To study the problem of nausea and vomiting in early pregnancy an epidemiological survey was undertaken, obtaining information from 500 consecutive antenatal patients. Seventy-six percent of women complained of symptoms during the first trimester, and in only 27% had the symptoms resolved by the twelfth week. Job efficiency was markedly impaired. Women who suffered nausea premenstrually, or on the oral contraceptive pill, were much more likely to develop symptoms, lending credence to a hormonal etiology for the condition.
The effect of spironolactone in the alleviation of the symptoms of the premenstrual syndrome was compared with placebo in a double-blind, parallel group controlled study. One tablet daily of 100 mg spironolactone or placebo was given to 63 women from Day 12 of the menstrual cycle until the first day of the next menstrual bleed. This regimen was repeated for two consecutive cycles. Spironolactone was statistically significantly superior in providing relief from bloatedness (p less than 0.001). No statistically significant changes were observed in blood biochemistry of plasma hormone levels of oestradiol, progesterone or prolactin, though an increase in serum aldosterone levels was seen in the spironolactone-treated group. No differences were detected in weight, blood pressure or the incidence and severity of complaints following treatment.
Objective: To reinforce the risk of feto-maternal haemorrhage associated with external cephalic version for breech presentation. Method: A single case report with a literature review. Results: Our case report was associated with the largest feto-maternal haemorrhage following external cephalic version reported so far. The perinatal outcome in this case was favourable despite a significant amount of fetal haemorrhage. The literature review did include cases with unfavourable outcomes. No reliable method of monitoring fetuses with feto-maternal haemorrhage has been reported, although middle cerebral artery Doppler studies appear to show promise. Conclusion: External cephalic version is useful in the management of breech presentations at term, but it is not without risks and clinicians need to be aware of this.
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