Congenital orofacial teratoma in a 22-week foetus.

No abstract available.

Prediction and prevention of early-onset pre-eclampsia: impact of aspirin after first-trimester screening.

OBJECTIVE: To examine the effect of a combination of screening and treatment with low-dose aspirin on the prevalence of early-onset pre-eclampsia (PE). METHODS: This was a retrospective analysis of two consecutive cohorts of women screened for early PE. The first cohort was observed to determine whether algorithms developed to screen for PE at 11 to 13 + 6 weeks' gestation could be applied to our population. High-risk women in the second cohort were advised on their risk and offered aspirin (150 mg at night), with treatment starting immediately after screening. The prevalence of early PE and the proportion of women with PE delivering at 34-37 weeks' gestation were compared between the cohorts. RESULTS: In the observational and interventional cohorts, 3066 and 2717 women, respectively, were screened. There were 12 (0.4%) cases of early PE in the observational cohort and one (0.04%) in the interventional cohort (P < 0.01). Among all women with PE delivering before 37 weeks, 25 (0.83%) were in the observational cohort and 10 (0.37%) in the interventional cohort (P = 0.03). CONCLUSIONS: A strategy of first-trimester screening for early PE coupled with prescription of aspirin to the high-risk group appears to be effective in reducing the prevalence of early PE.

Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised trial.

OBJECTIVE: To compare oral nifedipine with intravenous labetalol in their rapidity to control hypertensive emergencies of pregnancy. DESIGN: A double-blind randomised trial. SETTING: A university hospital in Malaysia. POPULATION: Pregnant women with severe gestational hypertension≥160/110 mmHg who required immediate treatment. METHODS: Patients were randomised to receive nifedipine (10 mg tablet, orally, up to five doses) and intravenous placebo saline injection or intravenous labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) and a placebo tablet every 15 minutes until the target blood pressure of ≤150/100 mmHg was achieved. Crossover treatment was effected if the initial treatment regimen was unsuccessful. MAIN OUTCOME MEASURE The time taken to achieve a blood pressure of ≤150/100 mmHg. RESULTS: The median time taken to achieve target blood pressure was 30 minutes (interquartile range, IQR 22.5-67.5 minutes) versus 45 minutes (IQR 30-60 minutes) for nifedipine and labetalol, respectively (P=0.59). Repeated measures analysis of variance indicated that in the first hour both systolic (F=87.6, P<0.001) and diastolic (F=55.8, P<0.001) blood pressure significantly decreased, but there was no difference between the nifedipine and labetalol groups for both systolic (F=0.12, P=0.74) and diastolic (F=0.92, P=0.34) blood pressure trends over time. Crossover treatment was required in 20% of women from each group. CONCLUSIONS: Oral nifedipine and intravenous labetalol regimens are similarly effective in the acute control of severe hypertension in pregnancy.