Management of labour in an isolated rural maternity hospital.

Abstract:

OBJECTIVES:To evaluate the use of a maternity unit run by general practitioners and midwives, describing the outcome of labour in an unselected group of women and quantifying the contribution made by general practitioners. DESIGN:Retrospective population based review of obstetric patients who had access to an isolated rural maternity unit. SETTING:Rural area 120 km from a consultant maternity unit. SUBJECTS:997 consecutive women delivered between January 1987 and May 1991. MAIN OUTCOME MEASURES:Mode of delivery and complications by place of booking and place of delivery; need for medical intervention and transfer. RESULTS:530 women (53%) were booked for delivery in the rural unit; this group had a caesarean section rate of 3.8% and an unplanned transfer rate of 12.8% to the consultant unit in labour. Of the 462 who delivered in the low risk unit, 25 (5%) required a forceps delivery; postnatal complications requiring emergency medical support occurred in a further 33 (7%). CONCLUSIONS:Risk characterisation is possible, but medical support from general practitioners and obstetricians is required in almost a third of women at low risk for complications of delivery. Results of this study support the team approach to obstetric management but not the move towards isolated units without organised medical support.

journal_name

BMJ

authors

Baird AG,Jewell D,Walker JJ

doi

10.1136/bmj.312.7025.223

subject

Has Abstract

pub_date

1996-01-27 00:00:00

pages

223-6

issue

7025

eissn

0959-8138

issn

1756-1833

journal_volume

312

pub_type

杂志文章
  • Perceptions of stroke in the general public and patients with stroke: a qualitative study.

    abstract:OBJECTIVES:To gain insight into people's thoughts on stroke and to inform the development of educational strategies in the community. DESIGN:Focus group discussions: two groups of people who had a stroke and their carers, and two groups of members of the general public. SETTING:New South Wales, Australia. PARTICIPAN...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.324.7345.1065

    authors: Yoon SS,Byles J

    更新日期:2002-05-04 00:00:00

  • Screening for abdominal aortic aneurysms: single centre randomised controlled trial.

    abstract:OBJECTIVE:To determine whether screening Danish men aged 65 or more for abdominal aortic aneurysms reduces mortality. DESIGN:Single centre randomised controlled trial. SETTING:All five hospitals in Viborg County, Denmark. PARTICIPANTS:All 12,639 men born during 1921-33 and living in Viborg County. In 1994 we include...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.38369.620162.82

    authors: Lindholt JS,Juul S,Fasting H,Henneberg EW

    更新日期:2005-04-02 00:00:00

  • A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database.

    abstract:OBJECTIVES:To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. DESIGN:Feasibility study. SETTING:Seven paediatric intensive care units in England. PARTICIP...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.38404.650208.AE

    authors: McKinney PA,Jones S,Parslow R,Davey N,Darowski M,Chaudhry B,Stack C,Parry G,Draper ES,PICANet Consent Study Group.

    更新日期:2005-04-16 00:00:00

  • Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants.

    abstract:OBJECTIVE:To determine the long term effects of antibiotic treatment for acute otitis media in young children. DESIGN:Prospective three year follow-up study within the framework of a primary care based, double blind, randomised, placebo controlled trial. SETTING:53 general practices in the Netherlands. PARTICIPANTS:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.b2525

    authors: Bezáková N,Damoiseaux RA,Hoes AW,Schilder AG,Rovers MM

    更新日期:2009-06-30 00:00:00

  • Serum complex of trypsin 2 and alpha 1 antitrypsin as diagnostic and prognostic marker of acute pancreatitis: clinical study in consecutive patients.

    abstract:OBJECTIVE:To estimate the usefulness of serum concentrations of the complex of trypsin 2 and alpha 1 antitrypsin in diagnosing and assessing the severity of acute pancreatitis in comparison with serum C reactive protein, amylase, and trypsinogen 2 concentrations (reference markers). DESIGN:Markers were measured in con...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7053.333

    authors: Hedström J,Sainio V,Kemppainen E,Haapiainen R,Kivilaakso E,Schröder T,Leinonen J,Stenman UH

