone an interview, clinical examination and 4D ultrasound (US) imaging supine and after voiding. Offline analysis of volume data was undertaken blinded against other data. Rectal ampulla position and rectocele depth were measured on Valsalva. A pocket depth of 10 mm was used as a cutoff to define rectocele on imaging.
RESULTS: Most women presented with prolapse (53%, n = 686); 810 (63%) complained of obstructed defecation (OD). Clinically, 53% (n = 690) had posterior-compartment prolapse with a mean Bp of -1 [standard deviation (SD)1.5; -3 to 9 cm]. Mean descent of the rectal ampulla was 10 mm below the symphysis (SD 15.8; -50 to 41). A rectocele on imaging was found in 48% (n = 618). On univariate analysis, OD symptoms were strongly associated with rectal descent, rectocele depth and rectocele on imaging (all P