The results of a prospective trial to evaluate the use of diazoxide and labetalol given intravenously in the management of severe hypertensive disease in pregnancy are presented. Both drugs had an efficient hypotensive action. The reduction in blood pressure in the labetalol group was better controlled and this may be a factor influencing perinatal outcome. Because of the freedom of maternal and fetal side-effects, labetalol given by intravenous infusion is a more appropriate drug for use in the management of hypertensive crises occurring in pregnancy and labour.
Prenatal cytogenetic diagnostic services for the whole of Western Australia are undertaken by 1 central department in Perth. The records of this unit have been used to calculate the utilization rates of amniocentesis by women aged 35 years or older at the estimated date of confinement for the 5-year period 1977-1981. During this time there were 5076 livebirths to mothers aged 35 years or more and 1,408 pregnancies in this age group were cytogenetically monitored, giving an overall utilization rate of 28%. This rate is comparable to similar rates in other developed countries. Possible directions for future expansion of the service are suggested.
Twenty-five patients with severe pre-eclamptic toxaemia in labour were treated with one of the hypotensive drugs bethanidine or diazoxide combined with diazepam. In all patients a satisfactory reduction and subsequent control of the blood pressure occurred. There was no maternal mortality or morbidity and there was one neonatal death from prematurity. Diazoxide has a more rapid and predictable action than bethanidine, but it may cause hyperglycaemia in the fetus and therefore should probably be avoided in diabetic patients.
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