A prospective study to evaluate the role of vitamin C and cervico-vaginal infection in the premature rupture of amniotic membranes (PROM) was designed. The leukocyte vitamin C levels of 44 pregnant women that did not consume vitamin supplements was evaluated at weeks 20, 28 and 32 of pregnancy. On each ...

The frequency of vaginal thrush was determined in an unselected group of patients attending the antenatal clinic. Diagnosis was based on phase-contrast microscopy and culture. One hundred and two patients were initially included but only 98 completed this study. Thrush infection was detected in 25 (25%) patients. All 25 patients ...

We sought to determine whether external cephalic version (ECV) with tocolytic agents in term patients with breech presentation could safely reduce the incidence of breech-related cesarean sections and vaginal breech deliveries. Four hundred and thirty-two patients with breech presentation at term who fulfilled broad criteria for attempted ECV and a ...

OBJECTIVE: To assess the course and outcome of pregnancy in patients who have undergone clam enterocystoplasty. PATIENTS AND METHODS: A retrospective study was carried out of 19 pregnancies in 18 women aged from 21 to 36 years who had undergone clam enterocystoplasty. RESULTS: Urinary tract infection was common but renal ...

Vacuum extraction can be an effective technique for operative vaginal delivery, and in some circumstances, it may even be a useful aid in abdominal delivery. Specialized equipment is required, but surprisingly little time is necessary to effect delivery in uncomplicated applications. Rigid vacuum extractors are more effective than pliable instruments ...

OBJECTIVE: To determine the longitudinal changes in the incidence of vaginosis in pregnancy. DESIGN: A prospective study of women during pregnancy. SETTING: A District General Hospital in North-West London. SUBJECTS: Seven hundred and eighteen pregnant women attending antenatal clinics. At their first attendance and subsequently, Gram-stained vaginal smears were examined ...

OBJECTIVES: To evaluate the use of feedback by graphical profiles of rates of episiotomy and the impact on clinical practice and perineal state after spontaneous vaginal deliveries assisted by midwives with different attitudes towards episiotomy. DESIGN: Observation period in labour ward followed by feedback to midwives about their own and ...

An enlarging cystic-solid cord abnormality was found at prenatal identification to be an angiomyxoma. Partial in utero decompression of the 16 x 12 x 5 cm cystic component allowed uncomplicated spontaneous vaginal delivery at 36 weeks' gestation. Doppler studies had shown variable systolic/diastolic ratios in the solid component of the ...

OBJECTIVE: To determine whether Kiellands forceps rotational delivery causes a significant reduction in fetal pH or base excess, as compared to a control group delivered using non-rotational forceps. DESIGN: A prospective observational study. SETTING: A teaching hospital labor ward in the UK. METHODS: Fetal blood sampling was performed prior to ...

A 23-year-old woman, gravida 1, para 0, at 42 weeks of pregnancy gave birth to a healthy female infant without complications except for a 4th-degree tear. Three hours after delivery, her voice was noted to have an unusual nasal quality, she complained of chest pain, and she developed extensive swelling ...

OBJECTIVES: To determine at which gestational age the ultrasound finding of a breech presentation should compel us to follow the pregnancy more closely with repeat ultrasound examinations. METHODS: A retrospective longitudinal investigation of ultrasound examinations in the second and third trimesters is reported. The study group consisted of 157 breech ...

OBJECTIVE: To design and conduct a mode of vaginal delivery for mentoposterior-presenting fetuses when cesarean delivery is not possible. METHODS: Eleven orthodox Jewish parturients who refused cesarean delivery had intrapartum bimanual conversion of mentoposterior to occipitoanterior presentation, concomitant with ritodrine infusion in ten. RESULTS: Excluding the first case, in which ...

OBJECTIVE: This study sought to determine whether low concentrations of fetal fibronectin in the cervical and vaginal secretions of patients at 39 weeks' gestation predicted pregnancies progressing beyond 41 weeks' gestation. STUDY DESIGN: A retrospective cohort study was undertaken using cervical and vaginal samples collected from 75 consenting patients during ...

