British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Nov 1980
Case ReportsCord entanglement causing premature placental separation and amniotic fluid embolism. Case report.
A woman died undelivered of amniotic fluid embolism. Postmortem examination showed that cord entanglement had caused premature placental separation with a marginal tear of the membranes and so opened a route of entry for amniotic fluid into the subplacental maternal venous sinuses. It is suggested that premature separation of the normally implanted placenta, associated with macro- or microscopic tears of or damage to the fetal membranes, provides a route of entry for amniotic fluid through the placental site in approximately one half of the fatal cases of amniotic fluid embolism.
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Br J Obstet Gynaecol · Nov 1980
The effect of lumbar epidural analgesia on the rate of cervical dilatation and the outcome of labour of spontaneous onset.
A study of 1055 spontaneous labours is presented relating progress and outcome to the presence of a lumbar epidural block in 282 of these patients and to the need for oxytocin augmentation in 427. Graphs for cervical dilatation starting at admission to hospital were constructed for normal and dysfunctional labours of spontaneous onset. ⋯ With an epidural block there was no increase in the number of babies with cerebral irritation or low Apgar scores and there was a statistically significant improvement in the Apgar scores of babies of mothers in augmented dysfunctional labour who had an epidural block. The incidence of rotational forceps delivery in patients with an epidural block could be reduced with safety by allowing such patients to have a longer second stage before considering interference purely for delay.