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  • 1
    Digitale Medien
    Digitale Medien
    The mortality and morbidity associated with umbilical cord prolapse (1995)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Objective To examine the management of cord prolapse and its morbidity and mortality.Design Retrospective study of consecutive babies born after cord prolapse, identified using the Oxford Obstetric Data System, and those with registered handicap, identified by the Oxford Region Register of Early Childhood Impairments.Setting District maternity hospital managing more than 6000 deliveries annually.Subjects One hundred and thirty–two babies born after the identification of cord prolapse in the John Radcliffe Hospital between January 1984 and December 1992.Main outcome measures Survival rates, condition at birth assessed by Apgar scores at 1 and 5 minutes and blood gas values on cord blood samples, and incidence of major handicap at three years of age.Results The incidence of cord prolapse was 1 in 426 total births. There were six stillbirths and six neonatal deaths. One baby died as a result of birth asphyxia. The uncorrected perinatal mortality rate was 91 per 1000. Of 120 survivors, only one baby was known to suffer a major neurological handicap. Electronic cardiotocographs aided the diagnosis of cord prolapse in 41 % of cases. Apgar scores were better with a shorter diagnosis to delivery interval, but cord gas results did not correlate well with Apgar scores or the diagnosis to delivery interval.Conclusions Cord prolapse occurs with a relatively stable incidence in this population irrespective of changes in obstetric practices. Despite the high incidence of ominous cardiotocographs, low Apgar scores and acidaemia on blood gas analysis, the fetal outcome is not as poor as might be expected and mortality is predominantly attributable to congenital anomalies and prematurity rather than birth asphyxia.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1995.tb10850.x
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  • 2
    Digitale Medien
    Digitale Medien
    The effect of pH on release of PGE2 from vaginal and endocervical preparations for induction of labour (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15286.x
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  • 3
    Digitale Medien
    Digitale Medien
    Anti-D concentrations in fetal and maternal serum and amniotic fluid in rhesus allo-immunised pregnancies (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Objective To investigate the relation between anti-D concentrations in maternal serum, fetal serum and amniotic fluid, and the development of fetal anaemia.Design Observational cross sectional and longitudinal study.Setting Regional referral centre.Subjects Sixty-one women undergoing fetal blood sampling at 19 to 36 weeks' gestation for fetal blood and haematocrit estimation for the management of Rh (D) allo-immunisation. Thirty-eight pregnancies (7 with an Rh (D) negative fetus) were tested only once but the rest had two to five fetal blood samplings.Interventions Ultrasound guided fetal blood sampling and amniocentesis, and automated analysis of anti-D antibody quantitation.Results There were strong correlations between maternal serum, fetal serum and amniotic fluid anti-D concentrations. Analyses of both longitudinal and cross sectional data demonstrated a decrease of the maternal/fetal serum anti-D ratio with gestation. In pregnancies with Rh (D) negative fetuses the maternal/fetal anti-D ratio was significantly lower (P〈0.0001) than in those with Rh (D) positive fetuses. The degree of fetal anaemia (delta haematocrit) was correlated with maternal serum and amniotic fluid anti-D concentrations (r=−0.55, n= 54, P〈0.0001; r=−0.57, n= 44, P〈0.0001, respectively) but there was a weaker correlation with fetal serum anti-D (r= 0.37, n= 54, P〈0.01).Conclusion Anti-D concentrations in maternal serum, fetal serum and amniotic fluid are correlated with fetal anaemia. The decrease in maternal/fetal anti-D ratio with gestation suggests an increase in placental permeability for anti-D with advancing pregnancy.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15108.x
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  • 4
    Digitale Medien
    Digitale Medien
    Discrepancy between curettage and hysterectomy histology in patients with stage l uterine malignancy (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. Histology reports of endometrial curettage and hysterectomy specimens were compared in patients with stage l uterine malignancy. In 63 of 117 (54%) the tumour grade or type reported in the curettage specimen differed from that described in the hysterectomy specimen; the grading was as likely to be more as less well differentiated at hysterectomy. The differences were not related to endometrial sampling technique or pre-operative intracavity radiotherapy. The results suggest that if decisions about patient management continue to be based on histological grading of tumours in endometrial curettage samples, unnecessary morbidity will be caused to some patients and inadequate treatment will be given to others.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb02427.x
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  • 5
    Digitale Medien
    Digitale Medien
    Tocolysis during cervical ripening with vaginal PGE2 (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. Forty-two primigravidae with unripe cervices (modified Bishop score ≤5) were pretreated with 8 mg of oral salbutamol 30 min before vaginal administration of 5 mg of PGE2. The proportion of patients in established labour after treatment (19%) was markedly less than results reported previously and cervical improvement occurred in 86% of the non-labouring patients. The improved outcome of labour associated with the prior administration of PGE2 when the cervix is unripe, including reduced induction-to-delivery intervals and higher rates of vaginal delivery was maintained. Apart from some minor side-effects, there were no adverse effects noted as a direct consequence of the tocolytic; blood loss was not increased, although one patient suffered an intrapartum abruption. This approach allows a greater control of induced uterine activity and timing of delivery which may be of particular importance in women with suspected placental insufficiency.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb01658.x
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  • 6
    Digitale Medien
    Digitale Medien
