The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · May 1996
Case ReportsCardiopulmonary arrest in pregnancy: successful resuscitation of mother and infant following immediate caesarean section in labour ward.
Our patient experienced cardiopulmonary arrest secondary to profound hypotension and was unable to be resuscitated with external cardiac massage and assisted ventilation. This case demonstrates the need for continued vigilance by medical and nursing staff when epidural anaesthesia is being established. Resuscitation equipment should be available in the labour ward as cardiopulmonary resuscitation and immediate Caesarean section can be lifesaving in the event of a cardiopulmonary arrest.
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Aust N Z J Obstet Gynaecol · May 1996
A study of patients' acceptance towards vaginal birth after caesarean section.
Patients' acceptance towards vaginal birth after Caesarean section (VBAC) was studied in 99 women with previous Caesarean section. Their attitude was strongly related to the chance of success of VBAC. ⋯ The major caused of a negative feeling towards the previous Caesarean section were postoperative pain and a long recovery period. There was no significant negative effect on acceptance of VBAC if the previous Caesarean section was performed as an emergency operation for slow progress of labour or cephalopelvic disproportion.
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Aust N Z J Obstet Gynaecol · Feb 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialGoserelin depot versus danazol in the treatment of endometriosis the Australian/New Zealand experience.
A multicentre, open, randomized comparison of depot goserelin versus danazol to treat endometriosis was undertaken in 9 Australian/New Zealand centres. The study compared the effects of the 2 drugs on subjective and objective parameters in women with symptomatic and/or infertility associated endometriosis. ⋯ Patients in our study showed considerably more intolerance of study drugs, particularly danazol, than women in American and European reports: 19 of 36 women randomized to danazol in our study failed to complete 6 months therapy, because of adverse events (9/36) or because of unwillingness to continue with therapy (8/36). Consumer satisfaction with medical treatment for endometriosis was an important issue in this study.
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Aust N Z J Obstet Gynaecol · Feb 1996
Randomized Controlled Trial Clinical TrialThe effect of intraumbilical oxytocin on the third stage of labour.
The umbilical vein administration of oxytocin in saline was compared with umbilical vein saline alone and the traditional management of the third stage of labour. Seventy-two women were randomized to 3 groups. ⋯ No significant differences were found in terms of the length of the third stage, the blood loss in the third stage and postpartum haematocrit differences among the 3 groups. The administration of diluted oxytocin or saline do not seem to have any superiority to the traditional management of the third stage of labour.
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Aust N Z J Obstet Gynaecol · Nov 1995
Randomized Controlled Trial Clinical TrialEfficacy of bupivacaine delivered by wound catheter for post-Caesarean section analgesia.
A prospective, randomized, double-blind trial was conducted to assess contribution to postoperative analgesia of intermittent instillation of 0.25% bupivacaine beneath the rectus sheath in 70 women delivered by lower uterine segment Caesarean section. The operations were performed via a Pfannenstiel incision under spinal anaesthesia. Background intravenous narcotic analgesia was provided with a patient controlled analgesia system (PCAS) using a standard morphine regimen. ⋯ The overall incidence of nausea was lower in the treatment group compared to the control group (Chi squared with Yates' correction p = 0.046) and a lower degree of sedation was seen in those receiving bupivacaine between 4 and 8 hours after commencing PCAS (Mann-Whitney U = 427, p = 0.028). No differences in other narcotic related side-effects (vomiting and pruritus) were shown between groups. Regular instillation of 0.25% bupivacaine beneath the rectus sheath of women delivered by Caesarean section reduces their morphine requirements by 25% in the 44 hours after operation, with an associated reduction in both nausea and early sedation.