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November 21, 1990

Effective Care in Pregnancy and Childbirth, vol 1: Pregnancy, parts I-V; vol II: Childbirth

Author Affiliations

Brown University Program in Medicine Providence, RI

Brown University Program in Medicine Providence, RI

JAMA. 1990;264(19):2577-2578. doi:10.1001/jama.1990.03450190109043

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In management of patients during pregnancy, labor, and delivery, there are many therapeutic options open to the clinician. Marked variations in patterns of care and options for therapeutic management exist from country to country, institution to institution, and among individual health professionals. Thus, disagreements and differences of opinion exist as to the most effective approach. How can past and present obstetric practices best be evaluated as to their efficacy?

Effective Care in Pregnancy and Childbirth attempts to answer this question. As stated by the editors in the preface, they have embarked upon a systematic review of randomized trials of obstetric practices, which is an innovative achievement and "represents a real milestone in the history of randomized trials and in the evaluation of care." Data for analysis were developed by using the MEDLINE database to identify studies that met the editors' criteria, doing a systematic hand search of over 60 key