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N Pattison

Publications and source records attributed to N Pattison.

11 recordsLinked to original sources
PubMed2000

Human chorionic gonadotrophin for recurrent miscarriage.

BACKGROUND: There may be an association between recurrent miscarriage and abnormal hormone function in the follicular phase. Human chorionic gonadotrophin may play a role in preventing miscarriages. OBJECTIVES: The objective of this review was to assess the effects of human chorionic gonadotrophin administration during early pregnancy on the risk of miscarriage in women with a history of recurrent miscarriage. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched. Date of last search: 9 January 1998. SELECTION CRITERIA: Randomised trials of human chorionic gonadotrophin compared with placebo or no treatment in women who have had two or more miscarriages. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: Four trials involving 180 women were included. The trials were of variable quality. Human chorionic gonadotrophin was associated with a reduced risk of miscarriage for women with a history of recurrent miscarriage (odds ratio 0.26, 95% confidence interval 0.14 to 0.52). This result should be interpreted cautiously because the apparent effect is greatly influenced by the two methodologically weaker studies. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of human chorionic gonadotrophin during pregnancy in order to prevent miscarriage in women with a history of unexplained recurrent spontaneous miscarriage.

Abortion, Habitual↗
PubMed2000

Cardiotocography for antepartum fetal assessment.

BACKGROUND: Cardiotocography is a form of fetal assessment which simultaneously records fetal heart rate, fetal movements and uterine contractions to investigate hypoxia. OBJECTIVES: The objective was to assess the effects of antenatal cardiotocography on perinatal morbidity and mortality and maternal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register (to 1 November 1998). SELECTION CRITERIA: Randomised trials comparing antenatal cardiotocography with a control group for fetal assessment. DATA COLLECTION AND ANALYSIS: Trial quality was assessed. MAIN RESULTS: Four studies involving 1,588 pregnancies were included. All trials were conducted on high or intermediate risk pregnancies. Antenatal cardiotocography appeared to have no significant effect on perinatal mortality or morbidity. There was a trend to an increase in perinatal deaths in the cardiotocography group (odds ratio 2.85, 95% confidence interval 0.99 to 7.12). There was no increase in the incidence of interventions such as elective caesarean section or induction of labour. The one trial which examined an effect on antenatal patient management showed a significant reduction in hospital admissions and a reduction in inpatient stay in the cardiotocography group. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of antenatal cardiotocography for fetal assessment. All of the trials included in this review date from the introduction of antenatal cardiotocography and may be difficult to relate to current practice.

Cardiotocography↗
PubMed1998

Induction of labour for post term pregnancy: an observational study.

The aim of the study was to compare the 2 management protocols for postterm pregnancy; elective induction of labour at 42 weeks' gestation and continuing the pregnancy with fetal monitoring while awaiting spontaneous labour. A retrospective observational study compared a cohort of 360 pregnancies where labour was induced with 486 controls. All pregnancies were postterm (>294 days) by an early ultrasound scan. Induction of labour was achieved with either prostaglandin vaginal pessaries or gel or forewater rupture and Syntocinon infusion. The control group consisted of women with postterm pregnancies who were not induced routinely and who usually had twice weekly fetal assessment with cardiotocography and/or ultrasound. Women who had their labour induced differed from those who awaited spontaneous labour. Nulliparas (OR 1.54; 95% CI 1.24-1.83) and married women (OR 1.76; 95% CI 1.45-2.06) were more likely to have their labour induced. There was no association between the type of caregiver and induction of labour. Induction of labour was associated with a reduction in the incidence of normal vaginal delivery (OR 0.63, 95% CI 0.43-0.92) and an increased incidence of operative vaginal delivery (OR 1.46; 95% CI 1.34-2.01). There was no difference in the overall rate of Caesarean section. There was no difference in fetal or neonatal outcomes. Parity had a major influence on delivery outcomes from a policy of induction of labour. Nulliparas in the induced group had worse outcomes with only 43% achieving a normal vaginal delivery (OR 0.78, 95% CI 0.65-0.95). In contrast for multiparas, the induced group had better outcomes with less Caesarean sections (OR 0.88, 95% CI 0.81-0.96). This retrospective observational study of current clinical practice shows that induction of labour for postterm pregnancy appears to be favoured by nulliparous married women. It suggests that induction of labour may improve delivery outcomes for multigravas but has an adverse effect for nulliparas.

Cesarean Section↗
PubMed1995

Aspirin and prevention of preeclampsia. Position statement of the use of low-dose aspirin in pregnancy by the Australasian Society for the Study of Hypertension in Pregnancy.

1. A heterogeneous group of randomized trials have been conducted using low-dose aspirin to prevent preeclampsia. The results do not support widespread use of low-dose aspirin to prevent preeclampsia. 2. On the basis of existing literature, it is reasonable to use prophylactic low-dose aspirin from early pregnancy in the following groups: (i) Women with prior fetal loss after the first trimester, with placental insufficiency (ii) Women with severe fetal growth retardation in a preceding pregnancy either due to preeclampsia or unexplained (iii) Women with severe early-onset preeclampsia in a previous pregnancy necessitating delivery at or before 32 weeks' gestation. 3. On the basis of existing literature, it is recommended that aspirin not be used in the following groups: (i) Healthy nulliparous women (ii) Women with mild chronic hypertension (iii) Women with established preeclampsia. 4. The data are sufficient to support further trials in more homogeneous select subgroups of women considered at risk of developing preeclampsia.

Aspirin↗
PubMed1992

Antiphospholipid antibodies in pregnancy.

We assessed the relationship between antiphospholipid antibodies and recurrent miscarriage, fetal deaths, and the pregnancy complications--placental abruption, fetal growth retardation and preeclampsia. The subjects were 81 women with a history of 3 or more miscarriages, 62 with a history of fetal death in the index pregnancy, 105 with a poor obstetric history or pregnancy complications and 13 with systemic lupus erythematosus. Antiphospholipid antibodies were found in 41% of women with a history of recurrent miscarriages, 29% with a history of recent intermediate fetal death or stillbirth, 19% with a poor obstetric history and 69% with systemic lupus erythematosus. There is a high incidence of antiphospholipid antibodies in complicated pregnancies. Patients presenting with the above pregnancy disorders should be tested for antiphospholipid antibodies because of the risk conferred on a fetus by their presence and to expand the treatment options.

Abortion, Habitual↗
PubMed1989

The management of severe erythroblastosis fetalis by fetal transfusion: survival of transfused adult erythrocytes in the fetus.

The survival of adult erythrocytes transfused into the fetus was measured after intravascular and/or intraperitoneal transfusion. We performed 80 fetal transfusions on 20 severely anemic fetuses, 18 of whom survived. The survival of adult erythrocytes in the fetal circulation was similar to that in the adult circulation and did not depend on the route of transfusion, gestational age, or presence of hydrops. Eighty percent of blood transfused into the fetal peritoneal cavity appeared in the fetal circulation.

Adult↗
PubMedDate not supplied

Fetal growth and birthweight in isoimmunized pregnancies after intravenous intrauterine transfusion.

Forty-seven fetuses treated with intravenous intrauterine transfusion for rhesus isoimmunization were studied. At the time of first transfusion the fetuses were below average in size with the fetal femur length being directly related to the degree of fetal anemia. Subsequent to transfusion therapy there was increased growth of all fetal parameters measured. Birthweight was similar to a control group of unaffected fetuses. This contrasts with results after intraperitoneal transfusion where birthweights have been reported as being below average.

Birth Weight↗