Placental drainage and fetomaternal transfusion.
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Biomedical subjects
Publications and source records attributed to G Chamberlain.
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We surveyed 551 women more than a year after they or their husbands had had a sterilization operation. According to menstrual data from before and after the operation, a much greater proportion of women who had been sterilized had longer periods after the operation than before, but so did women whose husbands had had a vasectomy. Women who had taken an oral contraceptive before operation, had more days of bleeding and heavier bleeding than women who had been using other methods of contraception; those who had an intrauterine device removed had fewer days of bleeding after the sterilization operation. Discontinuing the previous contraception probably had a greater effect on menstruation than had the operation, for the effect was the same for those who had sterilization and the women whose husbands had an operation.
Obstetricians pay much attention to the diet and environment of the pregnant woman in prenatal care, but perhaps the woman's work also may affect pregnancy outcome. All women work in the home in addition to any work performed outside the home. The former component needs careful assessment; to get from home to work may be itself a stressful experience. In the workplace, women may encounter specific hazards of radiation or chemicals. More widespread are the problems of fatigue and boredom, which need careful assessment in relation to the outcome of pregnancy. These factors should be measured more precisely, thus allowing the physician to advise pregnant women better about the safe duration of work. Currently, advice tends to be overly cautious, as physicians are uncertain of the data on which such standards are based.
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The recovery of gases used for insufflation at gynaecological laparoscopy was investigated in 163 women who were randomly allocated to receive insufflation with nitrous oxide or carbon dioxide, the two most commonly used gases. No difference was detected and since nitrous oxide has dangerous side effects, the use of carbon dioxide is recommended. Methods of enhancing the recovery of gas were then investigated in a further 207 women, treatment being allocated in a random fashion. No merit was found in the use of these techniques and they have been abandoned.
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Matched groups of primigravid women received one of three antenatal training programmes: normal antenatal classes, normal classes plus electromyography biofeedback relaxation training, or normal classes plus skin-conductance biofeedback relaxation training. Myographic training was found to be effective within conventional antenatal constraints, whereas skin-conductance training was not. The women reported use of biofeedback training and related skills to be of some benefit during early labour. However, no difference between effectively trained electromyographic, ineffectively trained skin-conductance and control groups was found on labour and delivery performance measures.
Early fetal biparietal diameter (BPD) measurements were obtained with ultrasound in 1062 women attending for antenatal care; a random half had the results withheld from the obstetricians. Of the 1026 women who were sure of the dates of their last normal menstrual period, 829 (81%) were found to have appropriate biparietal diameter measurements, in 3% the pregnancy was more than 2 weeks further advanced and in 14% more than 2 weeks less than calculated. In 30% of the women whose results were intended to be withheld, the code had to be broken because of clinical concern. There were no differences in fetal outcome (birthweight centile, Apgar score at 1 min and perinatal mortality) in the women whose BPD results were known compared with those whose results were withheld from the obstetrician. But a significantly larger number of labours were induced for suspected growth retardation when the gestational age was known.
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