ObjectiveTo investigate the association between epidural analgesia (EDA) vs patient-controlled remifentanil analgesia (PCRA) and emergency delivery for presumed fetal compromise, in relation to... Show moreObjectiveTo investigate the association between epidural analgesia (EDA) vs patient-controlled remifentanil analgesia (PCRA) and emergency delivery for presumed fetal compromise, in relation to birth-weight quintile.MethodsThis was a post-hoc per-protocol analysis of the RAVEL multicenter equivalence randomized controlled trial. Non-anomalous singleton pregnancies between 36 + 0 and 42 + 6 weeks' gestation were randomized at the time of requesting pain relief to receive EDA or PCRA. The primary outcome was emergency delivery for presumed fetal compromise. Secondary outcomes included mode of delivery and neonatal outcomes. Analysis was performed according to birth-weight quintile and was corrected for relevant confounding variables.ResultsOf 619 pregnant women, 336 received PCRA and 283 received EDA. Among women receiving EDA, 14.8% had an emergency delivery for presumed fetal compromise, compared with 8.3% of women who received PCRA. After adjusting for parity, women receiving EDA had higher odds of presumed fetal compromise compared to those receiving PCRA (odds ratio, 1.69 (95% CI, 1.01-2.83)). A statistically significant linear-by-linear association was observed between presumed fetal compromise and birth-weight quintile (P = 0.003). The incidence of emergency delivery for presumed fetal compromise was highest in women receiving EDA and delivering a neonate with a birth weight in the lowest quintile.ConclusionsIntrapartum EDA is associated with a higher rate of emergency delivery for presumed fetal compromise compared to treatment with PCRA. Birth-weight quintile is a strong predictor of this outcome, independent of pain management method. (c) 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. Show less
Assyrian imperialism is closely associated with the practice of mass deportation. This practice has been explained by recourse to many different motivations. But can we hope to pinpoint the logic... Show moreAssyrian imperialism is closely associated with the practice of mass deportation. This practice has been explained by recourse to many different motivations. But can we hope to pinpoint the logic informing deportation rather than merely identifying its advantages? This paper surveys the evidence of deportation in the Levant in the period 745–620 b.c.e. Focusing on deportation in this circumscribed time and place enables a more concentrated account of its use. Deportation is generally argued to have served three broad ends: bolstering the supply of human resources in the Assyrian heartland, meeting particular strategic needs, and dealing with dissent. This paper finds that despite the many uses of deportation, it was first and foremost a punitive instrument intended to curb resistance to Assyrian hegemony. This punitive dimension constituted the foundation of Assyrian deportation in the Levant in the age of Assyrian hegemony. Show less
Vijgen, S.M.C.; Ham, D.P. van der; Bijlenga, D.; Beek, J.J. van; Bloemenkamp, K.W.M.; Kwee, A.; ... ; Ppromexil Study Grp 2014
