Normal aging does not increase maximum (end-systolic) atrial size. The atrium compensates for changes in LV diastolic properties by augmenting active atrial contraction. Pulmonary vein flow patterns, although diastolic dominant using peak velocity, demonstrated no volumetric change with aging.

Analysis 1.16. Comparison 1 Massage versus usual care, Outcome 16 Spontaneous vaginal birth (not pre-specified).. Analysis 1.17. Comparison 1 Massage versus usual care, Outcome 17 Resuscitation of newborn (not pre-specified).. Analysis 2.1. Comparison 2 Warm pack versus usual care, Outcome 1 Pain intensity.. .. .. .. .. .. Analysis 2.2. Comparison 2 Warm pack versus usual care, Outcome 2 Length of labour (minutes).. .. .. .. Analysis 3.1. Comparison 3 Thermal manual methods versus usual care, Outcome 1 Pain intensity.. .. .. . Analysis 3.2. Comparison 3 Thermal manual methods versus usual care, Outcome 2 Assisted vaginal birth.. .. . Analysis 3.3. Comparison 3 Thermal manual methods versus usual care, Outcome 3 Length of labour (minutes).. . Analysis 3.4. Comparison 3 Thermal manual methods versus usual care, Outcome 4 Need for augmentation with oxytocin.

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Background Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011. Objectives To examine the effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour.

With the addition of five randomised controlled trials (2927 women) to this updated review, we found no clinically important difference in the incidence of neonatal sepsis between women who birth immediately and those managed expectantly in PPROM prior to 37 weeks' gestation. Early planned birth was associated with an increase in the incidence of neonatal RDS, need for ventilation, neonatal mortality, endometritis, admission to neonatal intensive care, and the likelihood of birth by caesarean section, but a decreased incidence of chorioamnionitis. Women randomised to early birth also had an increased risk of labour induction, but a decreased length of hospital stay. Babies of women randomised to early birth were more likely to be born at a lower gestational age.In women with PPROM before 37 weeks' gestation with no contraindications to continuing the pregnancy, a policy of expectant management with careful monitoring was associated with better outcomes for the mother and baby.The direction of future research should be aimed at determining which groups of women with PPROM would not benefit from expectant management. This could be determined by analysing subgroups according to gestational age at presentation, corticosteroid usage, and abnormal vaginal microbiological colonisation. Research should also evaluate long-term neurodevelopmental outcomes of infants.