摘要:

SummaryIn his review on the history and current status of caesarean section, in this issue, Dr F. P. Meehan cites the eighth amendment to the Irish constitution:‘The State acknowledges the right to life of the unborn and with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.’

ISSN:1340-9654    

DOI:10.3109/01443618809012283

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryThe term caesarean section, contrary to popular belief, is not associated with the birth of Julius Caesar, but is considered to have come from Roman law, entitledlex regia.This law is alleged to have ordered that a dead or dying pregnant woman should have an abdominal delivery to preserve her child for the state.Lex regiaeventually became known as,‘lex caesarica’but some historians believe that saving the child for the state was added by the Church in the Middle Ages and was not Roman in origin. Historically Roman law is thought to have referred to post mortem caesarean section.

ISSN:1340-9654    

DOI:10.3109/01443618809012284

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryElevations of maternal serum a-fetoprotein levels have been observed following amniocentesis and trans-abdominal chorion villus sampling in the middle trimester of pregnancy. The greatest rises were noted following unavoidable trans-placental amniocentesis. When the placenta was avoided the median increase in maternal serum a-fetoprotein with amniocentesis, 7-6 per cent, was comparable to the median rise with chorion villus sampling, 6-5 per cent. The Kleihauer-Beckte result was positive in only one case of chorion villus sampling. The significance of these observations on the use of transabdominal chorion villus sampling as an alternative to amniocentesis for fetal karyotyping is discussed.

ISSN:1340-9654    

DOI:10.3109/01443618809012285

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryIn a controlled double-blind trial 40 nulliparae admitted for first trimester legal abortion received a vaginal pessary containing 9-deoxy-16,16-dimethyl-9-methylene-prostaglandin E2, potassium salt, 10 mg (Meteneprost) or a matching placebo 3 hours before vacuum aspiration. The degree of cervical dilatation at the start of the abortion procedure was greater in the treated group than in the placebo group. Treatment also resulted in reduced bleeding after the abortion. Pre-operative side effects were minor apart from one case of uterine cramps. Meteneprost may be a safe and advantageous therapeutic adjunct to vacuum aspiration abortion.

ISSN:1340-9654    

DOI:10.3109/01443618809012286

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryVaginal pessaries, up to a maximum of5, each containing 1 mg of 16,16-dimethyl-ran.s-A2-prostaglandin E, ester (gemeprost) were inserted as high as possible into the posterior fornix of the vagina at 3 hourly intervals in 459 women with abnormal intra-uterine pregnancies presenting for termination of the pregnancy. There were 145 missed abortions (31-6 per cent), 207 intra-uterine fetal deaths (45-1 per cent), 86 molar pregnancies (18-7 per cent), 5 anencephalics (11 per cent) and 16 others (3-5 per cent). The study was conducted from July 1981 until March 1982. Four hundred and two women (87-6 per cent) underwent abortion within the 30 hour observation period, including 139 women (30-3 per cent) who required additional procedures to complete evacuation of the uterus. Expulsion of uterine contents failed to occur within 30 hours in 57 women (12-4 per cent) and alternative procedures were employed. These failures consisted of 37 missed abortions, 17 intra-uterine fetal deaths, two molar pregnancies, and one pregnancy with an intra-uterine contraceptive devicein situ.Side effects caused by the drug were mostly tolerable. Two hundred and thirty-four women (510 per cent) had one or more side effects, gastro-intestinal tract disturbances (nausea, vomiting and diarrhoea) being the most frequently observed, and moderate fever the next most frequent. There was one ruptured uterus.

ISSN:1340-9654    

DOI:10.3109/01443618809012287

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryMuch recent attention has been focused on patients' access to medical records. Some authors have argued that patients should be allowed to carry their own notes and consider that the presence of confidential information in these notes is not an important factor. There is little information on the prevalence of confidential information in hospital case notes. We are reporting a survey of 390 women booking consecutively for confinement, which shows that 31 (7-9 per cent) of these patients denoted some item in their history as being confidential. In many cases the family doctor or the partner were specifically excluded from the information. In such cases. allowing notes out of the hospital system may risk compromising patients' confidentiality.

