ISSN:1340-9654    

DOI:10.3109/01443619009151249

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryNinety-five pregnancies among 88 epileptic women were studied prospectively between 1982 and 1988. There were six miscarriages, three preterm pregnancies and 86 term pregnancies, resulting in 92 babies. There were no stillbirths, one neonatal death and one maternal death. The incidence of breech presentation and mode of delivery amongst epileptic mothers did not differ from that amongst control mothers delivering in the same unit. Birth weight and head circumference of the babies born to epileptic mothers did not differ from those of babies born to control mothers. There was also no difference in head circumference between babies born to epileptic mothers on different anticonvulsant regimens. There were eight minor and one major congenital malformations amongst the 92 babies. The incidence of talipes was 43·5 per 1000 live births, which is significantly greater than the 2·54 per 1000 incidence in the Plymouth Health Authority population. Poor control of epilepsy was not associated with malformations. Epileptic women were found to be of lower social class than the local population. Seventy-three per cent of the epileptic women were managed on a single anticonvulsant drug, which probably explains the good results obtained in this series.

ISSN:1340-9654    

DOI:10.3109/01443619009151250

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryEight patients having severe pregnancy induced hypertension complicated by thrombocytopenia and elevated liver function tests are described. The patients were treated with nifedipine. In addition to controlling blood pressure, nifedipine appeared to reverse thrombocytopenia; mean platelet count rose from 90×109/l to 159×109/l (P<0·05). Serum transaminases became normal. Mean lactate dehydrogenase decreased from 417 to 274 (P<0·05). The significance of HELLP syndrome is discussed.

ISSN:1340-9654    

DOI:10.3109/01443619009151251

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryFifty primigravid patients at term with ruptured membranes before labour and an unripe cervix were allocated at random to be managed by vaginal prostaglandin E2tablets or by intravenous oxytocin infusion. With prostaglandin there were longer intervals from treatment to the onset of contractions, to the second stage of labour and to delivery. The incidences of assisted delivery in general and caesarean section in particular were not increased. Two neonates, both from the prostaglandin patients, became pyrexial and were treated with antibiotics, but there were no serious infections in either group. We conclude that there are no advantages to initial treatment with prostaglandin E2vaginal tablets over the use of an oxytocin infusion.

ISSN:1340-9654    

DOI:10.3109/01443619009151252

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe effect on maternal and neonatal outcome of flexible guidelines for the management of the second stage of labour in uncomplicated primigravid term labours receiving epidural analgesia was examined in 327 consecutive confinements. With flexible guidelines, the second stage was allowed to proceed for an average of 44 minutes longer before it was felt that operative delivery was indicated for this reason alone. The total instrumental delivery rate after epidural analgesia decreased from 54 to 43 per cent (P<0·05) and the proportion of mid-cavity forceps for‘delay’was reduced (P<0·05). No change was found in maternal morbidity, measured by the frequency of haemorrhage, infection or bladder complications. The frequency with which active neonatal resuscitation was required seemed to be reduced; no relationship between umbilical cord venous pH and the duration of either active or passive second stages was found. A total second stage of up to 4 hours, consisting of 2·5 hours passive and up to 1·5 hours active labour, appears to be safe and offers an acceptable chance of normal delivery in this selected group.

ISSN:1340-9654    

DOI:10.3109/01443619009151253

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryOne hundred and twenty patients undergoing instrumental delivery during 18 months were allocated at random following delivery to two groups of 60 having their episiotomy repaired with either chromic catgut or poly-glycollic acid (Dexon). All the women were interviewed on the 1st, 3rd and 5th day post partum and the perineum inspected on the 5th day. Assessment of bruising and oedema was scored 0 (none) to 3 (severe), and the patient's subjective discomfort was analysed using a 10 cm visual analogue scale. No difference was found between the two groups with regard to pain reported, or their bruising and oedema scores. There is no evidence from this study that the choice between chromic catgut and polyglycollic acid sutures influences short term morbidity.

ISSN:1340-9654    

DOI:10.3109/01443619009151254

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryThe management of 208 mature singleton breech deliveries is reviewed. The total caesarean section rate was 13·5 per cent. Ten elective caesarean sections were performed. There were no specific criteria to fulfil to permit labour. Vaginal delivery was intended in 198 and the attempt was abandoned in 18 of these (9·1 per cent). Labour was induced in 46·4 per cent and when labour commenced spontaneously it was augmented with oxytocin in 40·2 per cent. The gross perinatal mortality was 43·3 per 1000 and the corrected rate 14·4 per 1000. It is suggested that X-ray pelvimetry is of little prognostic significance in assessing the likelihood of vaginal delivery.

ISSN:1340-9654    

DOI:10.3109/01443619009151255

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummarySerum concentrations of copper, zinc, calcium, magnesium, cobalt and manganese in maternal and cord blood at delivery were determined in term pregnancies among healthy Nigerian women. The cord serum concentrations of copper and calcium were lower than the corresponding maternal serum concentrations. No differences were found in cord and maternal serum levels of zinc, magnesium, cobalt and manganese.

ISSN:1340-9654    

DOI:10.3109/01443619009151256

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryOne thousand and thirty patients have been studied in one of the largest single centre prospective random trials, assessing the effects of two prostaglandin vaginal pessaries upon cervical dilatation and compliance during first trimester abortion by uterine aspiration under general anaesthetic. Gemeprost 1 mg pessaries inserted 1–4 hours before surgery produced marginally greater cervical dilatation and less operative blood loss than prostaglandin E210 mg pessaries, with a reduction in distressing pre-operative side effects. No reduction in effect upon the cervix was found if the pessaries were inserted for only 1–2 hours compared with 3–4 hours. Postoperative side effects and later complications were infrequent and similar with both preparations. Gemeprost 1 mg pessaries are thus to be preferred to prostaglandin E210 mg pessaries for this purpose.

ISSN:1340-9654    

DOI:10.3109/01443619009151257

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY

摘要:

SummaryAcardiac malformation is a rare lethal anomaly in one of monozygotic twins that occurs in approximately 1 in 34000 pregnancies. Although the aetiology remains unknown, two main theories have been proposed: (1) a chromosomal defect causing failure of development of cardiac and other tissues; (2) arrest of normal cardiac development secondary to circulatory reversal in the affected twin. The survival of the affected acardiac twinin uterodepends on blood supply from its normal co-twin. The perinatal mortality for the normal twin has been reported to be as high as 50 per cent. The cause of death is usually prematurity or congestive heart failure. Fetal monitoring of the normal twin should include serial high resolution sonography and Doppler blood flow studies. With signs of fetal compromise, delivery is usually recommended. Alternatively,in uterotreatment of heart failure may be advantageous at pre-viable gestational ages.

ISSN:1340-9654    

DOI:10.3109/01443619009151258

出版商:Taylor&Francis    

年代:1990

数据来源: WILEY