British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · May 1977
Randomized Controlled Trial Clinical TrialEffect of bromocriptine on the premenstrual syndrome. A double-blind clinical trial.
Twenty-one patients suffering from the premenstrual syndrome were each studied during three menstrual cycles. After a control cycle, bromocriptine and placebo were given during the luteal phase of the cycle in a random double-blind cross-over manner, each patient serving as her own control. ⋯ Serum progesterone and oestradiol-17-beta were within normal ranges, and did not change during treatment. Medication considerably improved all the premenstrual symptoms, but mastodynia was the only one where bromocriptine was significantly better than the placebo.
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The fetal heart rate was monitored during 30 deliveries by Caesarean section. General anaesthesia, but not epidural analgesia, caused a loss of beat-to-beat variation, but appeared to have no other adverse effects on fetal heart rate. The loss of beat-to-beat variation occurred after intravenous thiopentone and was most marked when atropine was used as premedication.
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Tubal ligation under epidural analgesia in the early puerperium (within 10 hours of delivery) was attempted in 51 patients who had an epidural block established during labour. The results are described. No major difficulties were encountered.
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Br J Obstet Gynaecol · Aug 1976
Comparative StudyA comparison of the effect of extradural and parenteral analgesia on maternal plasma cortisol concentrations during labour and the puerperium.
Maternal plasma levels of cortisol were measured serially by radioimmunoassay in two groups of 12 patients during induced labour and in the puerperium. One group was given continuous extradural analgesia throughout labour, the other group received pethidine and promazine in response to pain. ⋯ This study suggests that patients who had chosen to have extradural analgesia may have been more anxious before labour than the other patients but continuous, extradural analgesia suppressed to some extent the percentage increase in mean cortisol levels found during labour in patients given parenteral analgesia. In the puerperium, there was no difference in mean cortisol levels in the two groups.
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As part of a continuing major prospective survey, the outcome of 5530 pregnancies in former oral contraceptive (pill) users was compared with the outcome of 11 009 pregnancies in the control series of women who had never used the pill. In former pill users there was a significantly higher induced abortion rate. There was no increase in the reported spontaneous abortion rate, and there is evidence to suggest that the true spontaneous abortion rate may be materially lower in former pill users. The previous use of oral contraceptives appeared to have no adverse effect on subsequent births.