Press Releases Saturday 24 July 1999
No 7204 Volume 319
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://www.bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) BACTERIAL
VAGINOSIS SEEMS TO AFFECT
MISCARRIAGE
IN EARLY PREGNANCY
(2) PFI IS
BEING IMPLEMENTED WITH VIRTUALLY
NO PUBLIC
DEBATE
(3) SYNCHRONISE
CLOCKS TO FIND THE REAL
MILLENNIUM
BABY!
(1) BACTERIAL VAGINOSIS
SEEMS TO AFFECT
MISCARRIAGE IN EARLY PREGNANCY
(Influence of bacterial vaginosis
on conception and
miscarriage in the first trimester:
cohort study)
http://www.bmj.com/cgi/content/full/319/7204/220
Bacterial vaginosis, a form of inflammation
of the vagina
caused by bacteria, increases the risk
of miscarriage in the
early stages of pregnancy, say researchers
in this week's
BMJ. In their study of over 850 women
undergoing in vitro
fertilisation (IVF) in Leeds, Dr Susan
Ralph and colleagues
from Leeds General Infirmary found that
even though
bacterial vaginosis did not affect conception,
it was
associated with a two-fold risk of miscarriage
in the first
trimester.
Bacterial vaginosis is the most common
cause of abnormal
discharge among women of childbearing
age and prevalence
rates of between 13 and 31 per cent have
been reported in
pregnant women, say the authors. In their
study they found
that 24.6 per cent of women had bacterial
vaginosis, but that
there was no difference in the conception
rate between
these women and those with normal vaginal
bacteria (flora).
However, say Ralph et al, 31.6 per cent
of the women
studied with bacterial vaginosis had a
significantly increased
risk of miscarriage in the first trimester
as opposed to 18.5
per cent of women with normal vaginal
flora. This increased
risk remained significant even after the
researchers
accounted for factors known to increase
miscarriage, such
as increasing maternal age, smoking, polycystic
ovaries and
a past history of three or more miscarriages.
The authors conclude that their study is
the first to describe
a definite association between bacterial
vaginosis and
miscarriage in the first trimester, however,
they concede that
they are still not clear how this condition
affects
miscarriages. They speculate that the
cause is most likely to
be due to pre-existing endometritis (inflammation
inside the
uterus) which affects the implantation
of the fertilised egg in
the IVF process or its early embryonic
development. They
suggest that this phenomenon could also
be relevant to
naturally conceived pregnancies and call
for further research
to be conducted in this area.
Contact:
Dr Janet Wilson, Consultant Physician,
Department of
Genitourinary Medicine, General Infirmary
at Leeds, Leeds
Email: jdwilson{at}dunham.freeuk.com
(2) PFI IS BEING IMPLEMENTED
WITH VIRTUALLY
NO PUBLIC DEBATE
(The politics of the private finance
initiative and the new
NHS)
http://www.bmj.com/cgi/content/full/319/7204/249
In the last of four Education and Debate
articles published in
the BMJ, this week Declan Gaffney et al
from University
College London, and the Universities of
Northumbria and
Manchester, pull together their arguments
against the
continuation of the government's private
finance initiative
(PFI) within the UK's National Health
Service (NHS).
The authors conclude that "...the PFI provides
the conditions
and the mechanisms for reversing the principles
that health
care should be funded out of general taxation,
that public
services should remain in public ownership
and that health
services should be free at the point of
delivery." They go on
to say that "...The NHS has already undergone
major
redefinition with the redrawing of the
boundaries for long
term care, NHS dentistry, optical services
and routine
elective care. The PFI continues this
trend across the NHS
and all public services. It is being implemented
with virtually
no public debate."
Contact:
Professor Allyson Pollock, Health Policy
and Health
Services Research Unit, School of Public
Policy, University
College London
Email: allyson.pollock{at}ucl.ac.uk
(3) SYNCHRONISE CLOCKS
TO FIND THE REAL
MILLENNIUM BABY!
(Clocks in delivery wards may not
be sufficiently accurate to
validate birth of "Millennium babies")
http://www.bmj.com/cgi/content/full/319/7204/260
In a tongue-in-cheek letter in this week's
BMJ two
paediatricians from London warn that in
order to validate the
birth of the so-called "first millennium
baby", labour wards
should ensure that all their clocks are
set accurately!
Dr Jonathan Round and Dr Nigel Kennea report
that in a
study of their labour ward, where 2,600
babies are delivered
each year, all six clocks in the delivery
rooms were slow by
a median of 93.6 seconds. The authors
also surveyed the
clocks in the labour ward of a large teaching
hospital and
found that the median of eleven clocks
was 15 seconds
slow, but they ranged from four minutes
12 seconds slow to
two minutes 25 seconds fast!
They conclude that most parents expect
the clocks to be
accurate and might be surprised if their
baby became five
minutes older during transfer to a different
room!
Contact:
Dr Jonathan Round, Specialist Registrar
in Paediatrics,
Gravesend Hospital, Kent
Email: jround9{at}yahoo.com
or
Dr Nigel Kennea, Specialist Registrar in
Paediatrics
(neonatology), Department of Child Health,
St George's
Hospital Medical School, London
Email: n.ykennea{at}btinternet.com
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Advancement of Science
(http://www.eurekalert.org)
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