The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · May 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of tiaprofenic acid, mefenamic acid and placebo in the treatment of dysmenorrhoea in general practice.
The efficiency and side-effects of tiaprofenic acid, mefenamic acid and placebo were compared in the treatment of primary dysmenorrhoea. The trial was a double-blind prospective randomized 3-way crossover study during 6 successive menstrual cycles following a 2-cycle run-in period and involved 50 women with primary dysmenorrhoea selected from 96 volunteers between 16 and 35 years of age. Overall pain was significantly less (p less than 0.05) on treatment with tiaprofenic acid than on treatment with mefanemic acid, placebo, or the women's usual treatments. Both active treatments were well tolerated but more side-effects were reported during treatment with mefenamic acid.
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Aust N Z J Obstet Gynaecol · May 1992
Case ReportsA case of intrauterine fetal death associated with maternal Campylobacter coli bacteraemia.
Campylobacter species are known to cause infectious abortion in domestic animals. In humans, Campylobacter are an important cause of enteritis, an occasional cause of systemic infection and have had a rare association with abortion and perinatal infection. A case history of spontaneous abortion, at 26 weeks' duration, associated with maternal bacteraemia, due to Campylobacter coli is presented. Transmission, pathogenesis, treatment, and the need for further investigation are discussed.
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Aust N Z J Obstet Gynaecol · Aug 1991
Comparative StudyInduction of labour in nulliparas with poor cervical score: oxytocin or prostaglandin vaginal pessaries?
In a previous study nulliparas with poor cervical score (less than 5 out of 10) had a 43.5% Caesarean section (CS) rate of which 55% were for failed induction when labour was induced by artificial rupture of membranes and oxytocin infusion. In this study induction of labour by 2 doses of 3 mg prostaglandin E2 (PGE2) vaginal pessaries, 4 hours apart, and if necessary by artificial rupture of membranes and oxytocin infusion 24 hours later, resulted in a CS rate of 23.7% of which 38.9% were for failed induction. The latter regimen resulted in a significantly lower CS rate compared with labour induced by oxytocin infusion and rupture of membranes without the use of prostaglandins (p less than 0.001). ⋯ In those who did not start labour and needed rupture of membranes and oxytocin infusion 24 hours after the first pessary, 34 (47.9%) had a good cervical score (greater than or equal to 6 out of 10) and 37 (52.1%) had a poor cervical score (less than or equal to 5 out of 10) at the time of amniotomy. The CS rates in these groups were 8.8% and 48.6% respectively (p less than 0.001). In nulliparas with poor cervical score induction is better performed with vaginal prostaglandin pessaries in order to reduce the high CS rate associated with artificial rupture of membranes and oxytocin infusion.
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Aust N Z J Obstet Gynaecol · Aug 1991
Comparative StudyNeonatal outcome and its relationship with maternal age.
The relationship between maternal age and neonatal outcome was examined in 22,689 pregnancies using various determinants of neonatal well-being which included evidence of fetal distress, birth-weight, Apgar scores, the necessity for admission to the neonatal unit and other indicators of neonatal morbidity. Differences in the incidence of congenital malformations and perinatal mortality were also studied. There was a trend towards more frequent fetal heart monitoring, lower birth-weight and a higher rate of neonatal unit admission for infants delivered by younger women. ⋯ Maternal age had no effect, however, on the incidence of fetal distress, Apgar score, the development of respiratory disease, the need for intubation and ventilation nor on subsequent neonatal central nervous system complications. There was also no association between maternal age and either perinatal mortality or the incidence of congenital malformations. The favourable outcome in teenagers in this study may have been influenced by the extremely low pregnancy rate amongst young adolescents in Hong Kong, but a similar outcome in the mature age women was likely to have reflected the recognition of risk and its appropriate management.
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The results of 670 consecutive caudal blocks performed by the author for operative obstetrics over 20 years is reported. There was no morbidity attributable to the technique. ⋯ The causes of these failures are discussed. It is recommended that caudal analgesia continues to be used for operative vaginal obstetrics.