    更新日期:1996-08-10 00:00:00

  • Association between hormone replacement therapy and subsequent stroke: a meta-analysis.

    abstract:OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference li...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.38331.655347.8F

    authors: Bath PM,Gray LJ

    更新日期:2005-02-12 00:00:00

  • Substance use in remand prisoners: a consecutive case study.

    abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.315.7099.18

    authors: Mason D,Birmingham L,Grubin D

    更新日期:1997-07-05 00:00:00

  • Prevention of suicide: aspirations and evidence.

    abstract::The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.308.6938.1227

    authors: Gunnell D,Frankel S

    更新日期:1994-05-07 00:00:00

  • Screening for human T cell leukaemia/lymphoma virus among blood donors in Sweden: cost effectiveness analysis.

    abstract:OBJECTIVE:To analyse the cost effectiveness of a national programme to screen blood donors for infection with the human T cell leukaemia/lymphoma virus. DESIGN:Three models for calculating the costs and benefits of screening were developed. The first model analysed the cost of continuously testing all donations; the s...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.316.7142.1417

    authors: Tynell E,Andersson S,Lithander E,Arneborn M,Blomberg J,Hansson HB,Krook A,Nomberg M,Ramstedt K,Shanwell A,Bjorkman A

    更新日期:1998-05-09 00:00:00

  • Mortality associated with moderate intakes of wine, beer, or spirits.

    abstract:OBJECTIVE:To examine the association between intake of different types of alcoholic drinks and mortality. DESIGN:Prospective population study with baseline assessment of alcohol intake, smoking habit, income, education, and body mass index, and 10-12 years' follow up of mortality. SETTING:Copenhagen city heart study,...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6988.1165

    authors: Grønbaek M,Deis A,Sørensen TI,Becker U,Schnohr P,Jensen G

    更新日期:1995-05-06 00:00:00

  • Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group.

    abstract:OBJECTIVES:To prospectively assess the diagnostic performance of simple ultrasound rules to predict benignity/malignancy in an adnexal mass and to test the performance of the risk of malignancy index, two logistic regression models, and subjective assessment of ultrasonic findings by an experienced ultrasound examiner ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c6839

    authors: Timmerman D,Ameye L,Fischerova D,Epstein E,Melis GB,Guerriero S,Van Holsbeke C,Savelli L,Fruscio R,Lissoni AA,Testa AC,Veldman J,Vergote I,Van Huffel S,Bourne T,Valentin L

    更新日期:2010-12-14 00:00:00

  • Commodes: inconvenient conveniences.

    abstract:OBJECTIVES:To investigate use of commodes and attitudes of users and carers to them. DESIGN:Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS:140 users of a commode and 105 of their carers. RESULTS:Main reasons for being supplied with a co...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6914.1258

    authors: Naylor JR,Mulley GP

    更新日期:1993-11-13 00:00:00

  • Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia.

    abstract:OBJECTIVE:To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture. DESIGN:Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland. PARTICIPANTS:243 independently living patients aged 65 years or older admitted to hospital with ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.321.7269.1107

    authors: Huusko TM,Karppi P,Avikainen V,Kautiainen H,Sulkava R

    更新日期:2000-11-04 00:00:00

  • Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

    abstract:OBJECTIVES:To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire. DESIGN:Retrospective analysis of yearly data and projection of future trends. SETTING:England and Wales. SUBJECTS:General practitione...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.318.7179.306

    authors: Taylor DH Jr,Esmail A

    更新日期:1999-01-30 00:00:00

  • Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study.

