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  • 1
    Electronic Resource
    Electronic Resource
    A comparison of antenatal outcome, antenatal and intrapartum care between England and Wales and France (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15162.x
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  • 2
    Electronic Resource
    Electronic Resource
    The use of ultrasound examinations, intrapartum fetal heart rate monitoring and beta-mimetic drugs in France (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. We conducted a survey of French obstetricians to document their attitudes towards routine ultrasound, intrapartum fetal monitoring and beta-mimetics in 1987. A questionnaire was sent to 582 obstetricians or gynaecologists who were members of two French medical associations. The response rate was 85%. Of the respondents 92% prescribed two or three routine ultrasound examinations: only one doctor did not use electronic fetal monitoring and 99% of the respondents prescribed beta-mimetics to prevent preterm delivery. Some obstetricians reported a decrease in their use of ultrasound and more dramatically in the use of beta-mimetics. Side-effects were reported to be the major reason for the change in beta-mimetic use. Obstetricians who read English language journals were more likely to have reduced their use of ultrasound and beta-mimetics than those who read only French language journals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb01575.x
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  • 3
    Electronic Resource
    Electronic Resource
    Home visits for pregnancy complications and management of antenatal care: an overview of three randomized controlled trials (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units.Design A meta-analysis of three randomized controlled trials. Setting 9 maternity units in France.Subjects 1410 women with pregnancy complications.Intervention 1 or 2 home visits a week by a midwife.Main outcome measures Admission rate and length of stay in hospital.Results The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7–1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups.Conclusions The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb13723.x
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  • 4
    Electronic Resource
    Electronic Resource
    Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertension in pregnancy: a randomized controlled trial (1988)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 95 (1988), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Labetalol was compared with methyldopa in a randomized controlled trial involving 176 pregnant women with mild to moderate hypertension. Diastolic blood pressure below 86 mmHg was obtained in a similar proportion of women given labetalol or methyldopa. Intrauterine death occurred in four women treated with methyldopa, and the one neonatal death on day 1 occurred in the labetalol group. The average birthweight and the proportion of preterm or small-for-gestational-age babies were similar in both groups. Heart rate, blood pressure, blood glucose, respiratory rate, and Silverman score of the babies did not differ between the two treatment groups, whether the comparison was made for all the infants, or only for those that were preterm or small-for-gestational-age. These data indicate that maternal betablockade with labetalol is as safe as methyldopa for the fetus and the newborn.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1988.tb06571.x
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  • 5
    Electronic Resource
    Electronic Resource
    Mode of delivery and severe stress incontinence. A cross-sectional study among 2625 perimenopausal women (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  To estimate the prevalence of severe stress urinary incontinence (SUI) among perimenopausal women and to examine potential obstetric risk factors.Design  Mail survey of female volunteers for epidemiological research.Setting  Postal questionnaire on SUI.Population  Three thousand one hundred and fourteen women aged 49–61 years who comprised the GAZEL cohort.Methods  Logistic regression using data from the entire cohort to estimate the impact of risk factors. A second logistic regression using data from women who had given birth included obstetric history.Main outcome measure  Prevalence of severe SUI defined by the response ‘often’ or ‘all the time’ to the question ‘Does urine leak when you are physically active, cough or sneeze?’Results  Two thousand six hundred and twenty-five women (85%) completed and returned the questionnaire The frequency of SUI reported in the preceding four weeks was as follows: ‘never’ 32%, ‘occasionally’ 28%, ‘sometimes’ 26%, ‘often’ 10% and ‘all the time’ 5%. Prevalence of severe SUI was lowest among nulliparous women (7%), but it was similar among parous women regardless of birth number (14–17%). The prevalence of severe SUI was not associated with mode of delivery (14% for women delivered by caesarean only vs 16% for vaginal births). Significant risk factors for severe SUI were high body mass index (BMI 〉30), diabetes mellitus, previous incontinence surgery, parity and first delivery under the age of 22 years.Conclusion  Previous pregnancy itself is a risk factor for severe SUI among women who reach the age of 50. In this age group the impact of the mode of delivery (spontaneous, forceps or caesarean) on severe SUI is slight.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00763.x
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  • 6
    Electronic Resource
    Electronic Resource
    Aspirin (100 mg) used for prevention of pre-eclampsia in nulliparous women: the Essai Régional Aspirine Mère–Enfant study (Part 1) (2003)
    Oxford, UK : Blackwell Science Ltd
    BJOG 110 (2003), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To reduce the incidence of pre-eclampsia in nulliparous women, in accordance with the suggestion of a recent meta-analysis that low dose aspirin might decrease this incidence by more than half if used early enough in and at a sufficient dose during pregnancy (more than 75 mg).Design Multicentre randomised double-blinded placebo-controlled trial.Setting Twenty eight centres in Northern of France and one in Belgium.Population Three thousand and two hundred ninety-four nulliparous women recruited between 14 and 20 weeks.Methods Randomisation to either 100 mg aspirin or placebo daily from inclusion through 34 weeks.Main outcome measures Preeclampsia was defined as hypertension (≥140 and or 90 mmHg) associated with proteinuria (≥0.5 g/L).Results The aspirin (n= 1644) and placebo (n= 1650) groups did not differ significantly in the mothers' incidence of pre-eclampsia (28 of 1632 [1.7%] vs 26 of 1637 [1.6%]; relative risk, RR, 1.08, 95% CI 0.64–1.83), hypertension, HELLP syndrome or placental abruption, or in the children's incidence of perinatal deaths or birthweight below the 10th centile. The incidence of babies with birthweight below the third centile was significantly higher in the aspirin group, with no explanation. The incidence of maternal side effects was higher in the aspirin group, principally because of a significantly higher rate of haemorrhage.Conclusions Aspirin at a dose of 100 mg does not reduce the incidence of pre-eclampsia in nulliparous women. Aspirin (100 mg) is associated with an increase in bleeding complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1471-0528.2003.02096.x
