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Extremely preterm cesarean delivery "en caul".
MedLine Citation:
PMID:  21056307     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: Intact amniotic membranes may serve to protect the extremely fragile preterm infant from some of the mechanical forces caused by strong uterine contraction. This article introduces the technique of "en caul" cesarean delivery and reviews the experience of the National Taiwan University Hospital.
MATERIALS AND METHODS: This is a prospective study carried out to perform the "en caul" cesarean delivery for early preterm labors between October 2007 and December 2008. Cases were included if the estimated birth weight was below 1,500 g or gestational age was = 32 weeks.
RESULTS: Twenty women including four twin pregnancies were included, and 23 neonates were born with intact membranes. Preterm labor was indicated in 16 cases, and nine of the cases were due to severe hypertensive disorders during pregnancy. Except in the case of placenta accreta, all underwent lower transverse uterine incision without wound extension. One fetus died after 3 days due to sepsis and the mortality rate was 4.3%. A total of 15 babies had an Apgar score at 5 minutes of more than seven. The value of first arterial pH was 7.278 ± 0.117 and hemoglobin was 16.1 ± 2.1 g/dL. The corrected post-menstrual age at discharge was 277.75 ± 38.56 days.
CONCLUSION: Cesarean delivery en caul is an effective and easy technique for extremely preterm fetuses to protect them from pressure trauma and also results in less uterine injury.
Authors:
Chia-Hui Lin; Shin-Yu Lin; Yu-Hsuan Yang; Jin-Chung Shih; Ming-Kwang Shy; Chien-Nan Lee; Yu-Shih Yang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Taiwanese journal of obstetrics & gynecology     Volume:  49     ISSN:  1875-6263     ISO Abbreviation:  Taiwan J Obstet Gynecol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213819     Medline TA:  Taiwan J Obstet Gynecol     Country:  China    
Other Details:
Languages:  eng     Pagination:  254-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Taiwan Association of Obstetric & Gynecology. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
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