American journal of obstetrics and gynecology
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Three hundred thirty-six consecutive cesarean deliveries performed under epidural anesthesia were reviewed. Twenty per cent of mothers suffered at least a 20% fall in blood pressure following administration of epidural anesthesia. An additional 24% required ephedrine, a vasopressor with predominantly beta activity, when other corrective measures failed. ⋯ Following restoration of blood pressure with conventional measures and ephedrine therapy, lactic acidosis persisted until delivery, whereas PO2 and PCO2 reverted toward normal values. The hypoperfusion of the intervillous space was the most likely cause of the observed significant umbilical venous and arterial lactic acidosis. Maternal hypotension remains a significant problem complicating conduction anesthesia.
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Am. J. Obstet. Gynecol. · Nov 1981
The effects of bupivacaine and chloroprocaine as local anesthetics for epidural anesthesia of fetal heart rate monitoring parameters.
The effects of saline-induced pressure-volume changes in the epidural space, and bupivacaine and chloroprocaine as local anesthetics for epidural anesthesia, on various fetal heart rate monitor parameters were investigated in 34 low-risk women. Epidural space pressure-volume changes, bupivacaine, and chloroprocaine had no effect on the incidence of pathologic periodic fetal heart rate changes, the level of the baseline fetal heart rate, or the level of uterine activity units. Epidural space pressure-volume changes and chloroprocaine did not affect fetal heart rate variability. The use of bupivacaine was associated with a significant increase in fetal heart rate variability
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Am. J. Obstet. Gynecol. · Oct 1981
Randomized Controlled Trial Comparative Study Clinical TrialA randomized prospective study of the use-effectiveness of two methods of natural family planning.
The final results of a prospective comparative study of two methods of natural family planning indicate a significant difference in the 12 month net cumulative pregnancy rates between the ovulation and symptothermal methods. These differences are on the order of two to one in favor of the symptothermal method. ⋯ Dropout rates for both methods were high. Lack of interest or dissatisfaction with the method was the major reason for dropout training while pregnancy or desire for pregnancy were the major reasons for dropout during the formal phase of the study.
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Am. J. Obstet. Gynecol. · Oct 1981
Fatal amniotic fluid embolism during legally induced abortion, United States, 1972 to 1978.
Amniotic fluid embolism (AFE) has emerged as an important cause of death from legally induced abortion. In the period 1972-1978, 12 probably and three autopsy-confirmed cases of fatal AFE during legally induced abortion were identified in the United States (12% of all deaths from legal abortion). ⋯ Because treatment is frequently ineffective, prevention of AFE is critical. Performing abortions early in pregnancy and using curettage techniques whenever feasible should reduce the risk of death from this obstetric accident during legally induced abortion.