RESUMEN
OBJECTIVE: To investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within the same hospital. DESIGN: Randomised controlled trial. SETTING: Department of Obstetrics and Gynaecology, Østfold Hospital Trust, Tromsø, Norway. POPULATION: A total of 1111 women assessed to be at low risk at onset of spontaneous labour. METHODS: Randomisation into one of three birth units: the special unit; the normal unit; or the midwife-led unit. MAIN OUTCOME MEASURES: Total operative delivery rate, augmentation, pain relief, postpartum haemorrhage, sphincter injuries and intrapartum transfer, Apgar score <7 at 5 minutes, metabolic acidosis and transfer to neonatal intensive care unit. RESULTS: There were no significant differences in total operative deliveries between the three units: 16.3% in the midwife-led unit; 18.0% in the normal unit; and 18.8% in the special unit. There were no significant differences in postpartum haemorrhage, sphincter injuries or in neonatal outcomes. There were statistically significant differences in augmentation (midwife-led unit versus normal unit RR 0.73, 95% CI 0.59-0.89; midwife-led unit versus special unit RR 0.69, 95% CI 0.56-0.86), in epidural analgesia (midwife-led unit versus normal unit RR 0.68, 95% CI 0.52-0.90; midwife-led unit versus special unit RR 0.64, 95% CI 0.47-0.86) and in acupuncture (midwife-led unit versus normal unit RR 1.45, 95% CI 1.25-1.69; midwife-led unit versus special unit RR 1.45, 95% CI 1.22-1.73). CONCLUSIONS: The level of birth care does not significantly affect the rate of operative deliveries in low-risk women without any expressed preference for level of birth care.
Asunto(s)
Cesárea/estadística & datos numéricos , Partería/estadística & datos numéricos , Servicio de Ginecología y Obstetricia en Hospital/estadística & datos numéricos , Extracción Obstétrica por Aspiración/estadística & datos numéricos , Analgesia por Acupuntura/estadística & datos numéricos , Adulto , Canal Anal/lesiones , Analgesia Epidural/estadística & datos numéricos , Puntaje de Apgar , Femenino , Humanos , Noruega , Transferencia de Pacientes/estadística & datos numéricos , Hemorragia Posparto/epidemiología , Embarazo , Factores de Riesgo , Adulto JovenRESUMEN
The antigenicity of HCG was tested in twenty-three young healthy men receiving two different HCG preparations (A and B). Each subject received 5000 i.u. HCG intramuscularly daily for three consecutive days, followed by another course, 3 weeks later, of 5000 i.u. HCG injections daily for 3 days. Two of the fifteen subjects treated with preparation A developed HCG antibodies in response to the HCG injections. The results show that although HCG is of human origin and also occurs normally in men, it may induce antibody formation even after brief treatment.