    2308 second trimester terminations using extra-amniotic or intra-amniotic prostaglandin E2: an analysis of efficacy and complications (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: A total of 2308 mid-trimester terminations using PGE2 extra-amniotically (1608) or intra-amniotically (700) has been analysed for efficacy and immediate and early morbidity. The mean induction-to-abortion intervals were similar for the two routes. Overall, 67% of the patients were in hospital for 1 night. Morbidity rates were similar for the two administration routes and were no higher than those reported for second trimester terminations using dilatation and evacuation. Minor side-effects of vomiting occurred in 1006 (44%) and diarrhoea in 320 (14%). Forty (1·7%) lost more than 500 ml of blood during termination and 13 (0·6%) were transfused. Major complications were extremely rare and genital tract trauma only occurred in 4 (0·17%) and proven pelvic infection in 2 (0·08%) patients. Thirty-three (1·4%) were readmitted and required a surgical evacuation of the uterus. Since long-term complications have been assessed for this method of termination and found to be infrequent, we see no reason to consider a change in methods for second trimester terminations.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb06307.x
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  • 7
    Digitale Medien
    Digitale Medien
    A 1-hour hCG radioimmunoassay detection kit for the management of suspected ectopic pregnancy (1984)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. The value of a rapid hCG kit was assessed in 60 patients undergoing laparoscopy or laparotomy for suspected ectopic pregnancy, of whom 30 were subsequently proven to be pregnant. A high degree of specificity (93%) and sensitivity (97%) was found, with one false-negative and three false-positive results. If the kit had been used as a routine on admission three patients would not have been inadvertently discharged before the diagnosis of tubal pregnancy and 27 could have avoided a laparoscopy to exclude tubal pregnancy.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1984.tb03677.x
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  • 8
    Digitale Medien
    Digitale Medien
    The physiological and clinical effects of progesterone inhibition with mifepristone (RU 486) in the second trimester (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. A double-blind placebo-controlled trial was performed in 20 primigravidae to assess the physiological and clinical effects of oral mifepristone on myometrial contractility and sensitivity in the second trimester. Ten women received 600 mg of oral mifepristone and 10 women a placebo 24 h before abortion was induced in both groups, with extra-amniotic PGE2 instillation. Intrauterine pressure recordings demonstrated increased spontaneous uterine activity and increased sensitivity to PGE2 and ergometrine, but no change in oxytocin sensitivity after mifepristone treatment. There were no significant differences in PGE or PGF metabolite concentrations in peripheral maternal plasma over the 24-h study period after treatment between the mifepristone and placebo groups. The mean induction abortion interval in the mifepristone group was 512 (SD 321) min compared with 1128 (SD 606) min in the placebo group (P≤0.02). The mechanism whereby mifepristone provokes enhanced uterine contractility and sensitivity to prostaglandins, with a reduction in abortion times, does not appear to be through endogenous production of PGE or PGF.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb02517.x
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  • 9
    Digitale Medien
    Digitale Medien
    The placental transfer of mifepristone (RU 486) during the second trimester and its influence upon maternal and fetal steroid concentrations (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. A double-blind, placebo-controlled study has assessed the maternal and fetal endocrine effects of the maternal administration of the anti-progestin mifepristone in mid-pregnancy. There were six women in each group. Four hours after oral administration of 600 mg mifepristone, the drug was detected in both maternal and fetal circulations and in the amniotic fluid. No significant changes in progesterone, cortisol, oestradiol, or aldosterone concentrations were detected in the maternal circulation after treatment with mifepristone or placebo. In women treated with mifepristone, the mean fetal aldosterone level was 1699 (SD 217) pmol/1 which was significantly higher than the mean level of 999 (SD 84) pmol/1 in the control group but no significant changes occurred in the fetal progesterone, oestradiol or cortisol concentrations. The significance of these results is discussed in relation to the possible therapeutic uses of mifepristone for inducing labour.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb01827.x
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  • 10
    Digitale Medien
    Digitale Medien
    A comparison of perinatal outcome, antenatal and intrapartum care between England and Wales, and France (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Objective To compare the national statistics of England and Wales with the national statistics of France, and see if there are significant differences in obstetric care resulting in a significantly different perinatal outcome.Design Retrospective analysis of national statistics 1970–1989 (latest available figures) relating to perinatal outcome, antenatal and intrapartum care.Setting HIPE and DoH statistics (England and Wales); INSERM statistics (France).Subjects Pregnant women residents of England and Wales, and of France.Interventions Different aspects of obstetric care for which comparable data were available from national statistics.Main outcome measures Perinatal mortality rate, incidence of low birth weight and preterm delivery; type of antenatal care, number of antenatal visits and in-patient admission rate; induction of labour rate, incidence of acceleration of labour with oxytocin, incidence of spontaneous and operative deliveries and person undertaking delivery; episiotomy rate and postnatal in-patient stay.Results More antenatal intervention and marginally less intrapartum intervention in England and Wales as compared with France. No significant difference in the perinatal mortality rate, in the incidence of low birth weight or preterm delivery, with similar trends being observed over the two decades.Conclusion Significant differences in obstetric practices between the two countries without a major difference in perinatal outcome.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb13696.x
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