BJOG : an international journal of obstetrics and gynaecology
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Comparative Study
What are the implications for the next delivery in primigravidae who have an elective caesarean section for breech presentation?
To determine the mode of the next delivery for primigravid women who have an elective caesarean section for breech presentation. ⋯ Women who have an elective caesarean section for a breech presentation in their first pregnancy have about a 1 in 10 chance of having an elective caesarean section for a breech presentation in their second pregnancy. Overall, the incidence of repeat caesarean section for their second baby was 43.8%, and of those allowed to labour, 84% achieved a vaginal delivery. These results compared favourably with women who had an elective caesarean section with a cephalic presentation in their first pregnancy. This information is important in advising primigravid women with a breech presentation about longer term implications of elective caesarean section. It also allows healthcare managers to anticipate the resource implications of any changes in clinical practice for women with a breech presentation in their first pregnancy.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomised controlled trial of the closure or non-closure of peritoneum at caesarean section: effect on post-operative pain.
To compare the analgesic requirement in the post-operative period after closure or non-closure of the peritoneum at the caesarean delivery with a standardised anaesthetic and surgical technique. ⋯ Non-closure of both visceral and parietal peritoneum at the caesarean section produces a significant reduction in the post-operative use of patient controlled analgesia pump morphine and significantly higher patient satisfaction at 24 hours post-operatively.
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To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish. ⋯ Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.
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Randomized Controlled Trial Clinical Trial
Acupuncture treatment during labour--a randomised controlled trial.
To investigate acupuncture treatment during labour with regard to pain intensity, degree of relaxation and outcome of the delivery. ⋯ The results suggest that acupuncture could be a good alternative or complement to those parturients who seek an alternative to pharmacological analgesia in childbirth. Further trials with a larger number of patients are required to clarify if the main effect of acupuncture during labour is analgesic or relaxing.
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Multicenter Study
Combined ultrasound and biochemical screening for Down's syndrome in the first trimester: a Scottish multicentre study.
To evaluate the use of ultrasound measurements of fetal nuchal translucency (NT) obtained in a routine antenatal clinic setting in combination with appropriate biochemical markers as a first trimester screening test for Down's Syndrome. ⋯ NT in combination with appropriate serum markers has the potential to detect over 80% of Down's Syndrome fetuses in early pregnancy. However, NT measurement is highly operator-dependent. It requires training, external quality control and adequate time to allow accurate measurement, otherwise suboptimal performance will result.