BJOG : an international journal of obstetrics and gynaecology
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Randomized Controlled Trial
Oxytocin-ergometrine co-administration does not reduce blood loss at caesarean delivery for labour arrest.
To determine if intravenous infusion of a combination of oxytocin and ergometrine maleate is better than oxytocin alone to decrease blood loss at caesarean delivery for labour arrest. ⋯ In women undergoing caesarean delivery for labour arrest, the co-administration of ergometrine with oxytocin does not reduce intraoperative blood loss, despite apparently superior uterine contraction.
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Randomized Controlled Trial Comparative Study
Comparison of self-administered vaginal misoprostol versus placebo for cervical ripening prior to operative hysteroscopy using a sequential trial design.
To compare the impact of 1000 micrograms of self-administered vaginal misoprostol versus self-administered vaginal placebo at home on preoperative cervical ripening in both premenopausal and postmenopausal women before operative hysteroscopy. ⋯ One thousand micrograms of self-administered vaginal misoprostol 12 hours prior to operative hysteroscopy has a significant cervical ripening effect compared with placebo in premenopausal but not in postmenopausal women. Self-administered vaginal misoprostol of 1000 micrograms at home the evening before operative hysteroscopy is safe and highly acceptable, although a small proportion of women experienced severe lower abdominal pain. There is a risk of lower abdominal pain and light preoperative bleeding with this regimen, which is very cheap and easy to use.
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To assess the nature and outcome of intrapartum referrals from primary to secondary care within the Dutch obstetric system. ⋯ Risk selection is a crucial element of the Dutch obstetric system and continues into the postpartum period. The system results in a relatively small percentage of intrapartum urgent referrals and in overall satisfactory neonatal outcomes in deliveries led by primary level midwives.
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Maternal and paternal psychological distress influence children's development and health beyond the perinatal period. The aim of our study was to describe psychological health during a 5-year period in parents of preschool children. Secondarily, we wanted to explore differences between mothers and fathers and identify predictors for increased psychological distress in parents. ⋯ Fathers reported significantly lower frequency of clinically important psychological distress and more stable scores than mothers throughout the period. The results indicate that selected psychometric screening may be warranted for parents with known psychosocial risk factors.