ISSN:1340-9654    

DOI:10.3109/01443618809012288

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryThe purpose of routine antenatal care is to identify risk factors for mother and child and one of the commonest errors in obstetric practice is failure to act on such factors when they are known to be present. One solution to this problem is the preparation of a‘risk card’for each woman which highlights potential problems; this is the basis of the 'Sighthill Project’. Here, we describe the automatic preparation of patient-held risk cards by a computerised obstetric information system. This has many advantages over a manual system, notably convenience, accuracy and legibility. We have substantially modified the Sighthill factors to reflect local needs, and the frequency of abnormal factors has been reviewed with the aim of optimising the predictive clinical value of the risk card.

ISSN:1340-9654    

DOI:10.3109/01443618809012289

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryA survey of twin pregnancies occurring in the Northern Region of the United Kingdom in 1984 was carried out. Three hundred and fifty-one twin pregnancies were studied, representing 98 per cent of all the twin pregnancies in the region that year. Twins occurred once in every 110 pregnancies. The perinatal mortality rate in twin pregnancies was 42.7 per thousand total births and the extended perinatal mortality rate, including neonatal deaths up to 28 days, was 49.9 per thousand.The major cause of perinatal death was extreme immaturity; eight out of 35 perinatal deaths occurred before 26 weeks. Almost one-third of deaths (12 out of 35) were associated with delivery before 29 weeks.Nearly all (98.3 percent) twin pregnancies were identified by ultrasound before labour commenced. Intrauterine growth retardation was poorly identified by ultrasound. There was no apparent benefit from elective admission for rest.

ISSN:1340-9654    

DOI:10.3109/01443618809012290

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryIn prolonged pregnancy the adequacy of fetal energy supply before delivery has been studied by measuring in amniotic fluid hypoxanthine and xanthine which are intermediates in the metabolism of the energy currency of the cell ATP; these measurements can indicate ATP depletion. In addition erythropoietin has been measured as an indicator of oxygen delivery since after hypoxia this hormone stimulates red blood cell production. Such sensitive biochemical measurements may reflect events over the 24 h preceding amniotic fluid sampling.One hundred and seven mothers and fetuses with uncomplicated pregnancies were studied at gestational ages of 40-42 weeks by amniotic fluid sampling at the induction of labour.In pregnancies with babies of 4 kg or more, there were significant correlations between gestational age over 40 weeks and amniotic fluid hypoxanthine, xanthine and uridine concentrations, suggesting that fetal oxygen supply may be becoming inadequate.Otherwise, in first and later pregnancies there was no tendency for concentrations to increase with increasing gestational age from 40 to 42 weeks.

ISSN:1340-9654    

DOI:10.3109/01443618809012291

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY

摘要:

SummaryThe outcome of expectant management of spontaneous rupture of membranes involving postponement of oxytocin induction for at least 24 hours was assessed in 1285 patients who presented after 37 weeks of pregnancy. All but 88 (6-8 per cent) laboured spontaneously within 24 hours. Labour was induced with oxytocin in 41 of 88 mothers with prolonged rupture of membranes and four were delivered by caesarean section. Prolonged rupture of membranes was commoner among primiparae, as were operative delivery and the duration of oxytocin induction (when used). Vaginal cultures at delivery grew pathogens in 59 (67 per cent) mothers but only three needed antibiotics. Neonatal cultures were positive in 16 babies (18 per cent); five were given antibiotics and none suffered significant morbidity. There was one perinatal death associated with caesarean scar dehiscence. Postponement of oxytocin induction for 24-48 hours following spontaneous rupture of the membranes at term reduced obstetric intervention without a concomitant increase in infectious morbidity in mothers or babies.

ISSN:1340-9654    

DOI:10.3109/01443618809012292

出版商:Taylor&Francis    

年代:1988

数据来源: WILEY