{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T20:48:09Z","timestamp":1760906889731},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,3,19]],"date-time":"2006-03-19T00:00:00Z","timestamp":1142726400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Enemas are used during labour in obstetric settings with the belief that they reduce puerperal and neonatal infections, shorten labour duration, and make delivery cleaner for attending personnel. However, a systematic review of the literature found insufficient evidence to support the use of enemas. The objective of this RCT was to address an identified knowledge gap by determining the effect of routine enemas used during the first stage of labour on puerperal and neonatal infection rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>\n              <jats:bold>Design:<\/jats:bold> RCT (randomised controlled trial; randomized clinical trial).<\/jats:p>\n            <jats:p>\n              <jats:bold>Outcomes:<\/jats:bold> Clinical diagnosis of maternal or neonatal infections, labour duration, delivery types, episiotomy rates, and prescription of antibiotics<\/jats:p>\n            <jats:p>\n              <jats:bold>Setting:<\/jats:bold> Tertiary care referral hospital at the Javeriana University (Bogot\u00e1, Colombia) that attended 3170 births during study period with a caesarean section rate of 26%.<\/jats:p>\n            <jats:p>\n              <jats:bold>Participants:<\/jats:bold> 443 women admitted for delivery to the obstetrics service (February 1997 to February 1998) and followed for a month after delivery. Inclusion criteria were women with: low risk pregnancy and expected to remain in Bogot\u00e1 during follow up; gestational age \u2265 36 weeks; no pelvic or systemic bacterial infection; intact membranes; cervix dilatation \u22647 cm.<\/jats:p>\n            <jats:p>\n              <jats:bold>Intervention:<\/jats:bold> 1 litre saline enema, versus no enema, allocated following a block random allocation sequence and using sealed opaque envelopes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Allocation provided balanced groups and 86% of the participants were followed up for one month. The overall infection rate for newborns was 21%, and 18% for women. We found no significant differences in puerperal or neonatal infection rates (Puerperal infection: 41\/190 [22%] with enema <jats:italic>v<\/jats:italic> 26\/182 [14%] without enema; RR 0.66 CI 95%: 0.43 to 1.03; neonatal infection 38\/191 [20%] with enema <jats:italic>v<\/jats:italic> 40\/179 [22%] without enema; RR 1.12, 95% CI 95% 0.76 to 1.66), and median labour time was similar between groups (515 min. with enema <jats:italic>v<\/jats:italic> 585 min. without enema; P = 0.24). Enemas didn't significantly change episiorraphy dehiscence rates (21\/182 [12%] with enema <jats:italic>v<\/jats:italic> 32\/190 [17%] without enema; P = 0.30).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This RCT found no evidence to support routine use of enemas during labour. Although these results cannot rule out a small clinical effect, it seems unlikely that enemas will improve maternal and neonatal outcomes and provide an overall benefit.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2393-6-8","type":"journal-article","created":{"date-parts":[[2006,4,6]],"date-time":"2006-04-06T12:47:45Z","timestamp":1144327665000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effects of high volume saline enemas vs no enema during labour \u2013 The N-Ma Randomised Controlled Trial [ISRCTN43153145]"],"prefix":"10.1186","volume":"6","author":[{"given":"Luis Gabriel","family":"Cuervo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Pilar","family":"Bernal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Mendoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2006,3,19]]},"reference":[{"key":"75_CR1","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1136\/bmj.282.6272.1269","volume":"282","author":"ML Romney","year":"1981","unstructured":"Romney ML, Gordon H: Is your enema really necessary?. Br Med J (Clin Res Ed). 1981, 282: 1269-71.","journal-title":"Br Med J (Clin Res Ed)"},{"key":"75_CR2","volume-title":"Embarazo, nacimiento y reci\u00e9n nacido [Pregnancy, delivery and newborn]. Buenos Aires: Ed. Atl\u00e1ntida","author":"P Simkin","year":"1996","unstructured":"Simkin P, Whalley J, Keppler A: Embarazo, nacimiento y reci\u00e9n nacido [Pregnancy, delivery and newborn]. Buenos Aires: Ed. Atl\u00e1ntida. 1996"},{"key":"75_CR3","first-page":"iv","volume":"159","author":"S Drayton","year":"1984","unstructured":"Drayton S, Rees C: Nursing Mirror midwifery forum. Elegance for pregnant mothers: 'They know what they're doing'. Nurs. Mirror. 1984, 159: iv-viii.","journal-title":"Nursing Mirror midwifery forum. Elegance for pregnant mothers: 'They know what they're doing'. Nurs. Mirror"},{"key":"75_CR4","first-page":"117","volume":"39","author":"S Rutgers","year":"1993","unstructured":"Rutgers S: Hot, high and horrible. Should routine enemas still be given to women in labour?. 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