Alternatives to oral estrogen replacement, including the transdermal patch, deliver estradiol in a constant manner, produce more physiologic estrone and estradiol levels than oral therapy, and avoid the first-pass effect on hepatic protein synthesis. Transdermal patches and estradiol implants have been demonstrated to produce favorable lipid profiles, prevent bone loss, ...

Women members of the newly formed Ehlers-Danlos National Foundation (EDNF) were surveyed with a very detailed questionnaire with 50 questions concerning family history and inheritance, past medical history, and obstetric and gynecologic problems. They entailed the largest extant database on Ehlers-Danlos Syndrome (EDS) patients. The mean age of the 68 ...

The treatment of vaginal bleeding during pregnancy may require little more than careful evaluation of the patient. Sometimes, however, the emergency physician must perform the highest resuscitative skills. In either case, the fears and concerns of the mother for herself and the fetus are considerable. This article describes, in four ...

OBJECTIVE: To assess pregnancy outcome in women with ventriculoperitoneal or lumboperitoneal shunts. METHODS: Charts were reviewed retrospectively for mothers with ventriculoperitoneal or lumboperitoneal shunts delivered at Hutzel Hospital from 1976-1992. Patients were identified by cross-referencing medical records from Children's Hospital Neurosurgical Division and medical records at Hutzel Hospital during this ...

OBJECTS: Pregnancy and delivery in two laryngectomized women. RESULTS: One woman had a pregnancy complicated by hypothyroidism and stenosis of the tracheostoma, she was delivered by cesarean section. The other had an uneventful pregnancy and a spontaneous vaginal delivery. CONCLUSIONS: Individualized handling of the delivery. By modifying the technique of ...

Partograms of 42 grand multipara women (mean 10 previous deliveries) were analyzed and compared with the partograms of nulli- or second-/thirdpara women. All these full-term pregnancies were normal and the vaginal deliveries were spontaneous and non-instrumental. The grand multiparas had the shortest duration of the latent phase and the second ...

OBJECTIVES: To determine the incidence of defecatory symptoms, pudendal nerve damage and mechanical trauma to the anal sphincters during vacuum and forceps delivery. METHODS: Anal endosonography, manometry, pudendal nerve terminal motor latency (PNTML) measurements and perineometry were performed in 43 primiparae who had an instrumental delivery (17 vacuum and 26 ...

OBJECTIVE: To determine whether magnetic resonance imaging (MRI) in pregnancy would help define a benign pelvic mass, thereby avoiding laparotomy. METHODS: During a 2-3-year period, five pregnant women with adnexal masses suspected to be leiomyomas underwent MRI. RESULTS: Four patients had evidence of leiomyoma and one had a benign cystic ...

This review covers recent literature relevant to breech presentation. Some have advocated routine elective cesarean delivery of the breech fetus of any gestational age to reduce the alleged increase in perinatal morbidity and mortality associated with breech presentation. This indication for cesarean delivery accounts for approximately 15% of all cesarean ...

A group of 450 heifers, 13 to 15 mo of age, were individually identified, vaccinated (IBR, PI(3), Leptospira, Campylobacter fetus), examined (body condition score, reproductive tract evaluation, assessment of vaginal lesions), and cultured for U. diversum . Heifers were randomly allocated to either a treated group given chlortetracycline (approximately 350 ...

Fifty-five patients with non-vertex presentation at 37 to 40 weeks' gestation were evaluated to determine which factors were associated with a successful external cephalic version (ECV). Maternal parity, obesity, amniotic fluid volume, placental location, type of breech and position of fetal spine were analyzed. Only amniotic fluid volume and fetal ...

