British journal of obstetrics and gynaecology
-
Br J Obstet Gynaecol · Mar 1981
Randomized Controlled Trial Comparative Study Clinical TrialVaginal bleeding disturbances associated with the discontinuation of long-acting injectable contraceptives. From the World Health Organization Special Programme for Research, Development, and Research Training in Human Reproduction; Task Force on Long-acting Systemic Agents for the Regulation of Fertility.
A randomized comparative trial of 832 women receiving norethisterone oenanthate (NET-OEN) and 846 women receiving depot medroxyprogesterone acetate (DMPA) injections at 12 week intervals was conducted in 10 centers. The pregnancy rate with NET-OEN was significantly higher than with DMPA. ⋯ Bleeding for more than 30 days during an injection interval and complete amenorrhoea for a whole injection interval were jointly associated with 43.7% of all terminations among NET-OEN users and 64.5% of all terminations among DMPA users. In future efforts to improve the acceptability of long-acting injectable contraceptives, more attention should be given to the control of prolonged amenorrhoea and prolonged bleeding.
-
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.
-
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.
-
Of 10 479 single births in South Glamorgan between January 1974 and June 1976, 27.3 per cent of infants were born to women who had used oral contraception in the three months prior to their last menstrual period (users) and 72.3 per cent were born to women who had not used oral contraception during the same period (non users). There were significantly more infants with neural tube defects among users compared with non users. Abnormalities of the digestive, genito-urinary and cardiovascular system, bones, muscle, skin and connective tissues, endocrine glands, blood chromosomes and oral clefts, were of similar incidence in the two groups.
-
Br J Obstet Gynaecol · Jun 1980
Diazepam as an induction agent for caesarean section: a clinical and pharmacokinetic study of fetal drug exposure.
The transplacental passage and clinical effects of diazepam have been studied in 30 patients undergoing elective Caesarean section. General anaesthesia was induced with diazepam (20 mg) and maintained with nitrous oxide/oxygen. ⋯ The concentrations of diazepam in serial blood samples obtained from the mothers, the umbilical cord and the newborn infants demonstrated that the transplacental passage of the drug was rapid and there was evidence that the distribution of the drug between the mother and the fetus came close to equilibrium. There was no consistent relation between Apgar scores and the extent of the fetal exposure to diazepam.