    abstract:OBJECTIVE:To evaluate the association between consumption of ultra-processed foods and all cause mortality. DESIGN:Prospective cohort study. SETTING:Seguimiento Universidad de Navarra (SUN) cohort of university graduates, Spain 1999-2018. PARTICIPANTS:19 899 participants (12 113 women and 7786 men) aged 20-91 years ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.l1949

    authors: Rico-Campà A,Martínez-González MA,Alvarez-Alvarez I,Mendonça RD,de la Fuente-Arrillaga C,Gómez-Donoso C,Bes-Rastrollo M

    更新日期:2019-05-29 00:00:00

  • Failure to realise growth potential in utero and adult obesity in relation to blood pressure in 50 year old Swedish men.

    abstract:OBJECTIVES:To clarify the type of fetal growth impairment associated with increased blood pressure in adult life, and to establish whether this association is influenced by obesity and is mediated through impairment of insulin action. DESIGN:Cross sectional survey with retrospective ascertainment of size at birth from...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7028.401

    authors: Leon DA,Koupilova I,Lithell HO,Berglund L,Mohsen R,Vagero D,Lithell UB,McKeigue PM

    更新日期:1996-02-17 00:00:00

  • Prophylaxis and follow-up after possible exposure to HIV, hepatitis B virus, and hepatitis C virus outside hospital: evaluation of policy 2000-3.

    abstract:PROBLEM:Prophylactic treatment and follow-up after exposure to HIV, hepatitis B, and hepatitis C outside hospital needs to be improved. BACKGROUND AND SETTING:Until January 2000, people in Amsterdam could report exposure outside hospital to either a hospital or the municipal health service. If they reported to the mun...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.330.7495.825

    authors: Sonder GJ,Regez RM,Brinkman K,Prins JM,Mulder JW,Spaargaren J,Coutinho RA,van den Hoek A

    更新日期:2005-04-09 00:00:00

  • Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.

    abstract:OBJECTIVES:To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. DESIGN:Prospective, randomized, 52 week, single blind comparative effec...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.k851

    authors: Wang C,Schmid CH,Fielding RA,Harvey WF,Reid KF,Price LL,Driban JB,Kalish R,Rones R,McAlindon T

    更新日期:2018-03-21 00:00:00

  • Why Rudolph's nose is red: observational study.

    abstract:OBJECTIVE:To characterise the functional morphology of the nasal microcirculation in humans in comparison with reindeer as a means of testing the hypothesis that the luminous red nose of Rudolph, one of the most well known reindeer pulling Santa Claus's sleigh, is due to the presence of a highly dense and rich nasal mi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e8311

    authors: Ince C,van Kuijen AM,Milstein DM,Yürük K,Folkow LP,Fokkens WJ,Blix AS

    更新日期:2012-12-14 00:00:00

  • Incidence of cervical cancer after several negative smear results by age 50: prospective observational study.

    abstract:OBJECTIVE:To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN:Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopatho...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b1354

    authors: Rebolj M,van Ballegooijen M,Lynge E,Looman C,Essink-Bot ML,Boer R,Habbema D

    更新日期:2009-04-24 00:00:00

  • Making an advance directive.

    abstract::The introduction in Britain of advance directives--which allow a person to state in advance of becoming incompetent that they wish to take part in treatment decisions when no longer mentally competent--has now been advocated by the medical and legal establishments. The practical application of directives relating to h...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6974.236

    authors: Robertson GS

    更新日期:1995-01-28 00:00:00

  • Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis.

    abstract:OBJECTIVES:To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN:Randomised c...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38558.393669.E0

    authors: McManus RJ,Mant J,Roalfe A,Oakes RA,Bryan S,Pattison HM,Hobbs FD

    更新日期:2005-09-03 00:00:00

  • Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial.

    abstract:OBJECTIVE:To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. DESIGN:Randomised controlled trial. SETTING:Home based intervention in heart failure patients. PARTICIPANTS:293 patie...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.39164.568183.AE

    authors: Holland R,Brooksby I,Lenaghan E,Ashton K,Hay L,Smith R,Shepstone L,Lipp A,Daly C,Howe A,Hall R,Harvey I

