American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 1976
Cesarean section in present-day obstetrics. Presidential address.
Two thousand five hundred and sixty-three cesarean sections performed at Charlotte Memorial Hospital during 1963 through the first six months of 1975 were reviewed. The cesarean section rate was 6 per cent. The results of two earlier studies, starting with the opening of the hospital in 1940, were compared. ⋯ The present study shows that significant improvement has been made in reducing cesarean section deaths, morbidity, and complications, as well as fetal deaths. There have been no maternal deaths in the last 2,225 cesarean sections. Questionnaire returns from 50 representative medical schools and obstetricians throughout the United States discuss the increased cesarean section rate, the reasons for the increase, and the predicted cesarean section incidence of the future.
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Am. J. Obstet. Gynecol. · Oct 1976
Cigarette smoking, use of oral contraceptives, and myocardial infarction.
The excess risk of nonfatal myocardial infarction among users of oral contraceptives observed in England and Wales can be explained in terms of the high proportion of smokers in the study population. Among nonsmokers, the relative risk associated with the use of oral contraceptives is estimated to be 2 to 1, which is not statistically significant (P = 0.28, Fisher's exact probability test). ⋯ The relative risk of nonfatal myocardial infarction associated with the use of oral contraceptives observed in a society can vary between 0.9 to 1 and 11.7 to 1, depending upon the proportion of smokers. From the public health point of view, the reduction in the excess risk of nonfatal myocardial infarction achieved by eliminating smoking is estimated to be much more than can be achieved by eliminating the use of oral contraceptives.
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Am. J. Obstet. Gynecol. · Sep 1976
Maternal and fetal effects of lumbar epidural analgesia for labor and delivery in patients with gestational hypertension.
The effects of continuous lumbar epidural analgesia for labor and delivery were studied in 20 women with gestational hypertension. Maternal hemodynamics, renal function, acid-base, and blood gas findings were examined together with newborn APgar scores and umbilical vessel blood gas and acid-base values. ⋯ Apgar scores in both groups of subjects wer good. Continuous epidural analgesia is recommended as a useful form of therapy in the management of labor and delivery in women with gestational hypertension.