Recommended research questions for second
stage management
• What are the health benefits for mothers and infants of an appropriate
women-centered package of second stage care? The study design
could be preintervention/intervention or cluster randomized trial.
• What is the risk of short duration of ruptured membranes for transmission of HIV from mother to child? There is a lack of evidence to support
or refute the hypothesis that a woman who is HIV positive and whose
cervix is fully dilated has a reduced chance of transmitting HIV to her
infant if she has a cesarean delivery versus artificial rupturing of membranes to support vaginal delivery. Since a randomized controlled trial
would not be ethical or feasible, a retrospective, case–control study or
observational study would be the preferred study design.
• Is there an association between vacuum delivery and mother-to-child
transmission of HIV? Since a randomized controlled trial would not be
ethical or feasible, a retrospective, case–control study or observational
study would be the preferred study design.