OBJECTIVE: The purpose of this study was to determine the rate of potential contamination or splashes to the face of obstetricians during vaginal and cesarean delivery. STUDY DESIGN: Clear plastic face shields were worn during 50 consecutive vaginal and 50 consecutive cesarean deliveries. The face shields were then analyzed for ...

OBJECTIVE: To assess the efficacy of external cephalic version, including safety, cost-benefit analysis, and impact on the cesarean delivery rate. DATA SOURCES: A MEDLINE search was conducted to identify all articles published in English between 1980-1991 on external cephalic version. References were also cross-checked for all reports. METHODS OF STUDY ...

Abnormal Papanicolaou smears and colposcopic findings suggesting human Papilloma virus (HPV) infection and cervical intraepithelial neoplasia (CIN) may occur during pregnancy. Condylomata acuminata often grow rapidly during pregnancy and may regress spontaneously following delivery. However, the post-partum outcome of the untreated ante-partum abnormal cytologic smear and colposcopy has not been ...

OBJECTIVE: We sought to determine whether sacrospinous uterosacral ligament fixation restores the uterus to its normal anatomic position, preserving uterine function and allowing future childbearing. STUDY DESIGN: This study was undertaken at two separate medical centers. Women with symptomatic uterovaginal prolapse who desired either uterine preservation or future childbearing were ...

Three common infections account for most vaginal symptoms. Successful management depends on accurate identification of the etiologic agent and appropriate treatment. Clinical examination and office laboratory tests are usually adequate to diagnose bacterial vaginosis. Diagnosis of Candida vulvovaginitis and vaginitis caused by Trichomonas may require culture. Bacterial vaginosis is usually ...

BACKGROUND: The management of vaginal human papillomavirus (HPV) lesions may be difficult. We report an unusual long-term consequence of treatment. CASE: A 40-year-old woman presented with vaginal adenosis following treatment of multiple vaginal condylomata by endovaginal applications of 5% 5-fluorouracil cream and vaporization of the remaining subclinical condylomata by CO2 ...

OBJECTIVE: To determine whether maternal or fetal factors, other than vacuum-assisted delivery, play a role in neonatal retinal hemorrhage, and whether correlates are similar in retinal hemorrhage after spontaneous vaginal delivery. METHODS: A cross-section of assisted deliveries at an urban hospital (n = 156) over 7 months were compared with ...

The diagnosis of engagement of the fetal head is mandatory before operative vaginal delivery is to be attempted. There is widespread belief that the fetal head is engaged in the maternal pelvis when vaginal examination reveals that the bony presenting part has reached the level of the ischial spines. However, ...

The relative merits of vacuum extraction have been extensively studied and its advantages analysed. These include its ease of application, encouragement of "autorotation" of the malpositioned foetal head and its safety for both foetus and especially the mother. One hundred and eighty-six vacuum extraction assisted deliveries were performed at the ...

OBJECTIVE: The purpose of our study was to test the hypothesis that there is no increased morbidity or mortality associated with vaginal delivery of the nonvertex second twin. STUDY DESIGN: The medical records of 781 consecutive twin gestations achieving a gestational age > or = 20 weeks and delivering between ...

As various drugs might have an effect on the fetus during pregnancy, the use of drugs should be minimized in the pregnant woman. Since bacterial vaginosis (BV) can be associated with prematurity and postpartum complications, we searched for alternative therapy for its cure during pregnancy. Commercial yoghurt incorporates both factors ...

Eighty-two pregnancies involving a breech first twin were retrospectively analyzed over two study periods during which the cesarean section rates were 20.9 and 94.9%, respectively. The neonatal and maternal morbidity in both study periods was compared. There were no neonatal deaths during either study period and no cases of interlocking ...

In this study we treated a group of women during pregnancy by moxibustion on point 67 B (Zhiyin), to obtain inversion of fetuses in breech presentation. Comparison is made with a control group drawn retrospectively from clinical files at a regional hospital. The aim of the study is to identify ...