    更新日期:2007-05-26 00:00:00

  • Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial.

    abstract:OBJECTIVE:To compare whether differences exist between alternating pressure overlays and alternating pressure mattresses in the development of new pressure ulcers, healing of existing pressure ulcers, and patient acceptability. DESIGN:Pragmatic, open, multicentre, randomised controlled trial. SETTING:11 hospitals in ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38849.478299.7C

    authors: Nixon J,Cranny G,Iglesias C,Nelson EA,Hawkins K,Phillips A,Torgerson D,Mason S,Cullum N

    更新日期:2006-06-17 00:00:00

  • Positive and negative factors in defensive medicine: a questionnaire study of general practitioners.

    abstract:OBJECTIVES:(a) To investigate defensive medical practices among general practitioners; (b) to compare any such practices with general practitioners' understanding of certain aspects of the terms of service and medical negligence and practitioners' concerns about the risk of being sued or having a complaint lodged. DES...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6971.27

    authors: Summerton N

    更新日期:1995-01-07 00:00:00

  • Angiotensin converting enzyme insertion or deletion polymorphism and coronary restenosis: meta-analysis of 16 studies.

    abstract:OBJECTIVE:To assess the association between genotype at the insertion or deletion polymorphism of the angiotensin converting enzyme gene and risk of coronary restenosis after percutaneous coronary intervention. DESIGN:Meta-analysis of studies before July 2001 that reported on these genotypes and risk of coronary reste...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.325.7363.517

    authors: Bonnici F,Keavney B,Collins R,Danesh J

    更新日期:2002-09-07 00:00:00

  • US doctors file lawsuit against antiabortionists.

    abstract::In Oregon, Planned Parenthood and a group of physicians who perform abortions have filed a civil suit against several anti-abortion groups individuals. The suit seeks $200 million in damages and an injunction to bar the defendants from posting information on the Internet that threatens the lives and well-being of the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 新闻

    doi:10.1136/bmj.318.7178.214a

    authors: Charatan F

    更新日期:1999-01-23 00:00:00

  • Continuing medical education: experience and opinions of consultants.

    abstract::The right of consultants to study leave and expenses is not binding on trusts and has been eroded in directly managed units. Complaints led to a survey of consultants in North West Thames region. This showed that most consultants use their own time and money to maintain their knowledge by buying and consulting journal...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6889.1398

    authors: Kerr DN,Jones SA,Easmon CS

    更新日期:1993-05-22 00:00:00

  • Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK).

    abstract:OBJECTIVE:To estimate the risk of breast cancer associated with diagnostic radiation in carriers of BRCA1/2 mutations. DESIGN:Retrospective cohort study (GENE-RAD-RISK). SETTING:Three nationwide studies (GENEPSO, EMBRACE, HEBON) in France, United Kingdom, and the Netherlands, PARTICIPANTS:1993 female carriers of BRC...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e5660

    authors: Pijpe A,Andrieu N,Easton DF,Kesminiene A,Cardis E,Noguès C,Gauthier-Villars M,Lasset C,Fricker JP,Peock S,Frost D,Evans DG,Eeles RA,Paterson J,Manders P,van Asperen CJ,Ausems MG,Meijers-Heijboer H,Thierry-Chef I,Hau

    更新日期:2012-09-06 00:00:00

  • Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study.

    abstract:OBJECTIVE:To evaluate the effects on suicidal behaviour of legislation limiting the size of packs of paracetamol and salicylates sold over the counter. DESIGN:Before and after study. SETTING:UK population, with detailed monitoring of data from five liver units and seven general hospitals, between September 1996 and S...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.322.7296.1203

    authors: Hawton K,Townsend E,Deeks J,Appleby L,Gunnell D,Bennewith O,Cooper J

    更新日期:2001-05-19 00:00:00