BJOG : an international journal of obstetrics and gynaecology
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomised controlled trial of the closure or non-closure of peritoneum at caesarean section: effect on post-operative pain.
To compare the analgesic requirement in the post-operative period after closure or non-closure of the peritoneum at the caesarean delivery with a standardised anaesthetic and surgical technique. ⋯ Non-closure of both visceral and parietal peritoneum at the caesarean section produces a significant reduction in the post-operative use of patient controlled analgesia pump morphine and significantly higher patient satisfaction at 24 hours post-operatively.
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To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish. ⋯ Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.
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Multicenter Study
Combined ultrasound and biochemical screening for Down's syndrome in the first trimester: a Scottish multicentre study.
To evaluate the use of ultrasound measurements of fetal nuchal translucency (NT) obtained in a routine antenatal clinic setting in combination with appropriate biochemical markers as a first trimester screening test for Down's Syndrome. ⋯ NT in combination with appropriate serum markers has the potential to detect over 80% of Down's Syndrome fetuses in early pregnancy. However, NT measurement is highly operator-dependent. It requires training, external quality control and adequate time to allow accurate measurement, otherwise suboptimal performance will result.
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To test the hypothesis that suboptimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, when compared with Swedish mothers. ⋯ Suboptimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the suboptimal performance of certain health care routines in the Swedish perinatal care system.
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To determine how long it takes from the decision to achieve delivery by non-elective caesarean section (DDI), the influences on this interval, and the impact on neonatal condition at birth. ⋯ Fewer than 40% intrapartum deliveries by caesarean section for fetal distress were achieved within 30 minutes of the decision, despite that being the unit standard. There was, however, no evidence to indicate that overall an interval up to 120 minutes was detrimental to the neonate unless the delivery was a 'crash' caesarean section. These data thus do not provide evidence to sustain the recommendation of a standard of 30 minutes for intrapartum delivery by caesarean section.