Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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There is no consensus amongst medical and midwifery staff on the optimum time to cut the umbilical cord following childbirth. Studies have shown that delaying cord clamping for at least 30 seconds is associated with less need for blood transfusion and respiratory support. In 2004, Rabe et al. recommended delayed cord clamping for up to 120 seconds in preterm birth. ⋯ Obstetricians are reluctant to adopt the recommendation. Difficulty in clinical practice was the main reason. There is need for the Royal College of Obstetricians and Gynaecologists to produce guidelines for delayed cord clamping in obstetric practice.
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Review Case Reports
The role of recombinant activated Factor VII in major obstetric haemorrhage: the Farnborough experience.
Major obstetric haemorrhage is one of the commonest causes of maternal mortality and morbidity worldwide. It may result in coagulopathy and diffuse pelvic or vaginal bleeding. Correction of coagulopathy when administering Factor VII may be crucial to the management of selected cases. ⋯ Recombinant activated Factor VII is a potential haemostatic agent in massive obstetric haemorrhage. Its successful use has been reported in post-surgical bleeding and consumptive coagulopathy. It may abolish the need for hysterectomy, which has a devastating effect on the patient future fertility and psychological well-being.
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General versus neuraxial anaesthesia for caesarean section: impact on the duration of hospital stay.
We investigated retrospectively the duration of hospital stay of 1,619 women who received general (GA) (n = 582) or neuraxial anaesthesia (combined spinal-epidural [CSEA] (n = 614), epidural [EA] (n = 423)) for caesarean delivery over the years 2002-2005. Hospital stay was also analysed for the different obstetricians involved. Overall duration of hospital stay differed between 2002 and 2005 (p < 0.0001) but not between CSEA and EA (p = 0.460). ⋯ Duration of hospital stay after neuraxial anaesthesia differed between 2002 and 2005 (p = 0.013) and among different surgeons (p < 0.001). Discharge rates from the hospital were shorter after neuraxial anaesthesia versus GA for the 3rd and 4th postoperative days (p < 0.001 and p < 0.001, respectively). Neuraxial anaesthesia for caesarean section seems to be associated with shorter duration of hospital stay than GA.