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  • 1
    Electronic Resource
    Electronic Resource
    Planned abdominal compared with planned vaginal birth in triplet pregnancies (1995)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To compare a policy of planned abdominal delivery with a policy of planned vaginal delivery in triplet pregnancies.Design Retrospective study.Setting Two Dutch university hospitals, each having a different approach to the planned mode of delivery in triplet gestations.Subjects Thirty women giving birth to triplets in the hospital in Leiden, who favoured planned abdominal delivery, compared with 39 from the Medical Centre in Amsterdam who favoured vaginal delivery.Main outcome measures Perinatal mortality and early neonatal complications.Results Both centres were equally successful in achieving their planned policies: in Leiden 80% of women were delivered by caesarean section but in Amsterdam 87% of women were delivered vaginally. Compared with vaginal delivery, planned abdominal delivery was associated with a significantly hgher perinatal mortality rate (P= 0.02), primarily due to respiratory distress syndrome, and a higher recorded neonatal complication rate (P= 0.03), especially sepsis, respiratory distress syndrome, and necrotising enterocolitis.Conclusions A policy of planned abdominal delivery in triplets is not superior to a policy of planned vaginal delivery in terms of fetal and early neonatal outcome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1995.tb09134.x
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  • 2
    Electronic Resource
    Electronic Resource
    A loading model for ritodrine administration in preterm labour (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To develop a ritodrine infusion scheme for preterm labour that avoids plasma levels above those needed for tocolysis, requires only one rate adjustment, and is easy to apply in practice.Design Prospective study of tocolytic effect and plasma ritodrine concentrations during application of the infusion scheme.Setting High risk labour ward.Subjects Consecutive series of 31 women in labour at less than 36 weeks' gestation.Intervention Loading dose ritodrine infusion followed, as soon as tocolysis is reached, by a decrease in the infusion rate calculated on the basis of the interval between start of treatment and tocolysis.Results Overall, steady state ritodrine levels were nearly identical to those at the time of tocolysis and correlated well with levels anticipated on the basis of our calculation (n= 30; r= 0.91; P 〈0.001). Adjustments during steady state were made in 12 women (40%), but in only two of them within 12 h after tocolysis had been reached. Delivery was postponed for more than 48 h in 29 women (93.5%) and beyond 37 weeks' gestation in 19 (61.3%).Conclusion The loading model is easy to apply, avoids relative overdoses, requires few adjustments, is well tolerated, uses smaller quantities of ritodrine, and results in lower plasma ritodrine concentrations than the conventional infusion scheme.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15174.x
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  • 3
    Electronic Resource
    Electronic Resource
    RELIABILITY OF ULTRASOUND AS COMPARED TO DIRECT FETAL ELECTROCARDIOGRAPHY FOR ANTEPARTUM CARDIOTOCOGRAPHY (1981)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Eighty-five pairs of simultaneously recorded external and internal cardiotocograms (CTGs) were coded and evaluated with a ten-point scoring system routinely used for the assessment of antepartum CTG. The highest consistency in interpretation between the external ultrasound and the internal fetal scalp CTG was found for basal heart rate followed by decelerations. Oscillatory amplitude and frequency were interpreted differently in 14 per cent of CTGs and accelerations in 16 per cent. When differences in interpretation arose, there was certainly no tendency for the external CTG to present an optimistic image of the fetal heart rate variables. With the exception of oscillatory amplitude all variables, including oscillatory frequency and the total CTG score, were more frequently underestimated than overestimated on external CTGs. When accelerations were present on only one recording, there was an 85 per cent chance for these to be absent on the external CTG. The study abolishes fears that the routine clinical assessment of antepartum CTGs of adequate technical quality provides overrated and more optimistic data than would be achieved by direct fetal scalp monitoring.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1981.tb01002.x
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  • 4
    Electronic Resource
    Electronic Resource
    CONCENTRATIONS OF THE PROSTACYCLIN METABOLITE, 6–KETO–PROSTAGLANDIN F1α, IN AMNIOTIC FLUID DURING LATE PREGNANCY AND LABOUR. (1979)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 86 (1979), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Concentrations of 6–keto–prostaglandin F1α (6–keto–PGF1α, the stable metabolite of prostacyclin, PGI2) have been measured in amniotic fluid obtained during late pregnancy and labour. Samples taken at amniotomy during spontaneous labour contained a significantly greater concentration of 6–keto–PGF1α than samples taken at amniotomy before the onset of labour (p 〈0.01). There was no correlation between the level of 6–keto–PGF1α, in amniotic fluid before labour and gestational age (p 〉 0 1). It is suggested that prostacyclin may have a functional role in the mechanism of parturition in man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1979.tb10609.x
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  • 5
    Electronic Resource
    Electronic Resource
    NONSPECIFIC DECELERATIONS IN FETAL HEART RATE DURING HIGH-RISK PREGNANCY (1977)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 84 (1977), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Solitary nonspecific decelerations in fetal heart rate occurring in three patients during antepartum cardiotocography are described. The decelerations were nonspecific in that they were neither variable nor late nor associated with maternal hypotension. All occurred in pregnancies complicated by hypertension and placental insufficiency. In the three patients described, the fetus lived for at least three days after the first nonspecific deceleration was observed. Although solitary nonspecific decelerations may indicate danger to the fetus from placental insufficiency, these decelerations should not be considered as an indication for immediate delivery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1977.tb12481.x
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  • 6
    Electronic Resource
    Electronic Resource
