British journal of obstetrics and gynaecology
-
Br J Obstet Gynaecol · Jul 1990
Factors influencing the prevalence and severity of dysmenorrhoea in young women.
Factors influencing the prevalence and severity of dysmenorrhoea were assessed longitudinally in a representative sample of young women born in 1962. The prevalence of dysmenorrhoea was lower (P less than 0.01) at 24 years of age than at 19 years of age. At 24 years of age, 67% of the women still experienced dysmenorrhoea; 10% reported dysmenorrhoea which limited daily activity. ⋯ Dysmenorrhoea was reduced (P less than 0.001) in oral contraceptive users. The severity of dysmenorrhoea was significantly associated with the duration of menstrual flow, menarcheal age and cigarette smoking. The severity of dysmenorrhoea was not associated with age as an isolated factor, nor with height, weight, length of menstrual cycle or frequency of physical exercise.
-
The Report on Confidential Enquiries into Maternal Deaths in England and Wales 1982-84 (Department of Health 1989) recommends early involvement of the anaesthetist in women having emergency caesarean sections and the use of epidural anaesthesia in preference to general anaesthesia. In an observational prospective study the need for emergency abdominal delivery could be anticipated in 87% of 360 consecutive emergency caesarean sections. Early establishment of epidural analgesia allowed extension, to an appropriate level for the surgery, in 70%. The duty anaesthetist accompanying the obstetric team on three wardrounds a day could be forewarned of anticipated problems in most women who are eventually delivered abdominally.
-
Br J Obstet Gynaecol · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialA randomized comparison of early with conservative use of antihypertensive drugs in the management of pregnancy-induced hypertension.
Two treatment strategies were compared in 155 women with pregnancy-induced hypertension who were also given comprehensive non-pharmacological care. The mean gestation at entry was 28 weeks. As long as the diastolic blood pressure (DBP) remained below 106 mmHg, oxprenolol, or oxprenolol plus dihydralazine, were given to the early treatment group, and matching placebos to the control group. ⋯ Respiratory distress syndrome occurred in four infants in the early treated group and in 10 in the control group; 14 infants in the former group and 26 in the latter were in hospital for more than 10 days (18 vs 35%; 95% CI of difference 4-32%). These results indicate that early antihypertensive treatment with oxprenolol is safe for the fetus and newborn in pregnancy-induced hypertension, but has no advantage over non-pharmacological care in terms of fetal growth. However, it may prevent acute hypertension in late pregnancy and associated fetal distress, and thus reduce the number of caesarean sections.
-
Br J Obstet Gynaecol · Sep 1989
Clinical findings and results of operative treatment in ilioinguinal nerve entrapment syndrome.
Women complaining of lower abdominal and pelvic pain were tested for the presence of an ilioinguinal nerve entrapment. Forty-six women were considered to fulfill the requirements for this syndrome, five of them bilaterally. In the 51 nerves tested common findings were hyperaesthesia (88%), dysaesthesia (53%) and pain pressure at the nerve exit (75%); hypoaesthesia was rare (6%). ⋯ Some improvement was reported after six procedures whereas the operation had no effect in six others. A probable cause of the neuralgia could be found in only six women. Ilioinguinal nerve entrapment should be considered early in the differential diagnosis of lower abdominal and pelvic pain.