International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Two hundred eighty-four macrosomic babies of 4000 g or over at birth were compared with an equal number of appropriate weight term infants, to identify maternal risk factors and fetal outcome. Maternal obesity, grand multiparity, diabetes mellitus and postmaturity were the major maternal risks. Prolonged labor, shoulder dystocia and injury to infant following instrumental delivery for mid-cavity arrest were the major fetal risks. A protocol for management of fetal macrosomia is proposed.
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Spontaneous rupture of a normal spleen is a rare entity. We report a case of spontaneous rupture during early pregnancy. Ruptured ectopic pregnancy was suspected preoperatively, but on exploration a splenic rupture was detected and splenectomy performed.
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Int J Gynaecol Obstet · Sep 1989
Comparative StudyThe role of confidential enquiries in the reduction of maternal mortality and alternatives to this approach.
The aim of confidential enquiries into maternal deaths is to identify weaknesses in the maternal health care system with a view to remedying them. The method of confidential enquiry is explained using the British system as an example. The reasons why this apparently useful practice is not more widely adopted can in some countries include fears of litigation or lack of trust in confidentiality. Alternative approaches to maternal death audit are discussed.
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Int J Gynaecol Obstet · Jul 1989
Review Case ReportsPneumoperitoneum due to peritoneovaginal fistula following hysterectomy.
A patient with pneumoperitoneum that developed due to peritoneovaginal fistula following hysterectomy is presented. In addition, we have reviewed the literature and formulated guidelines for the management of this problem. ⋯ Laparotomy may be avoided if the cause of the fistula is suspected. Surgical closure of the fistula may be unnecessary since spontaneous closure occurs frequently.
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Int J Gynaecol Obstet · Jul 1989
Use of prostaglandin E2 vaginal suppositories in third-trimester fetal demise.
A retrospective analysis of eight cases of third-trimester fetal demise managed with prostaglandin E2 vaginal suppositories (PGE2) is presented. Management included laminaria insertion prior to induction and an initial lower dosage of PGE2. No cases of uterine rupture or cervicovaginal lacerations were encountered. A summary of the literature as it relates to PGE2 vaginal suppository use in third-trimester fetal demise is included.