Venous air embolism is an infrequent complication of pregnancy but may occur if air is blown into the vagina during orogenital sex. Air passes beneath the fetal membranes and into the circulation of the subplacental sinuses, invariably causing death to both mother and fetus within minutes. Reported is the case ...

This descriptive study was conducted to evaluate the risk of uterine rupture in cases of late vaginal induced abortions among women with previous cesarean sections. 23 women were referred at a mean gestational age of 23.9 (SD 6.9) weeks of gestation after one or two cesarean sections. Indications for terminating ...

We present the case of a 30-year-old woman, 33 weeks pregnant, whose pregnancy was complicated with the rare condition of pheochromocytoma-induced myocardial infarction. Alpha- and beta-adrenergic blockade was instituted immediately for control of hypertension and arrhythmias. Two weeks after myocardial infarction, fetal maturity was documented, and the patient underwent cesarean ...

Achondroplasia is a physeal dysplasia which leads to dwarfism secondary to a decrease in the proliferation of cartilage in the growth plate. This, coupled with normal persistent bone formation, leads to the development of short tubular bones. Achondroplastic dwarfism is among the more common types of dwarfism and is inherited ...

Changes in maternal hemoglobin concentrations after cesarean section performed before 35 weeks gestation were analyzed according to the type of anesthesia in a case-control retrospective study. There were 30 mothers who received general anesthesia (GA group) and 30 mothers who received regional anesthesia (RA group). The groups were matched for ...

Since cephalopelvic disproportion inevitably leads to cesarean section it seems to be mandatory to identify patients with an absolute discrepancy between the size of the fetus and the birth canal in order to avoid unnecessary trials of labour. In a case control study, comparing a group of patients who delivered ...

There are approximately 3,000 women of childbearing age who become spinal cord injured each year in the United States. There are few reports in the literature that address pregnancy, labor and delivery in this patient population. We are reporting on 22 women post spinal cord injury who had 33 pregnancies. ...

A retrospective study of 155 pregnant patients with obstetric fistulae was conducted to determine the factors associated with improvement in the pregnancy outcome. The successful repair of the fistula was associated with a reduced abortion rate (4.0%), incidence of premature rupture of the membranes (1.3%) perinatal mortality (13.0%) as well ...

Reports of dermatomyositis (DM) and polymyositis complicating pregnancy are rare. Only nineteen cases have been published. We describe the first case in which juvenile DM appeared during pregnancy. An emergency cesarean section had to be performed due to fetal distress at 37 weeks of gestation. Patient and infant are doing ...

Massive trauma in a near-term pregnant patient challenges the emergency physician with very difficult treatment choices. We present the case of a severely traumatized pregnant female, near term, in whom the decision to proceed with a perimortem cesarean section in the Emergency Department produced a viable infant. We discuss the ...

A 36-year-old black multipara at 32 weeks gestation was referred with apparent peripartal cardiomyopathy. Upon arrival, she was found to be in pulmonary edema; and shortly thereafter developed cardiopulmonary arrest. She failed to respond to initial attempts at cardiopulmonary resuscitation but subsequently responded after Caesarean section and pericardiocentesis. This case ...

In a prospective study of 318 consecutive pregnancies complicated by previous Caesarean section, 193 (61%) had an elective repeat Caesarean section, 125 (39%) had a trial of labour and 80 (64%) of these women achieved a vaginal delivery. The incidence of uterine rupture was 0.8% (1 of 125). The vaginal ...

Among the 960 women who successfully delivered by vaginal route after previous cesarean section, 10 (1.04%) had complete lower segment scar rupture over a 9 year period. All were sufficiently symptomatic in order to suspect a ruptured uterus prior to scar exploration. We conclude that lower uterine segment palpation should ...

In order to assess the contribution of antenatal diagnosis to the management of gastroschisis, the antenatal and postnatal data from 24 cases of gastroschisis observed between 1974 and 1990 were re-examined. The frequency of antenatal diagnosis (29%), polyhydramnios (21%), atresia of the small intestine (29%), length of pregnancy (36.6 +/- ...

A report on pregnancy in a quadriplegic patient treated with a high dose of 1000 mcg/24 h continuous intrathecal baclofen infusion using an implanted drug delivery system (Synchromed, Medtronic, USA). Spasticity could be managed up to the 35th week of gestation. However, uterine contractions evoke enormous spastic symptoms which we, ...

The appropriateness of cesarean section as the route of delivery in pregnancies complicated by fatal fetal abnormalities was evaluated in an obstetric population of 47,924 deliveries during the years 1978-90. The incidence of fatal fetal abnormalities was 0.50% and did not change during the study period. The cesarean section rate ...

This case report describes a woman who was admitted to the hospital one week before term to an elective cesarean section because of two previously cesarean sections. Her present pregnancy was uneventful, the CTG on admission was normal. During the operation preformed in epidural anesthesia the uterus was found to ...

