Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Seventeen in-patients with pregnancy-induced hypertension (PIH) in the last trimester of pregnancy underwent an exercise stress test. The mean exercise intensity achieved was 66% (55-77%) of submaximal exercise. The mean maternal heart rate rose significantly from a mean of 89 beats per minute (64-110 bpm) to a mean of 144 bpm (120-168 bpm) after exercise. ⋯ Subsequently it rose significantly to peak at 20 minutes of recovery. No evidence of ill effect from the exercise test was noted on any of the mothers or their fetuses. All pregnancies resulted in a good outcome.
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The 'Murphy's Law' concept that doctors have a higher incidence of adverse pregnancy outcome is often quoted anecdotally but has never been scientifically tested. A group of medical doctors (n =52) were prospectively matched closely with a group of non-doctors (n =52) and pregnancy outcome was recorded. ⋯ Whilst a much larger number of doctors is probably required to show a statistically significant difference, this first small study shows no clinically relevant difference between the two groups. The perception of Murphy's Law and the pregnant medical doctor would appear to be a myth.
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At a time when there is much criticism of increasing caesarean section rates, as well as an increased emphasis on involving the patient in decisions regarding her care, we decided to assess the effect of maternal request on the elective caesarean section rate. The study was a prospective patient interview and case note review, set at a District General Hospital in Watford, Hertfordshire over a 1-year period. ⋯ Of the elective procedures (18.2% of the total number of operations), 38% were performed because of maternal request. We conclude that maternal request is a significant factor in the rise in caesarean section rate.
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We analysed retrospectively the link between the incidence of epidural analgesia and the frequency distribution of instrumental delivery, caesarean section, labour induction and parity in a selected group of women with a low risk labour profile in all (85) obstetric units in Flanders (Northern Belgium). A group of 104 932 women with presumed low risk labour profile was subjected to analysis. ⋯ The incidence of instrumental delivery in a given unit was greatly influenced by the rate of epidural analgesia and labour induction for convenience (P < 0.001). However, the incidence of caesarean section in a given unit was not determined by either the rates of epidural, labour induction, attempted instrumental delivery or the size of the unit.