British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Sep 1986
Does 24-hour supervisory staff coverage in the labour and delivery area change the emergency caesarean section rate?
The influence on the emergency caesarean section rate of 24-h supervisory staff coverage in the labour and delivery area was investigated. In period I (1978-1979), the supervisory staff were inside the hospital from 07.01 to 17.00 hours, and on call at home from 17.01 to 07.00 hours of the next day, and in period II (1980-1981), the supervisory staff were inside the hospital 24 h a day. ⋯ The rate for maternal complications also increased in the 17.01-24.00 hours shift and decreased in the 07.01-17.00 hours shift during period II. However, the overall emergency caesarean section rate did not change between the two periods.
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Br J Obstet Gynaecol · Sep 1986
Maternal stress response associated with caesarean delivery under general and epidural anaesthesia.
The maternal stress response to caesarean delivery with either general or epidural anaesthesia was investigated. Patients given a general anaesthetic showed statistically significant increases in blood pressure, heart rate, and levels of plasma catecholamines, cortisol and glucose. Epidural anaesthesia, to at least the T6 dermatome, obtunded these responses. The significance of these findings to the choice of method of anaesthesia is discussed.
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Br J Obstet Gynaecol · Jun 1986
Case ReportsActive management of the unconscious eclamptic patient.
Of the many complications which may develop after eclamptic seizures, prolonged unconsciousness is one of the most difficult for obstetricians to manage as the pathophysiology of this condition remains largely unknown. Computed axial tomography (CT scan) was performed on 20 unconscious eclamptic patients, and autopsy was obtained on an additional two patients. ⋯ A programme of intensive neurological management aimed at optimizing cerebral perfusion and controlling intracranial pressure is outlined. We have reduced the mortality rate for unconscious eclamptic patients from 50% to 17% in our institution.
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Br J Obstet Gynaecol · Jan 1986
Randomized Controlled Trial Clinical TrialBladder drainage for caesarean section under epidural analgesia.
Fifty patients undergoing elective caesarean section under epidural analgesia were randomized prospectively to be catheterized with an 'in-out' or an indwelling urethral catheter. Of the patients who had catheterization for the time of surgery alone 44% subsequently required recatheterization, whereas all patients with indwelling catheters voided spontaneously on their removal. The frequency of significant bacteriuria was the same in both groups.