A nation-wide perinatal census which included 22,815 deliveries was carried out. The cesarean section rate was 9.6% and the perinatal mortality rate was 13.5/1000. Using a logistic regression analysis the risk factors for cesarean section and for perinatal mortality were ranked. Breech presentation and one uterine scar were found to ...

Though hyperbaric solution of bupivacaine following intrathecal injection had satisfactory spread of analgesia, it regressed rapidly with more side effects. Isobaric bupivacaine seemed to provide a slow regression of analgesia with fewer undesirable effects except for its inadequate spread of analgesia. As a result, if the dosages as well as ...

To assess the influence of maternal malnutrition on the mode of delivery and asphyxia neonatorum, a cross sectional survey of 615 women in the age group of 20-28 yrs at the time of delivery was done. Women with chronic ailments and complicated pregnancies were excluded. The mothers were then classified ...

The safety of trials of labor after cesarean section has yet to be established in developing countries. Centre Médical Evangélique is a referral hospital in rural northeastern Zaire. From August 1, 1989, to January 15, 1990, 33 women with previous cesarean deliveries were offered a trial of labor. Of them, ...

A retrospective study was carried out of caesarean sections at 30 completed weeks of gestation or less between 1/1/88 and 31/12/89 in Glasgow and The West of Scotland. One hundred and thirty-three caesarean sections were carried out resulting in 150 babies. Fifteen (11.3%) of these were classical sections. There were ...

A 20-yr-old primigravida at 38 weeks gestation with premature rupture of membranes and evidence of fetal distress required urgent Caesarean section. The diagnosis of osteogenesis imperfecta had been made 4 days earlier. The patient refused a regional anaesthetic. Difficulties in the administration of general anaesthesia to patients with osteogenesis imperfecta ...

We report spontaneous bladder and uterine rupture in a patient undergoing oxytocin augmented labor while under epidural anesthesia after a previous cesarean section. The presenting signs were gross hematuria at placement of an indwelling catheter and fetal distress. Cesarean section produced a healthy newborn. The patient recovered satisfactorily after subtotal ...

An evaluation of a 30 gauge spinal needle in a combined epidural/spinal anaesthetic technique for Caesarean section revealed a 25% failure rate of the spinal element. In this unit, no more than 4% of spinal anaesthetics might be expected to fail. One of the reasons for the higher failure rate ...

Transabdominal amnio-infusion preceding labor induction was evaluated as a means of avoiding fetal distress and cesarean delivery in patients with oligohydramnios. A preliminary study was performed in 8 consecutive term or post-term pregnancies complicated by severe oligohydramnios (amniotic fluid index less than or equal to 1 cm) with unripe cervices ...

Four hundred and five Maternal-Fetal Medicine specialists were surveyed to determine their clinical opinions regarding intrapartum management of the severely preterm fetus requiring delivery. Intrapartum fetal heart rate monitoring was initiated at 23, 24, and 25 weeks' gestation by 10%, 43%, and 66% of respondents, respectively. Cesarean section was not ...

The distribution of glycoconjugates in the endolymphatic sac (ES) and vestibular end organs from the 12th gestational day (GD) in the developing mouse to the 6th day after birth was analyzed using six biotinylated lectins: wheat germ agglutinin (WGA), Abrus precatorius agglutinin (APA), Ulex europaeus agglutinin I (UEA-I), Ricinus communis ...

A 20-year-old pregnant woman (8th month of gestation) developed signs of intracranial hypertension and coordination disorders. The CT examination demonstrated hydrocephalus, occlusion of the IV ventricle and hyperdense mass lesion in the right cerebellar hemisphere. Following ventricular drainage cesarean section was performed and then total removal of cerebellar hemangioblastoma, which ...

Of 44 pregnancies obtained at the Tenon Maternity Hospital by in vitro fertilization (IVF) using donated oocytes, 25 have already been completed by spontaneous delivery or cesarean section: 22 (88%) single; 2 (8%) twins, and 1 (4%) triple. The most frequently seen complications of pregnancy were hypertension (16%) and preterm ...

Hydrocephalic women with cerebrospinal fluid shunts are now surviving to reproductive age. Twenty-one pregnancies in 18 patients with shunts, including 11 from the present series and 10 from previous series, were analyzed for neurological, obstetrical, and perinatal outcome. Fourteen women had preexisting shunts, and 4 had the onset of symptomatic ...

Two hundred twenty women with prior cesarean section were delivered at our institution between January 1987 and February 1990. Vaginal delivery was achieved in 111 (66%) of 169 patients given a trial of labor (TOL). Success of TOL correlated positively with the number of prior vaginal deliveries (P less than ...

