Biomedical subjects
Publications and source records attributed to L Moukengue.
A real-time program for obstetrical and neonatal data was developed in June 1986 at the maternity hospital in Haguenau. Used routinely, this program has raised comments and controversy. With investigative questionnaires, we have attempted to evaluate how the introduction of computer sciences was perceived by the personnel as well as the patients.
The recent increase of premature births has led the authors to conduct an exhaustive, prospective investigation from computerized data, including 8,618 pregnant women who delivered at the Maternity Hospital in Haguenau between January 1980 and December 1985. Their results disclose a significantly increased ratio of premature births in the gravida I group and in women with a primary level of education, who were followed by a general practitioner. On the other hand, the ratio of premature births at 34 weeks and less, is also increased in people followed by a general practitioner, which is not the case for induced prematurity. These results, although preliminary, prompt the consultant to reconsider primary prevention in these groups with particular risks.
Between 1971 and 1985, at the Haguenau Maternity Hospital, a 20% decrease was observed in the rate of small-for-gestational-age infants (birthweight less than 10th centile using figures from all the study births) among 20,101 births between 28 and 42 weeks. This decrease could not be explained by simultaneous changes in socio-demographic and anthropometric characteristics of the pregnant women, nor a recruitment bias. The earliness of prenatal care at the Maternity Hospital may have played a role in the downward trend. Further research is needed to confirm the influence of prenatal care on the rate of small-for-gestational-age babies.
The authors recall the various techniques proposed from ancient times till to day and emphasize in this review, the privileged indications in the XIXth century in order to attempt by-passing pelvic atresiae.
Three methods deserve mentioning: on the one hand, administration of pitocin and prostaglandins, on the other hand, artificial rupture of the membranes. The authors are proposing a practical plan of these various indications.