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On epidemiological evidence, the definition of recurrent miscarriage should be three or more consecutive pregnancy losses. Data should be collected to 28 weeks' gestation but analysis up to 20-22 weeks' or 500 g fetal weight should also be possible. General practitioners and gynaecologists should do what they feel is suitable for couples whose history does(More)
Using immunohistological techniques, class 1 products of the major histocompatibility complex (MHC) have been demonstrated on various forms of human extra-villous trophoblast in placental tissues taken from first, second and third trimester pregnancies. This contrasts with the absence of class 1 MHC antigens on all forms of villous trophoblast. The(More)
OBJECTIVE To compare the effects on fetal and maternal morbidity of routine active management of third stage of labour and expectant (physiological) management, in particular to determine whether active management reduced incidence of postpartum haemorrhage. DESIGN Randomised trial of active versus physiological management. Women entered trial on(More)
CONTEXT Decision aids can increase patient involvement in treatment decision making. However, questions remain regarding their effects and cost implications. OBJECTIVE To evaluate the effects of information, with and without a structured preference elicitation interview, on treatment choices, health outcomes, and costs. DESIGN, SETTING, AND PARTICIPANTS(More)
Firm evidence on the causes of recurrent miscarriage is scant. The true rate is probably artificially heightened by a reproductive compensation effect. The commonest direct cause is probably repeated sporadic chromosome abnormalities, which occur consecutively merely by chance. Congenital and acquired anatomical defects of the uterine fundus and cervix,(More)
In a prospective audit of the obstetric management of 1210 consecutive deliveries the association was investigated between the need for operative delivery for fetal distress during labour and the condition of the newborn infant. Operative delivery was performed for only 11.5% of the newborn infants with severe acidosis at birth (umbilical artery pH less(More)
BACKGROUND There has been a threefold increase in the rate of Caesarean section over the past 25 years. The long-term consequences of Caesarean section may include subsequent subfertility. METHODS We investigated the relationship between Caesarean section and subfertility within a cohort of 14 541 pregnant women. RESULTS A history of previous Caesarean(More)