British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Sep 1997
Randomized Controlled Trial Clinical TrialRandomised trial of one versus two doses of prostaglandin E2 for induction of labour: 2. Analysis of cost.
To compare the impact upon maternity unit resources and finances of two protocols for induction of labour using prostaglandins. ⋯ The increased drug costs providing two prostaglandin E2 doses when required were off-set by reductions in the costs of other intrapartum interventions for both nulliparae and multiparae. The advantages of less time spent on the antenatal ward for multiparae when two prostaglandin E2 doses were used may be eliminated if amniotomy and oxytocin infusion was commenced six hours after the initial prostaglandin dose had been given if labour had not started.
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The influence of the location of the sensor on reflectance pulse oximetry during fetal monitoring in labour was investigated using the newborn infant as a model. ⋯ Assuming that the arterial blood oxygen saturation did not change substantially, our findings indicate that in reflectance pulse oximetry there is no unique relation between R/IR and arterial oxygen saturation. The differences in reflectance pulse oximetry at the various sites are explained by differences in optical properties (scattering and absorption) of the tissue underneath the sensor. These will affect the red and infrared light reaching the detectors in a different way, and consequently R/IR changes. Because during intrapartum monitoring exact positioning of the sensor on the fetal head is usually impossible, the accuracy of fetal reflectance pulse oximetry is impaired.
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Br J Obstet Gynaecol · Jul 1997
Randomized Controlled Trial Clinical TrialRoutine oxytocin in the third stage of labour: a placebo controlled randomised trial.
To compare intravenous oxytocin administration (Partocon 10 IU) with saline solution in the management of postpartum haemorrhage in the third stage of labour. ⋯ Administration of intravenous oxytocin in the third stage of labour is associated with an approximately 22% reduction in mean blood loss, and approximately 40% reductions in frequencies of postpartum haemorrhage (> 500 mL or > 800 mL) and of postpartum haemoglobin < 10 g/dL. Identification of risk groups for oxytocin treatment does not seem worthwhile. Oxytocin is a cheap atoxic drug and should be given routinely after vaginal delivery.
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Br J Obstet Gynaecol · Jul 1997
Is conservative surgery for tubal pregnancy preferable to salpingectomy? An economic analysis.
The traditional treatment of ectopic pregnancy is salpingectomy, while conservative surgery aims to save the function of the uterine tube. This study compares the effectiveness and the economic costs of salpingectomy and conservative tubal surgery in women with a tubal pregnancy. ⋯ Salpingectomy is the treatment of choice in women not desiring future pregnancy. Salpingectomy seems less effective than conservative surgery when future pregnancy is desired, but is less costly. Conservative surgery seems more cost effective than salpingectomy with additional IVF-ET.
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To review the obstetric problems, pregnancy outcome and management of carriers of haemophilia. ⋯ Carriers of haemophilia A and B require special obstetric care with close liaison with the haemophilia centre, and management guidelines should be available and observed. Knowledge of fetal gender is very valuable for management in labour and should be determined antenatally even if the mother declines prenatal diagnosis.