British journal of obstetrics and gynaecology
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To determine, from the best available evidence, the effectiveness and safety of misoprostol administered vaginally or orally for third trimester cervical ripening or induction of labour. ⋯ Overall, misoprostol appears to be more effective than conventional methods of cervical ripening and labour induction. Although no differences in perinatal outcome were shown, the studies were not sufficiently large to exclude the possibility of uncommon serious adverse effects. In particular the increase in uterine hyperstimulation with fetal heart rate changes following misoprostol is a matter for concern. It is possible that, if sufficient numbers are studied, an unacceptably high number of serious adverse events including uterine rupture and asphyxial fetal deaths may occur. The data at present are not robust enough to address the issue of safety. Thus, though misoprostol shows promise as a highly effective, inexpensive and convenient agent for labour induction, it cannot be recommended for routine use at this stage. Lower dose misoprostol regimens should be investigated further.
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Br J Obstet Gynaecol · Aug 1999
Randomized Controlled Trial Comparative Study Clinical TrialMisoprostol for induction of labour at term: a more effective agent than dinoprostone vaginal gel.
To compare the efficacy of vaginal misoprostol and dinoprostone vaginal gel for induction of labour at term. ⋯ Misoprostol 50 microg vaginally is a more effective induction agent than 1 mg dinoprostone vaginal gel, with no apparent adverse effects on mode of delivery, or on the fetus. The higher pain scores in the misoprostol group must be balanced against the reduction in time spent having labour induced, and the reduction in need for intravenous oxytocin augmentation. Further randomised studies must continue to exclude the possibility of rare adverse side effects.
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To determine: 1. whether an alternative definition of gestational hypertension and pre-eclampsia stratifies women according to their risk of maternal and fetal complications; 2. whether pregnancy outcome in women with gestational hypertension differs in the presence or absence of '+' proteinuria; and 3. whether a blood pressure rise of > or = 30/15 mmHg during pregnancy is associated with adverse outcome in women who remain normotensive. ⋯ In the nulliparous population studied our definition of gestational hypertension and pre-eclampsia identified women at increasing risk of maternal and fetal complications. In gestational hypertension, the presence of proteinuria '+' was associated with a 3.8-fold increase in severe maternal disease. Normotensive women who have a rise in blood pressure > or = 30/15 mmHg had uncomplicated pregnancies.
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Br J Obstet Gynaecol · Jul 1999
Randomized Controlled Trial Clinical TrialLabour pain treated with cutaneous injections of sterile water: a randomised controlled trial.
To evaluate the relief of pain in labour with subcutaneous and intracutaneous injections of sterile water, compared with placebo. ⋯ The new subcutaneous method of administering sterile water, as well as the earlier described intracutaneous injection method, were effective for the relief of pain in labour.
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Br J Obstet Gynaecol · Jun 1999
Randomized Controlled Trial Clinical TrialIs the provision of information leaflets before colposcopy beneficial? A prospective randomised study.
To assess the usefulness of a leaflet distributed to women before colposcopy designed to reduce their anxiety and psychosexual morbidity by providing information. ⋯ This study suggests that the provision of sending an information leaflet prior to colposcopy is not beneficial in isolation. Other approaches need to be considered.