    CHANGES IN PROSTAGLANDIN F AND 13,14-DIHYDRO-15-KETO-PROSTAGLANDIN F CONCENTRATIONS IN AMNIOTIC FLUID AT THE ONSET OF AND DURING LABOUR (1977)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 84 (1977), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Concentrations of prostaglandin F (PGF) and its major circulating metabolite 13,14-dihydro-15-keto-PGF (PGFM) have been measured in amniotic fluid during spontaneous labour at term. Levels of both PGF and PGFM were significantly higher during early spontaneous labour, at a cervical dilatation of less than 4 cm, than before the onset of labour. Patients who started labour spontaneously but later required oxytocin therapy for failure to progress in first stage had lower levels of PGF and PGFM than patients who progressed adequately without oxytocin therapy. During spontaneous labour, concentrations of both PGF and PGFM increased significantly with advancing cervical dilatation.These data indicate that the accumulation of prostaglandins in amniotic fluid during labour is not due to decreased metabolism. They furthermore provide the strongest evidence available so far for an increase in intrauterine prostaglandin synthesis during human parturition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1977.tb12484.x
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  • 7
    Electronic Resource
    Electronic Resource
    Distribution of prostaglandin endoperoxide synthase and prostacyclin synthase in the late pregnant uterus (1986)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 93 (1986), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Prostacyclin (PGI2) synthase and prostaglandin endoperoxide synthase (cyclo-oxygenase; PGH synthase) were measured with specific immunoradiometric assays in myometrial microsomes from different areas of a primigravid uterus at 34 weeks gestation. PGH synthase concentrations increased significantly from fundus toward lower segment (P 〈0·005), but that trend did not apply to PGI2 synthase concentrations, which were significantly higher on the placental than on the non-placental side of the uterus (P 〈0·005). PGI2 synthase concentrations showed no further increase with increasing proximity to the placental bed. In myometrium underneath the placental bed there was an inverse relation between the PGH and PGI2 synthase concentrations (r=0·86; P 〈0·0l) which did not apply to other regions of the uterus. The data suggest that local rather than general mechanisms control uterine PGH and PGI2 synthase concentrations, and that uterine prostaglandin and PGI2 production strongly depend on anatomical relations that have been neglected in previous studies on uterine prostaglandin biosynthesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1986.tb07903.x
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  • 8
    Electronic Resource
    Electronic Resource
    A survey of tocolytic drug treatment in preterm labour (1984)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a questionnaire survey among 1004 qualified and trainee obstetricians in The Netherlands and northern Belgium (Flanders) to which 521 (52%) replied, only one claimed never to use tocolytic drugs in preterm labour. At 32 weeks gestation drug treatment would be used by 88% if the cervix was 4 cm and by 97% if it was 2 cm dilated. At 4 cm dilatation Dutch obstetricians refrained from treatment significantly more often than Belgian obstetricians, but there was no such difference at 2 cm dilatation, nor was there a difference between university and other hospitals or between trainee and specialist obstetricians. Belgian respondents relied more heavily on prostaglandin synthesis inhibitors than Dutch respondents, but most used betamimetic drugs, virtually always (98%) by intravenous infusion. No one used ethanol or sedatives. Ritodrine (62%) and fenoterol (31%) were the main choices. Orciprenaline was used only in The Netherlands (4%), isoxsuprine only by non-academic obstetricians in both countries (3%) and no one claimed to use salbutamol, isoprenaline or terbutaline.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1984.tb04778.x
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  • 9
    Electronic Resource
    Electronic Resource
    Betamimetic drugs in the prophylaxis of preterm labour: extent and rationale of their use (1984)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A questionnaire survey among 1004 specialist and trainee obstetricians in The Netherlands and northern Belgium (Flanders), revealed that 45% of the 521 (52%) respondents would use prophylactic betamimetics to prevent preterm labour. A further 33% would only use them as maintenance therapy after an acute episode of preterm labour. Only 22% would use neither form of prophylaxis, 23% would not prescribe oral betamimetics for out-patients, and a mere 12% would use neither prophylaxis nor out-patient treatment. Nevertheless, only 4% of those using betamimetics either prophylactically or as maintenance therapy said that they were very effective. The data indicate that a large body of obstetricians will resort to dubious treatments with poor effectiveness and unknown risks in an attempt to avoid the known risks of a condition for which aetiological insight and effective therapy are lacking.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1984.tb04779.x
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  • 10
    Electronic Resource
    Electronic Resource
    CLINICAL SIGNIFICANCE OF SUSPICIOUS ANTEPARTUM CARDIOTOCOGRAMS: A STUDY OF NORMAL AND HIGH-RISK PREGNANCIES (1981)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Analysis of 594 antepartum cardiotocograms (CTGs) from 91 strictly normal pregnancies and of 2770 CTGs from 405 high-risk pregnancies showed a sus-picious pattern in 7·2 and 17·4 percent respectively. Careful analysis of these CTGs shows that they cannot be considered as either normal or abnormal, whereas their value for predicting the outcome of pregnancy is too limited to be of a direct clinical significance. Although their characteristics vary little between normal and high-risk pregnancy, their recurrence rate is much higher in high-risk pregnancy. During high-risk pregnancy this pattern was obtained on at least two consecutive recordings in 13·3 per cent and on at least three consecutive recordings in 6·2 per cent of patients, as compared to respectively 3·3 and 1·1 per cent during normal pregnancy. Although a single or even repeat occurrence of a suspicious CTG does not justify intervention during pregnancy, our study shows that an adequate follow-up of repeat CTGs will usually be able to distinguish pregnancies that are in need of intervention from those that are not.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1981.tb01276.x
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