The Australian & New Zealand journal of obstetrics & gynaecology
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The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. ⋯ After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient.
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Aust N Z J Obstet Gynaecol · May 1999
A new method for rapid measurement of lactate in fetal and neonatal blood.
A prospective trial to determine the accuracy and precision of the Boehringer Mannheim Accusport handheld lactate meter in measuring plasma lactate levels in umbilical cord blood and neonatal blood microsamples was performed in the labour ward and the neonatal intensive care unit of the NepeanHospital. Specimens were collected from the umbilical artery of 160 consecutive deliveries covering gestations from 26 to 42 weeks, and from 110 umbilical artery catheters covering a range of gestations from 26 to 41 weeks. Serum was also obtained from an exchange transfusion for coefficient of variation analysis. ⋯ The Accusport handheld lactate meter is an accurate, commercially available, method of measuring plasma lactate levels in only 60 seconds at the point-of-care. It requires only 15 microL of blood and is significantly cheaper than other assay methods. The BM lactate meter is well suited to assess lactic acidaemia of fetal scalp and neonatal blood samples to help quantify hypoxic stress in the perinatal period.
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Aust N Z J Obstet Gynaecol · May 1999
Patient preference the leading indication for elective Caesarean section in public patients--results of a 2-year prospective audit in a teaching hospital.
In response to a Western Australian Ministerial enquiry into the levels of intervention in childbirth, a 2-year prospective audit was undertaken of the indication and timing of all public Caesarean section deliveries at King Edward Memorial hospital. During the study period, a total of 9,138 deliveries were performed at the hospital, of which 1,624 were by Caesarean section, an overall rate of 17.8%. ⋯ The most common indications for nonelective Caesarean section birth were an intrapartum diagnosis of suspected fetal distress or failure to progress in labour. Strategies to reduce the incidence of Caesarean section birth need to focus on the pathways involved with maternal decision-making in the birth process, and on improving the diagnosis of intrapartum fetal compromise.
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Aust N Z J Obstet Gynaecol · Feb 1999
Quiet resting is not necessary prior to routine antenatal blood pressure measurement.
A premeasurement period of 5 minutes quiet resting is recommended prior to measuring blood pressure. The aim of this study was to determine the effect of this period of rest on the level of blood pressure in pregnant women. One hundred pregnant women had their blood pressure measured on a single visit using a QuietTrak ambulatory blood pressure monitor, used to remove human observer bias. ⋯ The corresponding diastolic values were 68.5 versus 65.6 (p = 0.34). Blood pressure was as likely to rise as to fall after a period of quiet rest. It is not necessary to have pregnant women quietly resting during routine visits before having blood pressure measured.
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Aust N Z J Obstet Gynaecol · Feb 1999
A survey of parturients using epidural analgesia during labour. Considerations relevant to antenatal educators.
The use of epidural analgesia (EA) during labour is increasing in Australasia. This highlights the need for improved educational and resource materials, current factual information about EA, and identification of consumer attitudes towards EA. In this survey, 350 parturients who had recently used EA for labour pain relief in a single maternity unit were asked to complete a questionnaire about their expectations and experience. ⋯ Anticipated pain during epidural placement was significantly greater than that experienced. Satisfaction with EA was high, although 36% described unpleasant or annoying effects associated with EA. Parent educators and epidural service providers should be aided by knowledge of where parturients obtain information and of consumer views about EA.