Many reported risk factors are weak and show inconsistencies between studies. They may be secondary to more direct, as-yet-undiscovered risk factors. Although irrelevant in the majority of cases, the increased risk associated with delivery by cesarean section deserves further study.

The raised incidence of obstetric complications often reported in people with schizophrenia is genuine and probably contributes to the aetiology of the condition.

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Objective To determine the indications for singleton caesarean sections in Scotland in 1994.Design Prospective survey of singleton caesarean sections using information provided by clinicians Setting Twenty-three consultant-led obstetric units in Scotland.Population Women undergoing caesarean section in participating Scottish maternity units during 1994.Results Using routinely collected data it was found that the caesarean section rate varied by maternal age, parity, gestation, history of previous section and hospital of delivery, but there was no difference by area of deprivation. 87.4% (836919573) of Scottish caesarean sections were included in the survey of which 8098 were in women with singleton pregnancies. Most singleton caesarean sections were undertaken in primiparae (50*5%), 3 1.2% were in women with a history of previous section and 18.3% were in multiparous women who had not had a previous section; 38.9% of the operations were elective, 13.9% were emergencies before labour and 47.2% were emergencies during labour. Four main indications-elective section for breech presentation (10.7% of all sections); emergency caesarean section before labour because of fetal problems (2.8%); emergency caesarean section during labour for fetal distress andor failure to progress (30.3%); repeat section for reasons other than above (1 6.2%) accounted for 60% of all Caesarean sections in women with no other recorded complications. 7.7% of all singleton caesarean sections (19.8% of elective operations) were associated with maternal request for the operation.Discussion The survey has identified why caesarean sections are performed by Scottish obstetricians and highlighted some areas where there would be scope to increase the vaginal delivery rate. Before this can be attempted, agreement must be reached by clinicians about effective management of particular problems. Women also need to have ready access to evidenced-based information about caesarean section.entering data onto a computer in labour wards.

Menstrual blood losses were measured in 348 women aged 17 to 45 years in a Northumbrian mining village. Menstrual loss was found to be related to parity and to the birthweight of previous children. It is possibly associated with height, and may be partly controlled by uterine size and blood flow.

Underlying causes of infant death, as coded in the ninth revision of the International Classification of Diseases, have been grouped into a system of seven functional categories plus one additional group of "other and unclassifiable" diagnoses. The groups comprise congenital anomalies, asphyxia related conditions, immaturity related conditions, infections, sudden death, deaths due to external causes, and other specific conditions. The groups were constructed by using a frequency distribution of underlying cause of death in 200,000 infant deaths in 1980-84 in the U.S.A. When analysed according to age at death and according to birth weight, the distribution of the functional groups had patterns which corresponded to what might be expected clinically. Each functional group has common features which require intervention at a specific time for prevention and treatment. We propose that it is used as a tool in epidemiological surveillance and to guide health authorities in priorities for disease control. International comparisons of time trends will be undertaken.

No abstract

Menstrual blood losses were measured in 348 women aged 17 to 45 years in a Northumbrian mining village. Menstrual loss was found to be related to parity and to the birthweight of previous children. It is possibly associated with height, and may be partly controlled by uterine size and blood flow.