摘要:

SummaryThe study was designed to investigate the prevalence and risk factors for malaria parasitaemia during pregnancy in Nigerian women. Ninety-one pregnant women (29 primigravidae and 62 multigravidae) in south-western Nigeria were recruited during their first antenatal attendance. They had not used antimalarial medications for 4 weeks before the study and were not more than 20 weeks pregnant. Women with malaria parasites in their peripheral blood smears were treated with oral chloroquine and re-examined 2 weeks later. There was an overall prevalence of parasitaemia of 12 per cent. None of those given choroquine to eliminate parasitaemia had malaria parasites at their second visit. The parasite rate before treatment was higher in primigravidae than in multigravidae. Haematocrit level was lower in women with parasitaemia than in those without, and in primigravidae compared with multigravidae. Malaria control measures commenced early in pregnancy and specific health education of women will reduce morbidity and mortality from malaria in pregnant Nigerian women.

ISSN:1340-9654    

DOI:10.3109/01443619609030034

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryA safe and efficient method for obtaining blood smears for the diagnosis of placental malaria infection is required in order to reduce the risks associated with direct blood contact. We describe a simple and safe method of needle aspiration of the placenta for the diagnosis of placental malaria infection. The method was compared with the conventional incision method in 60 consecutive placentae obtained at term. The quality of the blood smear prepared with the methods were similar. There was a significant correlation between parasite counts from samples prepared with both the incision and aspiration methods. Altman-Bland analysis of the counts revealed narrow limits of agreement with an insignificant bias. The method is useful for obtaining blood smears from the placenta for the diagnosis of placental malaria infection and reducing contact with potential pathogens in blood.

ISSN:1340-9654    

DOI:10.3109/01443619609030035

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryPlacental biopsy was carried out in a total of 283 pregnant women between 1989 and 1994, the main indication being abnormal ultrasound signs (68.6 per cent) detected in the second and third trimesters. Successful sampling was achieved in 98.6 per cent of the cases. Excluding the first year, karyotypic results were obtained in 98.2 per cent of received samples. Out of these, 6.5 per cent were abnormal, and confirmed by the culture method, amniocentesis, or cordocentesis. In addition, one case of mosaic trisomy 8 was confirmed to be confined to the placenta (0.4 per cent). A spontaneous abortion rate of 2.1 per cent was observed, but not necessarily procedure-related. We had one false-negative report. In conclusion, we found placental sampling to be a useful method allowing a rapid decision to be taken regarding further management of at risk pregnancies.

ISSN:1340-9654    

DOI:10.3109/01443619609030036

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryThe purpose of this study was to investigate, in a prospective manner. whether a warm bath during the first stage (if labour is associated with an increased risk of maternal and/or neonatal postpartum infectious morbidity and to examine the advantages and disadvantage, of bathing during labour. We undertook a prospective study of 317 patients with an uncomplicated pregnancy, who delivered a single infant between 37 and 42 weeks of gestation and who elected to have a warm bath during labour and compared them with a similar group of 312 patients who had no such desire. The postpartum maternal and neonatal infectious morbidity was compared as well as labour duration and the need of pain relief. This study showed that taking a warm bath during first stage of labour with intact-or ruptured membranes is associated with a significantly higher minor infectious morbidity for the mother while no increased risk was found for the child compared with the non-bathing control group. A significant prolongation of the first stage of labour and an increased need for pain relief was found in the bathing group.

ISSN:1340-9654    

DOI:10.3109/01443619609030037

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryA cross-sectional study was carried out to determine the prevalence of hypertension in black women during the first 24 hours postpartum. The obstetric records of 1455 black women who delivered at a tertiary care centre were reviewed for two or more documented diastolic blood pressure readings of 90 mm Hg or more during the 24 hours after delivery. It was noted whether the hypertension was mild (diastolic blood pressure 90–109 mm Hg) or severe (diastolic blood pressure≥110 mm Hg). Elevated blood pressure readings were found in 564 patients (40.5 per cent). Patients with mild and severe hypertension had had significantly more caesarean sections (difference, 17 and 33 per cent respectively), those with severe hypertension had an increased perinatal mortality rate (difference, 122/1000) and smaller babies (difference, 797 g) when compared with normotensive patients. The unusually high prevalence of hypertension found during the postpartum period indicates the need for close observation of all women during the first 24 hours after delivery.

ISSN:1340-9654    

DOI:10.3109/01443619609030038

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryCaesarean delivery of the second twin after vaginal delivery of the first twin is an infrequent event. However recent papers from both the United Kingdom and the United States of America describe an increase in the frequency of such differing modes of twin delivery, and the available literature is almost exclusively Western in origin. Accordingly, to define and investigate any trend for such differing modes of twin delivery in the Middle East we have conducted a retrospective study over the 10 years between January 1982 to December 1991 of all twin deliveries performed at the A1 Corniche Hospital in Abu Dhabi, the United Arab Emirates. We found that between 1987 and 1991 the relative risk of caesarean section delivery for the second twin following vaginal delivery of the first twin was 0·51 (95 per cent confidence interval 1·21–0·21) relative to the 1982 to 1986 data taken as a relative risk of 1. There was therefore no statistically significant increase in the frequency of such events in the population studied, and the reasons for this suggested increase in Western populations may include factors unique to such populations.

