Magnesium sulphate for pre-eclampsia and eclampsia: the evidence so far.
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Eclampsia↗
Biomedical subjects
L Duley
Publications and source records attributed to L Duley.
Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean.
OBJECTIVE: To present estimates of maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean, and to discuss strategies to prevent these deaths. DESIGN: Retrospective review of all available data. SETTING: Database of the World Health Organization's Maternal Health and Safe Motherhood Programme. MAIN OUTCOME MEASURES: Estimates of the total maternal mortality and the proportions of deaths associated with hypertensive disorders of pregnancy. RESULTS: Estimates of mortality associated with hypertensive disorders of pregnancy were similar in Africa, Latin America and the Caribbean, despite considerably higher total mortality in Africa. Variations in both overall mortality and that associated with hypertensive disorders of pregnancy were greatest in Asia. Despite their limitations, these data suggest that between 10-15% of maternal deaths are associated with hypertensive disorders of pregnancy, and that 10% are associated with eclampsia. CONCLUSIONS: Where maternal mortality is relatively high, the excess is likely to be due to a high mortality associated with haemorrhage and infection and reductions are most likely to come from reductions in these deaths. Evidence from both developed and developing countries suggests that deaths associated with hypertensive disorders of pregnancy are the most difficult to prevent. More rigorous assessment of interventions designed to prevent these deaths is urgently required.
Africa↗
Socio-economic and ethnic factors in stillbirth and neonatal mortality in the NE Thames Regional Health Authority (NETRHA) 1983.
All stillbirths and neonatal deaths occurring in the North East Thames region were studied in 1983. This report describes the socio-economic and ethnic differences in that cohort. The stillbirth and neonatal mortality rates of babies born to fathers of social class V (16.8 per 1000 total births) was almost double that of social class I fathers (8.6 per 1000 total births). The most marked social class gradient was seen in the macerated stillbirth groups. Of particular concern was the extremely high stillbirth and neonatal mortality rate for women born in the Indian subcontinent. This was most evident in Pakistani women who had a stillbirth plus neonatal mortality rate of 17.3 per 1000 total births, almost twice that of the women born in the UK (9.0 per 1000 total births). Again, as with social class, macerated stillbirths appeared to contribute disproportionately to the excess mortality. Mortality rates were aggregated into four birthweight specific groups. Asian women had higher mortality rates in the higher birthweight groups, whereas in the lower birthweight group their babies did slightly better. This study indicated that the special needs for working class and ethnic minority mothers within NE Thames were not being met, and the Regional Health Authority was strongly recommended to review services to these groups.
Adult↗
The role of electronic journals in reducing publication bias.
Publication bias poses a threat to the validity of medical research. It is unlikely that conventional paper journals can solve the problem of selective publication of studies with striking results because of their space limitation and need to be newsworthy. Peer-reviewed electronic journals without limitation of space might provide a solution to this paradox. To maintain the integrity of medical publication, editorial policy needs to be changed to accept clinical trials for publication, based only on the methodological criteria and not on the impact of their findings.
Clinical Trials as Topic↗