ment on such flights. In addition to the U.K., many flights have been undertaken to Europe, to such places as Copenhagen, Paris, and Majorca. At the present time the air wing is limited to sitting cases in its own aircraft and charters air ambulances for stretcher cases. It is hoped that an aircraft may be made available to us in the future for the carriage of stretcher cases. If any of your readers are alble to help us in this respect it will enable us to reduce the cost to the patient even further. All pilots, controllers, and medical and nursing air attendants give their time free, the only expense involved being the running cost of the aircraft and odd items such az landing fees. We shall be pleased to supply further information to any interested readers.-I am, etc., D. H. CLARK
The approach of term in the pregnancy of a diabetic woman is a time of anxiety for patient and physician alike. The impact of a conservative approach to the timing of delivery is outlined in this review of the clinical course and outcome of 276 pregnancies of diabetic women, delivered at the National Maternity Hospital, Dublin between 1981 and 1990. The mean gestation at delivery was 39 weeks, 229 patients (83%) delivered at or beyond 38 weeks and 112 patients (41%) delivered at or beyond 40 weeks. The overall induction of labour rate was 27% and the elective Caesarean section rate was 19%. Sixty seven percent of patients achieved a normal delivery, the forceps rate was 5%, and 28% of patients were delivered by Caesarean section. There were 16 perinatal deaths in the series, with 7 due to lethal malformations. There were 5 deaths of normally formed infants occurring at or beyond 38 weeks' gestation. All of these 5 deaths had been preceded by clinically apparent polyhydramnios or macrosomia and recognized poor control. This study stresses the value of strict diabetic control in the management of diabetic pregnancy and highlights the significance of polyhydramnios and macrosomia as indicators of risk approaching term in diabetic pregnancy.
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