British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Apr 1980
The use of prostaglandin E1 analogue pessaries in patients having first trimester induced abortions.
A new prostaglandin analogue, 16,16-dimethyl=trans-delta 2-PGE1 methyl ester (16 me E1) was used for preoperative cervical dilatation in 23 pregnant women who had abortion induced for socio-economical reasons in the first trimester of pregnancy. A single vaginal pessary containing 1 mg 16 me E1 was inserted into the posterior fornix at 3-hour intervals. ⋯ Apart from mild gastrointestinal symptoms, no serious side effects were noted. It is concluded that the new prostaglandin analogue, 16 me E1, could be used safely and effectively for preoperative dilatation of the cervix before surgical abortion in early pregnancy.
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Br J Obstet Gynaecol · Aug 1979
The effects of maternally administered pethidine or epidural bupivacaine on the fetus and newborn.
The continuous fetal heart rate rate pattern, condition of the baby at birth and its subsequent behaviour were compared in three groups of infants whose mothers received during labour either no drugs, intramuscular pethidine or epidural bupivacaine. The blood levels of pethidine and bupivacaine were measured at delivery in a maternal vein, and umbilical artery and vein, and in the newborn during the first 48 hours of life. The only significant changes in the fetal heart rate pattern occurred in association with maternal hypotension or uterine hyperstimulation. ⋯ Neonatal behaviour during the first six weeks of life was not significantly affected by pethidine or epidural bupivacaine when compared with the control group. Pethidine and bupivacaine were shown to cross the placenta freely. The half-life of these drugs in the newborn was longer than in the adult.
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Br J Obstet Gynaecol · Jun 1979
Placental intervillous blood flow measured by inhaled 133Xe clearance in relation to induction of epidural analgesia.
A method of determining placental intervillous blood flow (IBF) using an inhaled 133Xe technique is described. The method was used to investigate the effect on IBF of epidural analgesia with an initial dose of 37.5 mg bupivacaine. There was no statistically significant reduction in IBF following the initial dose of bupivacaine in spite of a small but statistically significant reduction in mean blood pressure. There was no significant correlation between the change in mean blood pressure and the percentage change in IBF following epidural block although the single largest percentage reduction in IBF was associated with the largest fall in mean blood pressure.
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The labour, delivery and state of the newborn were compared retrospectively in a group of women who had labour induced and a group who started labour spontaneously. There were 200 women at term in each group, individually matched for age, parity and social class and with no medical or obstetric complications prior to labour. ⋯ The higher incidence of operative deliveries in the induced group was not fully explained by the excess of epidurals and fetal monitoring received. More of the babies born after an induced labour had endotracheal intubation during resuscitation.
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Br J Obstet Gynaecol · Jun 1977
Comparative Study Clinical Trial Controlled Clinical TrialTreatment of pregnancy sickness.
A double-blind comparison was undertaken between Debendox with 10mg of extra pyridoxine and placebo with 10mg of pyridoxine, in 56 women suffering from nausea and/or vomiting during the first 10 weeks of pregnancy. The results of treatment were assessed on the patient's own dialy records of:the time of nausea, the frequency of nausea, and the severity of nausea, retching and vomiting. There were statistically significant differences in favour of Debendox with extra pyridoxine in respect of the days of nausea all day (P les than 0-02), the severity of nausea (P less than 0-05) and the severity of retching (P less than 0.05).