A study of the obstetric performance of the adolescent Jamaican primigravida

The obstetric performance of 226 primigravidas, aged 16 or less, delivered in the University Hospital, Kingston, Jamaica, was studied and compared with that of other primigravidas. There was no increase of the pre-eclampsia, antepartum hemorrhage, or anemia but postpartum hemorrhage was common in this group. The low operative delivery rate was associated with a low incidence of fetal distress and babies with good Apgar scores. The over-all good obstetric performance was probably achieved by good antenatal care.(AU)

Gastric emptying in pregnancy and labour - abstract

There is little evidence at present on which to base the assumption that gastric emptying is slowed during pregnancy. The present study was designed to obtain further information. The emptying of a 750ml 'meal' of water or saline (100meq/L) was measured in several groups of Jamaican women using a double sampling technique. Since the basic pattern of emptying in both pregnant and non-pregnant subjects was exponential, the rate of emptying could be described in terms of half-life. The mean half-life of both water and saline meals was significantly longer in the pregnant subjects with heartburn than in the non-pregnant and the other pregnant women. In the pregnant without heartburn there was no evidence of impaired gastric emptying of either meal. During labour the pattern of emptying was altered, and an exponential relationship between volume of gastric contents and time was not indicated. A comparison of the volume of gastric contents thirty minutes after imbibtion of either meal indicated a considerable slowing of gastric emptying during labour. The rate of emptying of both meals was virtually the same in labour, whereas in the other groups the saline meal emptied more rapidly than the water meal. In several women tested within 48 hours of delivery there was a returned to rapid exponential emptying. These studies support the suggestion that a slowing of gastric emptying might contribute to the sensation of heartburn in pregnancy, but do not provide any evidence of a generalized impairment of gastric emptying pregnancy. There is clear evidence that gastric emptying is slowed in labour, confirming the impressions based on clinical observations of the vomitus of women in labour. It is further concluded that the "duodenal brake", which can be triggered by the presence of water in the duodenum does not operate during labour due possibly to the high level of inhibition already present (AU)

Shirodkar suture: a review of 10 years experience

The outcome of 103 Shirodkar sutures was studied. The results were analysed in 3 groups according to the critaria for insertion of the suture. Highly significant success was obtained in each group and in the whole series. The operation is safe for mother and fetus provided no contraindication exists (Summary)

Gastric emptying time in late pregnancy and labour

Gastric emptying time was measured in non-pregnant, pregnant and labouring women. The results suggest an explanation for previously conflicting studies and support the suggestion that slowing of gastric emptying contributes to heartburn in pregnancy. However, there was no clear evidence that in pregnant women generally gastric emptying is impared. Gastric emptying times during labour were shown to be prolonged and the pattern of emptying altered (Summary)

The mortality of vulval carcinoma

Factors affecting mortality in fifty-two patients suffering from primary invasive carcinoma of the vulva are discussed. Suggestions for improvement in prevention and treatment are presented (AU)