The Australian & New Zealand journal of obstetrics & gynaecology
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Peripartum cardiomyopathy is an uncommon condition of unknown aetiology. Diagnosis requires exclusion of other causes of congestive cardiac failure and the demonstration of global ventricular dysfunction on echocardiography. ⋯ Prognosis is related to recovery of ventricular function. The availability of cardiac transplantation has improved the outlook for those with persistent dysfunction.
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Aust N Z J Obstet Gynaecol · Nov 1996
Induction of labour for trial of vaginal birth after caesarean section in a remote district hospital.
In a retrospective review of 79 women with 1 or more previous Caesarean section, 33 (41.8%) women agreed to a trial of vaginal birth. Twenty nine women had labour induced and 26 (89.7%) of them had a successful vaginal delivery. Four women laboured spontaneously and 1 of them needed an emergency Caesarean section for failure to progress. ⋯ The overall emergency Caesarean section rate was 4 of 33 (12.1%). During the study period the Caesarean section rate for the hospital fell from 32.2% to 11%. This study suggests that induction of labour in women with a previous Caesarean section is very successful in achieving vaginal delivery and has a role to play in remote and rural hospitals.
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Aust N Z J Obstet Gynaecol · Aug 1996
Severe chronic pelvic pain in women may be caused by ligamentous laxity in the posterior fornix of the vagina.
The aim was to prospectively study the relationship between pelvic pain of otherwise unknown origin and laxity in the posterior vaginal fornix. Twenty-eight patients with negative laparoscopy findings, lower abdominal pain and laxity in the posterior ligamentous supports of the uterus underwent surgical approximation of their uterosacral ligaments. ⋯ However, the results suggest that this may be a T12-L1 parasympathetic pain referred to the lower abdomen, perhaps due to the force of gravity stimulating pain nerves unable to be supported by the lax uterosacral ligaments in which they are contained. It was concluded that laxity in the posterior ligaments of the vagina should first be excluded before referring patients with pelvic floor discomfort or pain for psychiatric care.
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Aust N Z J Obstet Gynaecol · May 1996
Comparative StudyA comparison between visual estimation and laboratory determination of blood loss during the third stage of labour.
A prospective study was conducted to compare the accuracy of visual estimation of blood loss (EBL) at delivery with laboratory determination of measured blood loss (MBL). It showed that EBL tends to be clouded by the conventional teaching that blood loss at delivery is usually between 200 to 300 mL. ⋯ Of the 9 women with a primary postpartum haemorrhage, only one was correctly diagnosed as such and 3 women were estimated to have blood losses of at least 500 mL but the measured blood losses were all lower. It was concluded that visual estimation of blood loss is inaccurate, especially at the extremes of MBL and that primary postpartum haemorrhage is not detected by visual estimation of blood loss, unless there are associated signs of haemodynamic instability.