Biomedical subjects
Publications and source records attributed to G Kermans.
Desogestrel (150 micrograms), a potent progestogen virtually devoid of androgenic activity, was used in combination with 30 micrograms ethinyl estradiol as an oral contraceptive preparation (Marvelon). 219 women completed a total of 4074 cycles, and the use-effectiveness was 0.58 Pearl Units. Serious side effects were not observed. The drug-related discontinuation index was 12.8% in six months.
Data concerning 16 triplet and higher-order deliveries (resulting in a total of 56 infants) are reviewed. The vaginal delivery rate was 81%. Maternal morbidity was more serious after abdominal delivery. Prematurity (less than 36 weeks gestation) rate amounted to 68%. Overall perinatal and neonatal mortalities for infants born after 28 weeks gestation and weighing at least 1000 g were 7% and 3%, respectively. We doubt that neonatal outcome could have been markedly improved by performing more cesareans. The importance of antenatal care is stressed.
O'Neil designed a set of suction cups which, because of more efficient lateral pull and greater maneuverability, were claimed to be more efficient and perinatally safer than the Malmström model. These claims were checked by comparing the two instruments in a randomized controlled trial comprising 410 attempted elective extractions. The two instrument groups were comparable at entry and the operators had a similar degree of experience, the sole inter-group difference being the 0.5 cm larger diameter of the O'Neil cups. No significant differences were found between the two types of instrument as to failure rate, incidence of correct cup positioning, and capacity of eliciting internal rotation nor was there a significant divergence in neonatal safety. In a few cases the perineum was lacerated by the traction cord affixed to the O'Neil instrument. The results of this study indicate that the relative advantages and disadvantages of the two cup models are unremarkable.
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