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C R Leitch

Publications and source records attributed to C R Leitch.

7 recordsLinked to original sources
PubMed1998

The rise in caesarean section rate: the same indications but a lower threshold.

OBJECTIVE: To investigate the reasons for the rise in caesarean section rate and note any change in indications. DESIGN: A retrospective, descriptive study comparing the years 1962 and 1992. SETTING: A large city centre teaching hospital. RESULTS: There was an overall increase in the caesarean section rate from 6-8% in 1962 to 18.1% in 1992. No single cause contributed more than 30% towards this increase. The main indications in both years were similar: failure to progress (42.2% vs 36.7%) and fetal indications (18.1% vs 18.9%). The largest relative increases were in the malpresentation group (10.8% vs 16%) and previous caesarean section (4.5% vs 15.2%). CONCLUSIONS: These results suggest that there has been a lowering in the overall threshold concerning the decision to carry out a caesarean section rather than changes in obstetric management. Obstetricians and the women in their care have to decide whether the current balance between risk and benefit is acceptable or whether they wish to alter the underlying philosophy if any significant reduction is to be sustained.

Adult↗
PubMed1997

Recombinant human relaxin as a cervical ripening agent.

OBJECTIVE: The aim of this study was to investigate the efficacy and safety of recombinant human relaxin (rhRIx) as a cervical ripening agent in women with an unfavourable cervix before induction of labour at term. DESIGN: A multi-centre, double-blind, placebo-controlled trial performed in Edinburgh, Glasgow and Oxford. Women were treated with 0, 1, 2 or 4 mg of rhRIx in a gel vehicle administered intravaginally. Analysis of variance tests were performed on all continuous variables, and Cochran Mantel-Haenszel tests employed for all discrete variables. PARTICIPANTS: Ninety-six women at 37 to 42 weeks of gestation with a singleton pregnancy and a modified Bishop score of < or = 4 were recruited. RESULTS: There was no significant difference in the change in modified Bishop score between the four treatment groups. The lengths of the first and second stages of labour were similar in all 4 groups. PGE2 and oxytocin requirements were similar in all groups, as was the mode of delivery. There was no evidence that relaxin was absorbed systemically when given in this way. CONCLUSION: Recombinant human relaxin 1 to 4 mg, administered as an intravaginal gel, has no effect as a cervical ripening agent before induction of labour at term.

Administration, Intravaginal↗
PubMed1997

The changing pattern of eclampsia over a 60-year period.

OBJECTIVE: To determine changes in the incidence and pattern of eclampsia within the same geographical area over a 60-year period. DESIGN: A retrospective, descriptive study of 1259 consecutive women classified, at the time, as having had an eclamptic convulsion between the years 1931 and 1990. SETTING: A large city centre teaching hospital and the surrounding catchment area. MAIN OUTCOME MEASURES: The changes in the incidence and timing of the convulsion and the outcomes for the mother and baby. RESULTS: Over the study period, the incidence of eclampsia fell by more than 90%, from 74.1/10,000 in the 1930s to 7.2/10,000 in the 1980s. Most of the reduction occurred over the first four decades, with little change in the last 20 years. Overall, 44% of the cases of eclampsia occurred in the antenatal period, 33% intrapartum and 23% postpartum. Since the biggest decreases were seen in the incidence of antenatal and particularly intrapartum eclampsia, there has been a relative increase in the proportion of eclampsia occurring postpartum. Maternal death from eclampsia occurred in 15.1% of cases between 1931 and 1940, 13.4% between 1941 and 1950, but fell dramatically to < or = 3.9% after 1950. There has been no maternal death since 1964. Apart from the first decade, postpartum eclampsia was associated with significantly less risk of death to the mother throughout the study period. Perinatal death rate has fallen steadily from 432.6/1000 cases of eclampsia between 1931 and 1940 over the first three decades, to 168.7/1000 between 1961 and 1970. There has been little change since, although a lower proportion of neonatal deaths occurred as stillbirths. CONCLUSIONS: We found a significant reduction in both the incidence of eclampsia and associated morbidity in this population over the last 60 years. This has occurred in association with the introduction of the National Health Service, widespread antenatal care for all and a general improvement in health and welfare. Any further reduction in the incidence in the UK may be difficult to achieve. Since the incidence of eclampsia is now low, efforts should perhaps be directed at minimising the morbidity associated with severe pre-eclampsia rather than prevention of convulsions.

Adult↗
PubMed1993

Interleukin 8.

Explore the source record for details and available documents.

Amniotic Fluid↗
PubMed1979

Identification of a Rous sarcoma virus transformation-related protein in normal avian and mammalian cells.

Avian sarcoma viruses (ASV) contain a gene (src) whose protein product mediates sarcomagenic transformation. This product is a 60,000-Mr phosphoprotein designated pp60src. We have found that normal uninfected frog, chicken, rat, and human cells contain a 60,000-Mr phosphoprotein related to the product of the ASV src gene and have designated that protein pp60. A phosphoprotein of similar size was not detectable in Drosophila cells. The pp60 proteins were detected by immunoprecipitation with rabbit antitumor serum containing broad spectrum antibodies to pp60src. Peptide maps of [35S]methionine-labeled pp60 and pp60src indicated major similarities as well as some differences in amino acid composition. Peptide maps of the 32P-labeled proteins demonstrated that the phosphopeptides of all endogenous pp60 molecules tested were identical. However, some differences were noted between the phosphopeptide patterns of pp60 and viral pp60src. The kinase activity associated with pp60src was measured in the immunocomplex and resulted in the transfer of radioactive phosphorus from [gamma-32P]ATP to the immunoglobulin heavy chain as well as to an 80,000-Mr phosphoprotein. The pp60 of chicken, rat, and human origin also contained an associated kinase activity. These results are consistent with the notion that the pp60 molecules are the protein products of endogenous sarc sequences found in vertebrate cells.

Amino Acid Sequence↗