British journal of obstetrics and gynaecology
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To determine the effect of labour on free oxygen radical activity in the fetus, as reflected by lipid peroxide levels in umbilical cord arterial blood. ⋯ The findings indicate that high levels of free oxygen radical activity in the fetus are a function of the labour process, as are changes in acid-base balance.
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Br J Obstet Gynaecol · Jul 1998
Randomized Controlled Trial Clinical TrialPuerperal thromboprophylaxis: comparison of the anti-Xa activity of enoxaparin and unfractionated heparin.
Low molecular weight heparins are used extensively for thromboprophylaxis. The aim of this study was to compare the activity of the low molecular weight heparin, enoxaparin, 20 mg and 40 mg, given once per day with unfractionated heparin, 7500iu given twice per day, in terms of their anti-Xa activity in puerperal women following caesarean section and with an additional risk factor for venous thromboembolism. Seventeen women were randomised to receive one of the three treatments. ⋯ The mean anti-Xa values of the groups receiving enoxaparin, 20 mg and 40 mg, were significantly higher than those of the group receiving unfractionated heparin. There was no difference between the two enoxaparin groups in terms of the anti-Xa activity profiles. This study suggests that the use of enoxaparin is superior to unfractionated heparin in terms of anti-Xa activity.
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Br J Obstet Gynaecol · Jul 1998
Comparative StudyPlanned vaginal delivery versus elective caesarean section: a study of 705 singleton term breech presentations.
To compare neonatal mortality and neonatal and maternal morbidity in planned vaginal delivery versus elective caesarean section for breech presentation at term. To identify factors associated with the risk of caesarean section during labour. ⋯ There is no firm evidence to recommend systematic elective caesarean section for breech presentation at term. Large unbiased studies are needed to determine whether a potential benefit for the newborns outweighs the increased risk for the mothers associated with elective caesarean section.
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Br J Obstet Gynaecol · Jul 1998
Expression of endothelin-1 in amniotic fluid embolism and possible pathophysiological mechanism.
Since endothelin is a potent vasoconstrictor and bronchoconstrictor, endothelin-1 expression in the lung was investigated using immunohistological techniques in two cases of amniotic fluid embolism. Intense expression of endothelin-1 was observed in amniotic squames while weaker staining was seen in alveolar epithelium, bronchiolar epithelium and intraalveolar macrophages and focally in vascular endothelium. Endothelin-1 may play a role in the early and transient haemodynamic alteration of pulmonary hypertension in amniotic fluid embolism.
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Br J Obstet Gynaecol · May 1998
Optimising maternal-fetal outcomes in preterm labour: a decision analysis.
To compare, using decision analytic techniques, maternal and fetal risk and benefits of three strategies for the management of preterm labour after 32 weeks. These strategies are empiric tocolysis, no tocolysis, or amniocentesis for fetal maturity testing. ⋯ This analysis supports the empiric use of tocolytics at 32 weeks. At 34 weeks, either tocolysis or no tocolysis appear to be reasonable alternatives. At 36 weeks no tocolysis is probably preferred. This analysis also suggests that amniocentesis should not be employed in the management of preterm labour at these gestational ages.