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Improving perinatal care in Latin America
ISRCTN ISRCTN82417627
ClinicalTrials.gov identifier NCT00070720
Public title Improving perinatal care in Latin America
Scientific title
Acronym GUIDELINES Trial
Serial number at source GN 01
Study hypothesis The aim of this trial is to evaluate the effect of a multifaceted behavioural intervention on the use of two evidence-based birth practices, the selective use of episiotomies and active management of the third stage of labor (injection of 10 International Units of oxytocin).
Lay summary
Ethics approval The protocol was submitted and approved by the IRBs of the following institutions:
1. University of North Carolina at Chapel Hill (USA)
2. Tulane University (USA)
3. Research Triangle Institute (USA)
4. Pan American Health Organization (USA)
5. School of Medicine of the University of the Republic in Uruguay (Uruguay)
6. The University Hospital of Montevideo (Uruguay)
7. The Argentinean Society for Clinical Research (Argentina)
Study design Randomised controlled trial
Countries of recruitment Argentina, Uruguay
Disease/condition/study domain Episiotomy use; post-partum haemorrhage
Participants - inclusion criteria 24 public hospitals in Argentina and Uruguay that had:
1. At least 1000 vaginal deliveries per year
2. No explicit policy for selective episiotomy or active management of third stage of labor
Participants - exclusion criteria Does not comply with above inclusion criteria.
Anticipated start date 01/09/2003
Anticipated end date 01/09/2006
Status of trial Completed
Patient information material
Target number of participants 24
Interventions Intervention group:
Evidence based clinical practice guidelines development workshop for opinion leaders. Opinion leaders will then use academic detailing, reminders, and feedback for dissemination and implementation of guidelines at the hospital level.

Control group:
Control hospitals will continue with their usual in-service training activities and will receive components of the intervention at the end of the study period.
Primary outcome measure(s) The rates of episiotomy and oxytocin use during the third stage of labor.
Secondary outcome measure(s) 1. Perineal sutures
2. Postpartum haemorrhages
3. Birth attendants opinions
Sources of funding 1. National Institute of Child Health and Human Development (NICHD) (USA)
2. Global Network for Women's and Children's Health Research (USA)
3. Bill and Melinda Gates Foundation (USA)
Trial website
Publications Protocol in http://www.ncbi.nlm.nih.gov/pubmed/15823211
Contact name Dr  Pierre  Buekens
  Address School of Public Health and Tropical Medicine
Tulane University
1440 Canal St
Ste 2430
  City/town New Orleans, LA
  Zip/Postcode 70112
  Country United States of America
  Tel +1 504 988 5397
  Fax +1 504 988 5718
  Email pbuekens@tulane.edu
Sponsor National Institute of Child Health and Human Development (NICHD) (USA)
  Address 6100 Executive Boulevard
Room 4B05H
  City/town Rockville, MD
  Zip/Postcode 20852
  Country United States of America
  Tel +1 301 402 0830
  Fax +1 301 480 7773
  Email wrightl@mail.nih.gov
Date applied 04/11/2004
Last edited 18/02/2008
Date ISRCTN assigned 25/02/2005
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