The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Feb 2008
Practice GuidelineGuidelines for the use of recombinant activated factor VII in massive obstetric haemorrhage.
Recombinant activated factor VII (rFVIIa) is emerging as a novel therapy for the treatment of life or fertility-threatening post-partum haemorrhage (PPH) unresponsive to standard therapy that in some cases may prevent the need for peripartum hysterectomy. The level of evidence to date for use of rFVIIa in PPH is limited to case reports and case series with one nonrandomised study. No high-quality randomised controlled trials have been published at this stage, precluding a quality systematic review. ⋯ A multidisciplinary group of Australian and New Zealand clinicians from the fields of obstetrics, anaesthesia and haematology, who have both clinical experience in and/or knowledge of rFVIIa was convened by the manufacturer. This group produced an opinion and guideline based on their experience and the published international literature on the use of rFVIIa. This is intended to be used as a guideline and algorithm for the use of rFVIIa, though any use should be tailored to local practice and resources.
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Aust N Z J Obstet Gynaecol · Dec 2007
Fetal growth restriction and other risk factors for stillbirth in a New Zealand setting.
Stillbirth affects almost 1% of pregnant women in the Western world but is still not a research priority. ⋯ This study again emphasises the importance of suboptimal fetal growth as an important risk factor for stillbirth. Customised centiles identified more stillborn babies as SGA than population centiles especially preterm.
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Aust N Z J Obstet Gynaecol · Oct 2007
Randomized Controlled TrialDoes postoperative misoprostol use induce intestinal motility? A prospective randomised double-blind trial.
Misoprostol has been shown to increase colonic activity and decrease colonic transit time in chronic constipation patients. ⋯ Rectally administered misoprostol does not improve intestinal motility in the early postoperative period and thus, it is not effective in providing early oral food intake. On the contrary, it causes distention that requires additional analgesics and vomiting that naturally limits oral diet intake.
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Four days after an elective caesarean section, a patient went blind within a few hours, associated with a sudden rise in blood pressure. The blindness, initially thought to be caused by a cerebral infarct, was ultimately diagnosed as a result of posterior reversible leuco-encephalopathy syndrome. This rare syndrome is reviewed.