No abstract

SummaryWarfarin was measured with a sensitive and specific method in the plasma and breast milk of 13 mothers.Less than 0-08 [tmol warfarin per litre (25 ng/ml) of breast milk was found in each instance. Seven of the mothers were breast-feeding their infants, in none of whom was warfarin detected in the plasma; furthermore, in three the British corrected ratio of the plasma was appreciably less than that of the mother and was within the expected range. We conclude that nursing mothers given warfarin may safely breast-feed their infants. IntroductionNursing mothers given anticoagulants by mouth are often advised against breast-feeding because of the risk of transferring the drug to the infant. More mothers are now seeking advice about this because of the widespread use of oral anticoagulants post partum and because of the increased popularity of breastfeeding.This problem has been investigated previously, but for several reasons there is little consensus on whether oral anticoagulants are present in breast milk. Firstly, the standard of clinical documentation in many reports leaves much to be desired.

No abstract

The amount of pain that had been experienced by 1000 women during vaginal delivery of a live child was determined by interview within 48 hours of delivery. Patients had been offered a choice of analgesia, and 536 had received epidural analgesia: pain relief was greatest in this group, just over half having had a painless labour. The duration of pain was also reduced by a third in this group even though patients who had received an epidural block had tended to have longer labour and an incidence of assisted delivery of 51% compared with 6% in the remainder. Seventy-two per cent of the patients receiving an epidural had had as much pain as they had expected.A similar proportion (70%) was reported with simpler analgesic methods, suggesting that women may expect a certain amount of pain in labour and request further analgesic treatment when this is exceeded.

Summary Intravenous salbutamol and ethanol were compared as treatments for preterm labour, 42 patients being assigned randomly to salbutamol and 46 to ethanol. There was no statistically significant difference in outcome between patients in the two groups, the mean delay in delivery achieved being 15 days with salbutamol and 20 days with ethanol. Neither treatment was very effective since only 10 patients given salbutamol and 14 given ethanol had their delivery postponed to 37 weeks or later. Salbutamol was more rapidly acting than ethanol but produced more cardiovascular side effects.