British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Jan 1988
Review Clinical TrialChoice of oxytocic preparation for routine use in the management of the third stage of labour: an overview of the evidence from controlled trials.
Prophylactic use of oxytocics reduces the risk of postpartum haemorrhage by about 40%. The analysis presented in this paper assesses which oxytocic preparation is associated with the least risk of postpartum haemorrhage and examines the relative effects of different preparations on the length of the third stage, the risk of manual removal of the placenta, blood pressure and other side-effects. A mixture of oxytocin and ergometrine (Syntometrine) appears to be the safest and most effective prophylactic of the alternatives which have been compared, but the quality of the evidence is not satisfactory. There is scope for a randomized comparison of Syntometrine with oxytocin to obtain unbiased and more precise estimates of their relative effects on postpartum haemorrhage, blood pressure and unpleasant side-effects.
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Br J Obstet Gynaecol · Aug 1987
Review Comparative StudyManagement of the mature selected breech presentation: an analysis based on the intended method of delivery.
The outcome of 313 mature singleton breech deliveries, covering a 3-year period at the Queen Charlotte's Hospital, is reviewed. Maternal and fetal outcome were analysed by the intention to deliver vaginally compared with planned caesarean section. There was no serious fetal morbidity or mortality in either of these groups despite considerable mechanical difficulty with vaginal delivery of the head in one patient. ⋯ Trial of vaginal delivery was abandoned in 59 (40%) of the 149 women where this was attempted. Epidural analgesia appears to increase the duration of the second stage of labour in those who were delivered vaginally. Younger women and those with smaller babies were more likely to succeed with a trial of vaginal delivery but there was no relation between birthweight and the radiological obstetric conjugate and success or failure of trial of labour.