British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Jun 1989
Haemodynamic changes associated with caesarean section under epidural anaesthesia.
Serial haemodynamic investigations were performed in 15 women delivered by elective caesarean section under epidural anaesthesia at 38-40 weeks gestation. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. No haemodynamic changes were demonstrable after attainment of surgical anaesthesia (T5 or above). ⋯ There was a fall in heart rate and cardiac output between the second and the sixth days after delivery. By 2 weeks after delivery cardiac output was 28% lower than pre-operative values. Compared with pre-operative values, diastolic blood pressure was lower on the first and second postnatal days.
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Br J Obstet Gynaecol · Mar 1989
Clinical TrialEfficacy of progesterone support for pregnancy in women with recurrent miscarriage. A meta-analysis of controlled trials.
Progesterone appears to be necessary to support an early pregnancy, and it has been used for this purpose for several decades. Its potential role in women with recurrent miscarriage due to luteal phase deficiency has been suggested, but its efficacy has not yet been demonstrated. ⋯ The resulting odds ratio for pregnancies reaching at least 20 weeks gestation was 3.09 (95% CI 1.28 to 7.42) which indicates that there is evidence to support the suggestion that progesterone given in early pregnancy is useful in women with recurrent miscarriage. Although, before progesterone is used in this way its efficacy in women with recurrent miscarriage due to luteal phase deficiency must be assessed in prospective double-blind randomized controlled trials mounted in the light of the results of this meta-analysis.
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A survey of all registered deaths which occurred during 1981-1983 in women of reproductive age was carried out in Menoufia Governorate, Egypt. Surviving family members were interviewed by trained social workers, and information was collected on symptoms of the disease that led to death. The completed questionnaires were reviewed by a panel of local physicians and a cause of death was assigned by the panel. ⋯ There were 190 maternal deaths per 100,000 livebirths and 45 maternal deaths per 100,000 married women aged between 15 and 49 years. Most of the maternal deaths (63%) were due to direct obstetric causes of which haemorrhage was the main cause. Another 27% of the maternal deaths were due to indirect obstetric causes of which rheumatic heart disease was the main cause.
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Br J Obstet Gynaecol · Oct 1988
Classical versus low-segment transverse incision for preterm caesarean section: maternal complications and outcome of subsequent pregnancies.
In a retrospective, controlled, follow-up study of 326 women who had a primary preterm caesarean section, the risks of postoperative maternal morbidity and uterine rupture or dehiscence in subsequent pregnancies were investigated in relation to the mode of incision (classical compared with low-segment transverse incision). The classical incision was associated with a higher frequency of postpartum fever in the immediate postoperative period (16% compared with 6%, P less than 0.01). ⋯ Of the pregnancies after the classical operation 13% had abnormal scars compared with none of those after the low-segment transverse operation (P = 0.0014). The frequency of scar dehiscence was 6% after a classical scar compared with none after a low-segment transverse scar (P = 0.0581).