British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Aug 1998
ReviewThe association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis.
To investigate the association between maternal HIV infection and perinatal outcome by a systematic review of the literature and meta-analysis. ⋯ The findings of this review have implications for women infected with HIV who are planning a pregnancy or who find themselves pregnant. There appears to be an association, although not strong, between maternal HIV infection and an adverse perinatal outcome. This relationship may be due to bias including uncontrolled or residual confounding. There does, however, appear to be a real and large increase in the risk of infant death in developing countries associated with maternal HIV infection, especially so when there has been an attempt to control for confounding.
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Br J Obstet Gynaecol · Aug 1998
Risk of myocardial infarction, angina and stroke in users of oral contraceptives: an updated analysis of a cohort study.
To investigate risk of myocardial infarction, angina and stroke in users of contraceptive pills compared with users of other methods of contraception. ⋯ Use of oral contraception is associated with increased risk of ischaemic stroke and increased risk of myocardial infarction (only in heavy smokers), but no increased risk of angina. These increased risks need to be considered within the context of the very low absolute risks of cardiovascular disease in this population. 5880 women need to take oral contraception for one year to cause one extra stroke, and 1060 women who are heavy smokers need to take it for one year to cause one extra myocardial infarction.
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Br J Obstet Gynaecol · Aug 1998
First trimester screening for Down's syndrome using maternal serum PAPP-A and free beta-hCG in combination with fetal nuchal translucency thickness.
The aim of this study was to evaluate the potential effectiveness of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free beta-hCG in combination with nuchal translucency thickness in first trimester screening for Down's syndrome. Maternal serum levels of PAPP-A and free beta-hCG were assayed in stored sera from 32 Down's syndrome and 200 unaffected pregnancies. Fetal nuchal translucency was measured by ultrasound at the time of blood sampling. Screening of Down's syndrome using a combination of maternal age, PAPP-A, free beta-hCG and nuchal translucency would achieve a detection rate of 75.8% for a false positive rate of 5%.
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To determine the effect of labour on free oxygen radical activity in the fetus, as reflected by lipid peroxide levels in umbilical cord arterial blood. ⋯ The findings indicate that high levels of free oxygen radical activity in the fetus are a function of the labour process, as are changes in acid-base balance.
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Br J Obstet Gynaecol · Jul 1998
Randomized Controlled Trial Multicenter Study Clinical TrialThe haemodynamic effects of ketanserin versus dihydralazine in severe early-onset hypertension in pregnancy.
To compare the haemodynamic efficacy of ketanserin (a selective serotonin2-receptor blocker) with dihydralazine in the management of severe early-onset hypertension in pregnancy. ⋯ The antihypertensive profile of ketanserin is characterised by an early and gradual reduction of blood pressure in combination with a moderate decrease in systemic vascular resistance and no significant change in cardiac output. Dihydralazine causes market tachycardia resulting in a considerable increase in cardiac output.