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Objective To compare the effectiveness of carbetocin and oxytocin when they are administered after caesarean section for prevention of postpartum haemorrhage (PPH).Study design Double-blind randomised single centre study (1:1 ratio).Setting Teaching hospital in Bristol, UK with 6000 deliveries per annum.Population Women at term undergoing elective or emergency caesarean section under regional anaesthesia, excluding women with placenta praevia, multiple gestation and placental abruption.Methods Women were randomised to receive either carbetocin 100 lg or oxytocin 5 IU intravenously after the delivery of the baby. Perioperative care was otherwise normal and use of additional oxytocics was at the discretion of the operating obstetrician. Analysis was by intention to treat.Primary outcome measure The proportion of women in each arm of the trial that needed additional pharmacological oxytocic interventions.Results Significantly more women needed additional oxytocics in the oxytocin group (45.5% versus 33.5%, Relative risk 0.74, 95% CI 0.57-0.95). The majority of women had oxytocin infusions. There were no significant differences in the secondary outcomes, including major PPH, blood transfusions and fall in haemoglobin.Conclusions Carbetocin is associated with a reduced use of additional oxytocics. It is unclear whether this may reduce rates of PPH and blood transfusions.

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and seven platelet concentrates were administered. Cyklokapron, Sulprostone, Methergine and Eptacog alpha were also administered. After packing of the uterus with gauzes, the fascia was closed and the patient was transferred to the intensive care unit. At the intensive care unit, haemolysis occurred as a result of the transfusion of uncrossmatched blood and DIC, antibiotics were given and hypotensive periods were treated with noradrenaline. Computed tomography did not show any cerebral, pulmonary or abdominal abnormalities. The patient received hydro-cortisone because amniotic fluid embolism was the most likely diagnosis. Thirty-six hours after PMCS, DIC resolved and the gauzes were removed by relaparotomy. Extubation followed 24 hours later. The symptoms of a paralytic ileus recovered after the administration of erythromycin in combination with a stomach tube and parenteral feeding. Following transfer to the maternity ward an uneventful recovery was seen within a few days. The patient started to remember the day of the induction of labour, became able to perform daily activities and started taking care of her daughter. Two weeks after PMCS, both mother and daughter were discharged without any neurological or other abnormalities. j References 1 Dijkman A, Huisman C, Smit M, Schutte J, Zwart J, van Roosmalen J, et al. Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

AbstractsResults Of the 1,118 recruited patients, 606 (54%) had normal UA Doppler studies and 512 (46%) had abnormal UA Dopplers, defined as UA PI > 95 th centile or AREDF. The group with abnormal UA Doppler was delivered earlier and more commonly by CS, had more admissions to NICU and adverse perinatal outcomes ( Induced abortion (IA) is believed to increase the risk of spontaneous preterm labour. Few studies have investigated the impact of method used (medical versus surgical) or the gestational age at IA. In a population based retrospective cohort study using data from the Aberdeen Maternity Neonatal Databank, the outcome of a subsequent viable pregnancy in 3186 women who underwent IA in their first pregnancy was compared with 42446 primigravid women. The exposed cohort was stratified according to method and gestational age at IA. Perinatal outcomes following medical IA was compared to those following surgical IA, as well as those in primigravid women. Similarly, women who underwent IA at <13 weeks were compared to women with history of IA at > = 13 weeks and primigravid women. Univariate and multivariate logistic regression adjusted for maternal age at delivery, smoking and socioeconomic status were used to analyse the data. No statistically significant association was found between previous IA and spontaneous preterm labour (aOR 1.05 (0.88-1.27)). Neither the method of termination (aOR 0.95 (0.72 to 1.25)) nor gestational age (aOR 1.00 (0.99 to 1.00)) at IA appeared to affect the risk of spontaneous preterm delivery. IA increased the risk of antepartum haemorrhage (p < 0.001; aOR 1.22 (1.09 to 1.36) in the next pregnancy. Previous IA appeared to protect against pregnancy induced hypertension (aOR 0.67 (0.60-0.74)). Method and gestational age at IA largely did not affect future obstetric and perinatal outcomes. Evidence remains conflicting on pregnancy outcomes following termination of pregnancy. PP.02taken at deliveries (91%) and the results stored (100%). However, there are some areas where improvements are needed such as the documentation of consent, reasons for FBS, results, and the documentation of review at 30 minutes post FBS. Conclusion Despite being indicated in the trust guideline, some of the essential documentations regarding FBS are still missing. Therefore, for these cases any future claims for cerebral palsy would be indefensible. FBS proforma was developed and are used for all FBS cases. This recommendation was subsequently adopted by DMH. 1 prompted investigation into the causes of delay in discharge from hospital following an uncomplicated elective or emergency Caesarean section. A retrospective audit of the patient health record at the Royal Devon and Exeter Hospital revealed that time to discharge appeared to be independent of parity, urgency of delivery (elective or emergency Caesarean section) or intended feeding method (breast of artificial feeding). tiME to discharGE followinG uncoMPlicatEd ElEctivE or EMErGEncy caEsarEan sEction: isIn patients without medical or surgical complication...