Two cases of advanced intraligamentary pregnancy have been seen at the Colonial War Memorial Hospital, Suva, Fiji, in the 10 years, 1972-81, during which time approximately 50,000 births have occurred. One patient presented with diarrhoea, and the other with the development of shock early in spurious labour.

No abstract

Failure of the shoulders to follow readily after delivery of the head is a life-threatening emergency for the mother and baby which is occasionally encountered by most obstetricians, and receives scant attention in current obstetric textbooks. This is a record of my personal experience of the condition, including 7 patients in whom a destructive procedure was required.

Given the ethnic differences in fetal growth and maturation, it would be appropriate to use ethnicity-specific standards for perinatal care in Fiji.

Forty patients presenting for vaginal termination of pregnancy, divided randomly into four groups, received either no medication, sodium citrate 30 ml orally, ranitidine 150 mg orally or ranitidine 50 mg intravenously. During the procedure, gastric contents were removed by 01'0gastric tube for volume and pH measurements. Ranitidine, orally and intravenously, significantly increased gastric pH and reduced gastric volume. In the control group only one pH was greater than 2.5. Sodium citrate raised the pH above 2.5 in 6 out of 10 patients. Fasting patients in the first months of pregnancy may be at risk of developing Mendelson's syndrome. Ranitidine is very effective in increasing gastric pH and at the same time reducing gastric volume in such patients.