Biomedical subjects
J Lumley
Publications and source records attributed to J Lumley.
How to find out if assuming the knee-chest position is superior to external cephalic version in turning the breech. Commentary.
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Do hospitals with family-centered maternity care policies have lower intervention rates?
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Commentary: does this work?
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Does this work?
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Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.
A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.
Very low birth-weight (less than 1,500 g) and previous induced abortion: Victoria 1982-1983.
In Victoria, previous termination of pregnancy is a risk factor for giving birth to a very low birth-weight infant (less than 1,500 g)--the risk of giving birth to an infant less than 1,000 g is increased more than 2.5-fold by a prior induced abortion and more than 3.5-fold by 2 or more prior abortions. However, more than 97% of women with a prior termination gave birth to infants weighing more than 1,500 g. Subsequent very preterm delivery appears to be a real but rare complication of induced abortion, responsible for about 9% of very low birth-weight infants in 1982-1983.
What the Dublin trial suggests about benefits: what comments suggest about who should interpret the tracings; oxytocin, neonatal seizures and other insights derived from the Dublin trial. Roundtable. Part II.
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The proposed Victorian Donor Gamete Register.
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A failed RCT to determine the best method of delivery for very low birth weight infants.
An RCT to determine the optimum method of delivery for very low birth weight (VLBW) infants was canceled after it had been in progress for only 5 months when it was discovered that more than 40% of eligible patients were being withdrawn from the trial before randomization. A review of hospital births before the trial began suggested that the trial was held too late: that a critical shift in obstetric practice towards abdominal delivery of VLBW infants had already occurred. Obtaining patient consent to participation, which had been the main predicted problem, was not difficult.
Comparison of infusions of propofol and methohexitone to provide light general anaesthesia during surgery with regional blockade.
General anaesthesia was induced with, and maintained by, an infusion of either propofol or methohexitone, in patients undergoing surgery with the aid of regional blockade. Both agents provided satisfactory and controllable anaesthesia. Complications were few with a similar incidence for the two drugs. Recovery from anaesthesia was significantly faster following propofol.
Low birth weight in Tasmania 1975-1983: the effect of socioeconomic status.
An analysis of all births in Tasmania from 1975 to 1983 showed that social class differences in low birth weights were almost entirely restricted to infants between 1500 and 2500 g weight at birth. There was a marginal increase in very low birth weight infants (less than 1500 g) among women whose partners were unemployed or in unskilled work but extremely low birth weight infants (less than 1000 g) were evenly distributed across the whole social spectrum.
Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981-82.
Analysis of cigarette smoking and alcohol consumption patterns recorded in pregnancy could not detect a harmful effect of alcohol at levels below 2 glasses a day. Total abstainers fared very slightly worse than those who drank occasionally. Smoking was associated with lower birth-weight and a worse fetal outcome independent of socioeconomic status, parity, maternal age or alcohol consumption. There was evidence of an interaction between smoking and adverse social and parity factors in low birth-weight.
Assessing satisfaction with childbirth.
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Myoclonus after etomidate anesthesia.
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Some studies on the properties of the intravenous anaesthetic, propofol ('Diprivan')--a review.
Four studies have been carried out on propofol in this department, one being part of a multicentre trial. The minimum induction dose in unpremedicated patients was found to be 2.5 mg/kg. Propofol has been shown to be an acceptable induction agent, although with an incidence of pain on injection which is much higher when small veins are used. When given by continuous infusion to supplement regional anaesthesia, recovery was much more rapid than with methohexitone. The potency of propofol to thiopentone has been shown to be 1:1.604. Slight falls in cardiac output occurred following propofol 2.5 mg/kg, with significant reductions in mean arterial blood pressure and systemic vascular resistance. These changes were greater than those following an equipotent dose of thiopentone 4 mg/kg.
Births at home: facts and fictions.
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Sedation for local anaesthesia. Comparison of intravenous midazolam and diazepam.
Intravenous midazolam and diazepam have been compared as sedatives during surgery performed under local anaesthesia. Satisfactory conditions were produced by both drugs. No difference was detected in the rate of recovery, but a highly significant greater degree of amnesia followed the use of midazolam.