Zeitschrift für Geburtshilfe und Neonatologie
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Z Geburtshilfe Neonatol · Oct 2009
Randomized Controlled Trial[Effectiveness and safety of atosiban vs. pulsatile administration of fenoterol in the treatment of preterm labour].
The aim of this study was to compare the efficacy and side effects of atosiban with those of fenoterol (pulsatile administration) for acute tocolysis. ⋯ Atosiban was comparable in clinical effectiveness and was associated with fewer maternal and fetal adverse effects, so that fenoterol cannot be recommended. Completion of tocolytic therapy 12 hours after arrest of preterm labour is effective and associated with a short mean duration.
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Z Geburtshilfe Neonatol · Aug 2009
[Careful planning of the decision-making process in neonatology: ethical orientation].
Many decisions in neonatology are complex and demanding. Consequently, the involved persons can expect guidance which is provided to them by specialist organisations of the scientific community. Their documents deal with such substantial questions as how to treat extremely premature newborns and severely ill infants. They also address procedural aspects of the decision-making process; however, they could be made more transparent in this respect. ⋯ Good decision making in neonatology must be context sensitive. General guidelines can be a helpful resource for carefully developing such a process. By taking the factors described in this paper into consideration, this task will be completed more efficiently.
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Z Geburtshilfe Neonatol · Oct 2008
Randomized Controlled Trial Comparative Study[Oral misoprostol against vaginal dinoprostone for labor induction at term: a randomized comparison].
It was the objective of this study to compare the efficacy and safety of oral misoprostol with those of vaginal dinoprostone for the induction of labour at term. ⋯ Oral misoprostol is effective and safe for induction of labour at term. In addition, it is much cheaper and independent of storage conditions. At the doses and with the administration intervals used in this study, dinoprostone was slightly more effective than misoprostol.
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Z Geburtshilfe Neonatol · Aug 2008
Outcome measures in perinatal medicine - pH or BE. The thresholds of these parameters in term infants.
Hypoxia and severe foetal acidosis may lead to cerebral injuries and multi-organ failure. Base excess (BE) and actual pH determined in umbilical artery (UA) blood are valid parameters to measure (metabolic) acidosis. Until now there is no consensus worldwide as to which of the two parameters should preferably be used and which thresholds should be applied: the thresholds 7.000, 7.100 and 7.200 are discussed for pH,UA and - 16.0 mmol/l for BE,UA, respectively. The aim of this study was to redefine these thresholds for term infants taking into account the entire spectrum of complications in early neonatal life and to compare the diagnostic power of both variables under investigation. ⋯ Thresholds in UA blood for pH, pCO2, sO2 and BE(oxy.) in term-infants are: 7.000, 84 mmHg, 3.0 % and - 20 mmol/l, respectively. Delivery of an otherwise healthy baby without getting in touch with these thresholds seems to be safe both for the baby and the obstetrician. In addition, severe neonatal depression (Apgar 1 min: 0 and 1) is usually avoided (0 / 398). BE(oxy.) does not offer a higher diagnostic power when compared with actual pH.