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Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Generalitat de Catalunya

Attempted vaginal birth after cesarean section is a safe and appropriate option for most women with a previous segmental cesarean section and they should be offered this option and counseled accordingly. Exceptionally, an elective cesarean section will be recommended in cases with a high risk of uterine rupture and when there is a contraindication to vaginal delivery for another reason. Vaginal delivery after cesarean section is successful in more than 70% of cases and can reach 90% in patients ...

Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Generalitat de Catalunya

Pregnant women in labor with epidural analgesia do not have to be routinely administered oxytocin, neither to prevent slowing of the birth process, nor to reduce the incidence of instrumental deliveries. Regardless of epidural analgesia, confirmation of delayed labor progress is required to consider oxytocin treatment. The benefits of administering oxytocin without this confirmation do not outweigh the risks and its inappropriate use may cause harm to the woman or baby.

Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Generalitat de Catalunya

Performing a vaginal examination is the method used by obstetrics professionals to determine the onset of labor, evaluate its progression and diagnose labor dystocia. Performing vaginal examinations at intervals more frequently than necessary in pregnant women during the birth process can lead to an overdiagnosis of labor dystocia, triggering a cascade of interventions, such as the use of oxytocin or the performance of cesarean sections. Performing frequent vaginal examinations may increase the ...

NICE

NICE

Varices are dilated veins. Gastric varices are prone to bleeding, and this is associated with high mortality and poor prognosis. The aim of this treatment is to obliterate the varices and manage acutely bleeding gastric varices or those at high risk of bleeding. Evidence on the safety and efficacy of transvenous obliteration of gastric varices is adequate in the short term but limited in the long term.

NICE

NICE

Clinicians wanting to do percutaneous transluminal renal sympathetic denervation for resistant hypertension should: Inform the clinical governance leads in their healthcare organisation, ensure that people (and their families and carers as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these, audit and review clinical outcomes of everyone having the procedure and discuss the outcomes of the procedure during their annual appraisal to reflect, learn and ...