Objective association with placental abruption. Design Prospective descriptive study. Subjects 18 women with clinical evidence of severe placental abruption delivered by caesarean section. Interventions Placental bed biopsies were obtained at caesarean section and studied histologically. Results Six specimens did not include trophoblast in the myometrium and were therefore not representative of the placental bed. Of the 12 representative specimens, seven demonstrated absence of physiological transformation of the utero-placental arteries (four of these were from hypertensive patients). Four biopsies showed abnormal vascular structures deep in the myometrium. One of these abnormal vessels included a fresh plug and extensive surrounding intramyometrial haemorrhage. Conclusions Vascular malformations in association with placental abruption may be the result of trophoblastic invasion and could be the site of vessel rupture. Further descriptive and comparative studies are needed. J Path B0c.t 93, 569-579.

Objective To determine whether the administration of prophylactic intravenous magnesium sulphate Design Randomised controlled trial.Setting A tertiary referral obstetric unit.Population Eight hundred and twenty-two women with severe pre-eclampsia requiring termination of Methods The women were randomised to receive either placebo (saline) or magnesium sulphateMain outcome measure The occurrence of eclampsia in the two groups. ResultsThe data of 699 women were evaluated. Fourteen were withdrawn after randomisation. The overall incidence of eclampsia was 1.8% . Of 345 women who received magnesium sulphate, one developed eclampsia (0.3%); in the placebo group, 11 1340 women (3.2%) developed eclampsia (relative risk 0.09; 95% confidence interval 0.01-069; P = 0.003). ConclusionThe use of intravenous magnesium sulphate in the management of women with severe preeclampsia significantly reduced the development of eclampsia.reduces the occurrence of eclampsia in women with severe pre-eclampsia.pregnancy by induction of labour or caesarean section.intravenously. The investigators were blinded to the contents of the pre-mixed solutions.

Objective To determine whether the administration of prophylactic intravenous magnesium sulphate Design Randomised controlled trial.Setting A tertiary referral obstetric unit.Population Eight hundred and twenty-two women with severe pre-eclampsia requiring termination of Methods The women were randomised to receive either placebo (saline) or magnesium sulphate Main outcome measure The occurrence of eclampsia in the two groups. ResultsThe data of 699 women were evaluated. Fourteen were withdrawn after randomisation. The overall incidence of eclampsia was 1.8% . Of 345 women who received magnesium sulphate, one developed eclampsia (0.3%); in the placebo group, 11 1340 women (3.2%) developed eclampsia (relative risk 0.09; 95% confidence interval 0.01-069; P = 0.003). ConclusionThe use of intravenous magnesium sulphate in the management of women with severe preeclampsia significantly reduced the development of eclampsia.reduces the occurrence of eclampsia in women with severe pre-eclampsia.pregnancy by induction of labour or caesarean section.intravenously. The investigators were blinded to the contents of the pre-mixed solutions. 219-229. 565-567.