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  • 7
    Electronic Resource
    Electronic Resource
    Algorithms for combining menstrual and ultrasound estimates of gestational age: consequences for rates of preterm and postterm birth (2002)
    Oxford, UK : Blackwell Science Ltd
    BJOG 109 (2002), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We compared rates of preterm and postterm birth according to six algorithms for gestational age (GA) estimates based on last menstrual period (LMP) and early ultrasound (EUS): LMP alone, LMP if the discrepancy between the two estimates was within 14 days and otherwise EUS (14-day rule), a 10-day rule, a seven-day rule, a three-day rule and EUS alone. In a sample of 44,623 births in a Canadian tertiary hospital, the choice of algorithms makes a substantial impact on both preterm and postterm birth rates, even when EUS was used for discrepancies over two weeks.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2002.01068.x
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  • 8
    Electronic Resource
    Electronic Resource
    Very and moderate preterm births: are the risk factors different? (1999)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 106 (1999), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To describe the risk factors for very pretenn births and to compare the strengths of the associations between these risk factors and very and moderate preterm births.Design A case-control study.Setting Fifteen European countries.Methods Between 1994 and 1997, 1675 very preterm births, 3652 moderate preterm births and an unmatched control group of 7965 births at term were included. Odds ratios for very and moderate preterm births (related to socioeconomic status, behavioural factors, maternal age, body mass index and obstetric history) were estimated and compared using polytomous logistic regression.Results Underprivileged social situation, older maternal age and adverse previous pregnancy outcomes were significantly related to very and moderate preterm births. However, these factors were more strongly associated with very preterm births than with moderate preterm births, for both spontaneous and induced deliveries. Smoking during pregnancy, young maternal age and low body mass index were significantly related to very and moderate spontaneous preterm births, but no significant difference in odds ratios was observed between the two outcomes.Conclusion These results suggest that risk factors for very and moderate preterm births are similar, but the strength of the associations differ, especially for social factors and obstetric history.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1999.tb08142.x
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  • 9
    Electronic Resource
    Electronic Resource
    Effects of early augmentation of labour with amniotomy and oxytocin in nulliparous women: a meta-analysis (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives To estimate the effects among nulliparae of early augmentation with amniotomy and oxytocin on caesarean delivery, and on other indicators of maternal and neonatal morbidity including transfusion, Apgar score 〈 7 at 5 minutes, and admission to the special care nursery.Design Meta-analysis.Methods Published studies were identified through manual and computerised searches. Two unpublished studies were identified through direct communication with the investigators. Twelve trials were identified which compared a policy of early labour augmentation including amniotomy followed by oxytocin with a less active form of management. Two methodologically unacceptable studies were excluded. Studies were grouped according to whether they admitted only women with abnormal progress (therapy trials: n= 3) or accepted women with normal labour (prevention trials: n= 7).Results Unstratified analysis did not provide support for the hypothesis that early augmentation reduces the risk of caesarean section (typical odds ratio [OR] 0.9; 95% CI 0.7–1.1). The typical odds ratio for prevention trials was similar to that obtained in the unstratified analysis (typical OR 0.9, 95% CI 0.7–1.2). Although only a small number of women have been randomised in therapy trials, a trend toward a reduction in the rate of caesarean section with early intervention was seen in this group (typical OR 0.6,95% CI 0.2–1.4).Conclusions Early augmentation does not appear to provide benefit over a more conservative form of management in the context of care of nulliparous women with mild delays in the progress of labour. In the context of established delay in labour, an active policy of augmentation may reduce the risk of caesarean section. However, only three small trials have been performed in this context, and they do not have adequate power to allow firm conclusions to be drawn.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb10051.x
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  • 10
    Electronic Resource
    Electronic Resource
    Determinants and consequences of discrepancies in menstrual and ultrasonographic gestational age estimates (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives  To assess the association between maternal and fetal characteristics and discrepancy between last normal menstrual period and early (〈20 weeks) ultrasound-based gestational age and the association between discrepancies and pregnancy outcomes.Design  Hospital-based cohort study.Setting  Montreal, Canada.Sample  A total of 46,514 women with both menstrual- and early ultrasound-based gestational age estimates.Main outcome measures  Positive (last normal menstrual period 〉 early ultrasound, i.e. menstrual-based gestational age is higher than early ultrasound-based gestational age, so that the expected date of delivery is earlier with the menstrual-based gestational age) discrepancies ≥+7 days, mean birthweight, low birthweight, stillbirth and in-hospital neonatal death.Results  Multiparous mothers and those with diabetes, small stature or high pre-pregnancy body mass index were more likely to have positive discrepancies. The proportion of women with discrepancies ≥+7 days was significantly higher among chromosomally malformed and female fetuses. The mean birthweight declined with increasingly positive differences. The risk of low birthweight was significantly higher for positive differences. Associations with fetal growth measures were more plausible with early ultrasound estimates.Conclusions  Although most discrepancies between last normal menstrual period- and early ultrasound-based gestational age are attributable to errors in menstrual dating, our results suggest that some positive differences reflect early growth restriction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2004.00311.x
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