Summary
We report on the use of epidural analgesia during labour in 58 out of a total of 234 twin deliveries performed over a five‐year period. A comparable control group consisted of 44 twin pregnancies delivered consecutively during the year preceding the introduction of epidural analgesia into our department. Epidural analgesia shortened the mean time of labour and made possible the performance of all necessary instrumental and obstetrical manoeuvres, without additional anaesthesia or adverse effects on the second twin. The epidural group required oxytocin more often due to an increased incidence of hypotonic uterine dysfunction. There was also a considerable increase of instrumental deliveries in the epidural group. The condition of the newborn infants of both groups, evaluated by Apgar score at one minute, was similar, but there was a higher perinatal mortality among pre‐term infants delivered under epidural analgesia. Epidural analgesia was found to be an acceptable method of relieving pain in twin labour, but because of the increased necessity to use oxytocin and the relatively high perinatal mortality observed among pre‐term infants, further experience is necessary before it can be claimed that this is the method of choice for relief of pain in twin labour.
Summary. Prostaglandin E (PGE) concentration was measured in decidual tissue after spontaneous and missed abortion and compared with that obtained from induced abortion. Tissues were obtained by curettage from groups of 10 patients each and PGE was estimated by radioimmunoassay. After spontaneous and missed abortions decidual tissue contained significantly higher mean concentrations of PGE, (486.3 and 66.7 ng/g wet tissue respectively) than after induced abortion (18.6 ng PGE/g wet tissue). It is suggested that an increased rate of PGE biosynthesis or reduced breakdown, or both, may play a role in the mechanism of human abortion.
Seventy patients between the ages of 37 and 59 suffering from the menopausal syndrome were included in a clinical trial and treated for a period of 6 to 18 months. Out of the seventy, 43 were suffering from spontaneous and 27 from surgical menopause. Forty of them were given 1 mg of quinestrol and 30 received placebo. The drug was administered orally in a one-tablet dose once a month. An improvement took place in 35 (87.5%) of the women receiving quinestrol but in only 15 (50%) of those receiving placebo. Among the patients with spontaneous menopause an improvement was seen in 22 out of 25 (88%) receiving quinestrol, compared with 9 out of 18 (50%) receiving placebo. Tolerance of the drug was good and most of the laboratory tests as well as blood pressure and body weight showed statistically non-significant changes. This kind of treatment is expecially suitable when daily intake is undesirable.
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