Pelvimetry remains a useful technique as part of the assessment of the term breech pregnancy where vaginal delivery is planned. MR pelvimetry is accurate, well tolerated and shows soft-tissue structures as well as bone. It avoids the potentially carcinogenic effects of ionising radiation and is thought to be completely safe ...

Current knowledge of fungal cell architecture and biochemistry allows limited understanding of the mode of action of presently available topical antifungal agents. Nystatin, first introduced in the 1950s for treatment of vulvovaginal candidiasis, has been surpassed by the imidazoles and triazoles as the first choice of treatment for vulvovaginal candidiasis. ...

A study of the vaginal yeast flora in pregnant women living in Cusco and in its region (Peru), located approximately 3000 m above sea level, is reported. We observed 300 pregnant, healthy and non-diabetic women who attended a gynaecological clinic in the Lorena, Regional or IPSS (Instituto Peruano de Seguridad ...

A major postpartum haemorrhage occurred in a patient with a previous history of female circumcision. Following assisted vaginal delivery 6 litre blood loss occurred as a result of tears to the vagina and perineum. The tears were sutured, followed by insertion of vaginal packs. Replacement fluid therapy was given. To ...

Despite the use of prophylactic antibiotics, endometritis occurs in 1-31% of patients after cesarean delivery. We sought to identify predictors of prophylactic antibiotic failure. In a retrospective review of 1800 cesarean deliveries, 766 patients had either ampicillin or cefazolin prophylaxis; 240 (31.3%) developed endometritis. Stepwise logistic regression identified the number ...

Vaginal scanning of the ovaries and the uterus is a diagnostic and monitoring tool of utmost importance in assisted conception. Although the value of ultrasound for monitoring follicular growth has been questioned, few groups working on assisted conception do not use it. Follicle aspiration under the guidance of vaginal sonography ...

In a prospective study of 124 neonates born to mothers with normal pregnancy and pregnancy associated hypertension (PAH), serum IgG, IgA and IgM were estimated by single radial immunodiffusion technique. Significantly low levels of IgG were found in mothers having PAH, as compared to normal pregnancy (p less than 0.001), ...

Urinary leakage was reported in 53.5% of our patients at least once during pregnancy. Multigravidae and women older than 30 were affected more often than primigravidae or women younger than 30. 6.2% of all women, who were continent before pregnancy, developed permanent stress incontinence after vaginal delivery. As a conclusion, ...

External cephalic version (ECV) using tocolysis is a widely recognized low-risk intervention in cases of breech presentation, particularly in areas where resources are scarce and the perinatal mortality is high in vaginal breech deliveries. In such a setting, pregnant women were trained to make regular self-assessments of the presenting fetal ...

Elevated maternal serum alpha-fetoprotein (MSAFP) levels have been associated with an increased incidence of both placental sonolucencies and pregnancy complications. We designed a prospective study to test the hypothesis that the presence of these sonolucencies or a positive maternal Kleihauer-Betke stain would be associated with an elevated risk of obstetric ...

Five percent 5-fluorouracil (5-FU), an antineoplastic agent, is often applied to the lower genital tract in the treatment of vaginal and vulvar human papillomavirus infections. Little is known regarding possible teratogenic effects from its topical use in pregnancy. Five cases of antenatal lower genital tract 5-FU use were correlated with ...

OBJECTIVE: To discuss the aetiology, diagnosis and management of ureteric obstruction in pregnancy and to describe the use of double-pigtail ureteric stents in a series of 10 patients. DESIGN: Retrospective study of women presenting to a maternity unit in whom the diagnosis of ureteric obstruction is reached. SETTING: Southmead Hospital ...

Ten gravidas with bacteriuria in the immediate antepartum period subsequently delivered vaginally and did not receive antibiotic therapy. Four of these women developed postpartum endometritis and in three of them, the same Enterobacteriaceae recovered from the urine was present in the endometrial cultures. Of the 1233 study subjects whose screening ...