Trauma during pregnancy is a unique situation. Understanding injury patterns, anatomic and physiologic changes, and the initial approach to resuscitation is essential for all emergency nurses. Maternal resuscitation is the only means of fetal resuscitation. Meticulous attention must be given to the ABC's, with some minor modifications. Cervical spine immobilization ...

During the period extending from January 1982 to December 1989, we delivered 9,637 women at the University Teaching Hospital (C.H.U.), Yaounde, Cameroon. Seven hundred and forty-one (7.69 pc) of these patients underwent caesarean section (CS) Most of them were in the 20-30 year age group and of low parity (0-4). ...

An Italian nationwide presentation of data concerning the proportion of births by caesarean section (CS) for the period 1980-1985 is presented here. A constant increase in CS was noted, from 11.2% in 1980 to 15.8% in 1985. The increase was observed in all regions while higher rates were noted in ...

The pharmacokinetics of piperacillin during pregnancy were investigated. Eight pregnant women received 4 g of piperacillin intravenously before caesarean section. Likewise, five non-pregnant subjects of child bearing age received the same dose before a gynaecological operation. The mean peak plasma concentrations of piperacillin were 87.5 and 172.2 mg/L for the ...

This study was designed to determine the presence and different levels of placental neuropeptide Y (NPY) in women at parturition between normal spontaneous delivery (NSD) and cesarean section (C/S) under spinal anesthesia and to compare it with the level of catecholamines. Umbilical vein plasma levels of neuropeptide Y and catecholamines ...

Ehlers-Danlos syndrome (EDS) is a heterogeneous connective tissue disorder rarely complicating pregnancy. Some types are associated with high maternal mortality, while others appear more benign. Two term, vaginally delivered pregnancies with good outcomes from one patient were managed with EDS type III. The patient experienced no significant morbidity attributable to ...

Approximately 100,000 cesarean sections are performed each year in the United States because of breech presentation. Numerous studies have shown that external cephalic version can eliminate the need for many of these operations. However, because of the fear of uterine rupture, these studies have generally excluded patients who have undergone ...

The purpose of this study was to investigate the influence of postnatal x-ray pelvimetry after caesarean section on the management of the subsequent pregnancy. The case records of 331 women delivered by casearean section in their first pregnancy were reviewed. By standard radiological criteria, the pelvis was considered to be ...

OBJECTIVES: To determine (a) trends in the cesarean section rate in Alberta from April 1979 to March 1988, (b) the contribution of different primary indications to the overall increase in the cesarean section rate and (c) trends in the cesarean section rate by residence of the mother. DESIGN: Retrospective study. ...

The diagnostic and therapeutic problems posed by Sneddon's syndrome are discussed with reference to the case of a 31-year-old pregnant woman. This patient developed episodes of cerebral ischemia with multiple neurological deficits in the 24th week of pregnancy. The symptoms were associated with the dermatological signs of livedo racemosa. Delivery ...

STUDY OBJECTIVE: To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. DESIGN: Randomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study. SETTING: Inpatient obstetric department at a general hospital. PATIENTS: Seventy patients scheduled for elective cesarean ...

Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about ...

Today EPA is staying the effectiveness of subpart I of 40 CFR part 61, the National Emission Standards for Hazardous Air Pollutants for Radionuclide Emissions (54 FR 51654, December 15, 1989) as applied to facilities licensed by the Nuclear Regulatory Commission or an Agreement State ("NRC-licensed facilities"), other than nuclear ...

We studied the effects of a silicone gel bandage that was worn for at least 12 hours daily on the resolution of hypertrophic burn scar. In a second cohort, the prevention of hypertrophic scar formation in fresh surgical incisions by this bandage was also evaluated. In 19 patients with hypertrophic ...

The purpose of this study was to clarify the role of the intestinal anaerobic bacteria colonizing the intestine of the newborn delivered by cesarean section. Control of the intestinal microecology is dependent on many factors including intestinal peristalsis, the intraluminal environment, and microbial interactions, that deter the overgrowth of pathogens ...

The purpose of this paper is to determine the incidence of fetal macrosomia, analyze risk factors, and review maternal and fetal outcome. Macrosomia occurred in 15.1% of deliveries, with very macrosomic fetuses comprising 4.1% of these pregnancies; 61.3% were male. Diabetes mellitus, post-term pregnancy, and excessive weight gain were identified ...

There is considerable disagreement over the management of postterm pregnancies. The main controversy is whether to adopt a policy of routine induction or one of selective induction allied to frequent fetal surveillance. Current evidence suggests that routine induction at 42 weeks' gestation does not increase the risk of instrumental delivery ...

Two hundred and sixteen transverse caesarean section scars were examined sonographically near term by a conventional method (175 scars) and a new method (41 scars). The new method consisted of obtaining a transabdominal longitudinal scan by the conventional method and also by a 3M conductor, a transabdominal frontal scan to ...