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Thirty-two consecutive women with pregnancy-induced hypertension of early onset were randomly allocated to treatment with pindolol or methyldopa. There was no difference between the groups in regard to the average time of delivery (36.33 vs. 36.6 weeks) and weight of the newborn (2850 vs. 2870 g). A significant drop in systolic (P less than 0.005) and diastolic (P less than 0.05) blood pressure was observed in the group of patients treated with pindolol as compared with the methyldopa group. In the pindolol group an improvement in renal function was observed as determined by CCT and serum creatinine. There were no side effects from the drugs in the mother or in the newborn.

We have investigated the significance of single sporadic deceleration during reactive nonstress testing in normal pregnancies at term. A prospective study was performed during a 1-year period including 4742 nonstress tests performed between the 38th and 42nd weeks of pregnancy in patients referred to our department for antepartum testing and without any complication or pathology. Nonstress test (NST) was carried out with the patient lying on her left side, and was defined as reactive if at least two accelerations of 15 beats/min (bpm) or more lasting 15 sec were observed in a 20-min period. Sporadic deceleration was defined as a decrease in the fetal heart rate to less than 90 bpm or a decrease of 40 bpm below the baseline, lasting at least 2 min. The sporadic deceleration was considered as single when only one appeared in the first 20 min of monitoring and repeated when observed again once in at least one subsequent monitoring. Thirty-four cases of single sporadic deceleration were observed among women with reactive NST. In 14 cases there were repeated sporadic decelerations. The patients were divided into two groups according to the presence or absence of repeated decelerations. Outcomes of patients with repeated sporadic decelerations were compared with a group of 34 patients where sporadic decelerations were not observed during the antepartum testing. A significantly higher percentage of pathological fetal heart rate traces during labor were observed in the group of repeated decelerations. In conclusion the presence of repeated sporadic decelerations during a reactive NST suggests that the cause of cord compromise is persistent and recurrent cord compression is possible. Therefore, in these cases an increased fetal risk could be expected.

Summary We report on the use of epidural analgesia during labour in 58 out of a total of 234 twin deliveries performed over a five‐year period. A comparable control group consisted of 44 twin pregnancies delivered consecutively during the year preceding the introduction of epidural analgesia into our department. Epidural analgesia shortened the mean time of labour and made possible the performance of all necessary instrumental and obstetrical manoeuvres, without additional anaesthesia or adverse effects on the second twin. The epidural group required oxytocin more often due to an increased incidence of hypotonic uterine dysfunction. There was also a considerable increase of instrumental deliveries in the epidural group. The condition of the newborn infants of both groups, evaluated by Apgar score at one minute, was similar, but there was a higher perinatal mortality among pre‐term infants delivered under epidural analgesia. Epidural analgesia was found to be an acceptable method of relieving pain in twin labour, but because of the increased necessity to use oxytocin and the relatively high perinatal mortality observed among pre‐term infants, further experience is necessary before it can be claimed that this is the method of choice for relief of pain in twin labour.