ISSN:1340-9654    

DOI:10.3109/01443619609030039

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryThere is ample evidence for the efficacy and safety of antenatal steroids in the acceleration of lung maturation, with a 40 per cent reduction in mortality and a corresponding reduction in the incidence of respiratory distress syndrome and intraventricular haemorrhage. It is now recommended that all fetuses between 24 and 34 weeks gestation, threatened with premature delivery should receive antenatal steroids. Despite this the reported use of antenatal steroids in many studies remains disappointingly low. Our objectives in this study were to review the use of antenatal steroids at the Rotunda Hospital over a recent 2-year period, and to identify whether all eligible infants were treated appropriately. The charts of 250 mothers who delivered before 35 completed weeks pregnant between 1 January 1993 and 31 December 1994 and whose infants were admitted to the neonatal intensive care unit were reviewed retrospectively. There were 303 infants delivered to the 250 women during the study period. Of the 129 women who were hospitalised for more than 24 hours prior to delivery, 80 per cent received a full course of dexamethasone. Eighty-five per cent of those less than 30 weeks and 77 per cent of those 30 to 35 weeks received a full course. Excluding those over 34 weeks, 86 per cent received a full course. Of the group hospitalised for over 24 hours, 10 per cent received no steroids. All but one patient had a reasonable explanation for the withholding of steroids. A further 19 per cent of patients received a partial course. Of the 121 women who were hospitalised for less than 24 hours, 48 per cent received a partial course of steroids. Of these 121 women, only 56 were in hospital for more than 4 hours prior to delivery and of these 69 per cent received a partial course. The overall use of steroids either as a complete or partial course was 70 per cent.We conclude that in the Rotunda Hospital, steroid use in the antenatal population threatened with premature labour conforms to a high standard of care. This is a result of a policy of promotion of awareness of antenatal steroids among the house staff in the hospital.

ISSN:1340-9654    

DOI:10.3109/01443619609030040

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryFifty healthy pregnant women in the last trimester of pregnancy had an acute exercise test. Fetal aortic velocimetry waveforms were measured to monitor the effect of maternal exercise on the fetal aorta. The mean gestational age was 33 weeks (range 28–38 weeks). The mean exercise intensity achieved was 67 per cent of wbniasinial exercise (range 56–92 per cent). Following exercise, the systolic over diastolic ratio (SD) of fetal aortic blood How decreased. The fetal S/D ratio wsas found to be directly related to maternal heart rate and blood pressure after exercise. the lower the maternal heart rate and the lower the blood pressure, the lower the fetal S/D ratio. In addition, lower fetal S/D ratios were found in multigravidae, women with a haernoglobin greater than 12 g/dl and non-smokers. Those women who were active before pregnancy also had lower S/D ratios, the lowest values being exhibited by athletes. Higher S/D ratios were found in small fetuses and female fetuses. Apgar scores at birth were lower in those babies with a higher S/D ratio. This study demonstrates that exercise is not harmful to the fetus in healthy pregnancies.

ISSN:1340-9654    

DOI:10.3109/01443619609030041

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryTen per cent of caesarean sections are not preceded by a fetal blood sample as a result of technical difficulties in obtaining a sample in early labour. This article describes a novel technique for obtaining a fetal blood sample using a fetal scalp electrode to locate the fetal scalp. A small randomised comparative study shows that this novel technique significantly reduces the time taken to obtain a blood sample and thus aids the appropriate management of the abnormal cardiotocograph in early labour.

ISSN:1340-9654    

DOI:10.3109/01443619609030042

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY

摘要:

SummaryHaemorrhage associated with childbirth continues to be a significant cause of morbidity and mortality. Despite recommendations in the Report on Confidential Enquiries into Maternal Deaths, obstetric haemorrhage ranks in the top three leading causes of death and is associated with many of the other fatalities studied in these reports. The aim of this study was to look for risk factors that are associated with significant obstetric haemorrhage. The case notes and blood transfusion records of all women delivering after 25 completed weeks gestation who suffered obstetric haemorrhage and required at least 6 units of blood to be transfusedwereidentified and then studied in detail. Over the six year period January 1984 to December 1989, there were 38 480 deliveries at the hospital of which 34 446 were considered as part of this study cohort. The incidence of major obstetric haemorrhage in this population was 1:931 deliveries. Most obstetric units can therefore expect to see at least two or three cases per year. The incidence of postpartum hysterectomy was 1:4306. Our figures show a trend towards a greater incidence of haemorrhage in parous women and, strikingly, 17 of these 24 (71 per cent) parous patients had a prior caesarean section. The high risk status of such should be recognised, treatment of any haemorrhage should be prompt and aggressive.

ISSN:1340-9654    

DOI:10.3109/01443619609030043

出版商:Taylor&Francis    

年代:1996

数据来源: WILEY