International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Jun 1989
ReviewRisk factors for fever, endometritis and wound infection after abdominal delivery.
Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). ⋯ By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.
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In an analysis of 6376 singleton births the prevalence of macrosomia was 4.9%; the attending perinatal mortality was 58/1000 compared to 18/1000 in controls. Eighty-three percent perinatal deaths occurred in unbooked patients after prolonged and neglected labor. ⋯ Pregnancy was significantly prolonged with higher incidence of emergency sections and primary postpartum hemorrhage in mothers of macrosomic babies. Fetal sex does not appear to be an important factor in macrosomia.
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Prostaglandin E2 (PGE2) suppositories have been shown to be active contractile agents and are effective in uterine evacuation for mid-trimester abortion or fetal demise. In this study, 85 patients were treated with vaginal PGE2 suppositories. When laminaria were used in patients with closed cervices, and compared to those who had minimal cervical dilatation, there was no difference in the time from induction to expulsion. ⋯ In this study, 81% of the abortions were complete, and in one-third of the remaining patients dilatation and curettage was performed just after delivery of the fetus. The incidence of minor side-effects ranged from 12 to 21%, and there were no major complications. It is concluded that the use of vaginal prostaglandin E2 suppositories for induction of mid-trimester abortion or fetal demise in the third trimester is safe and effective.
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The maternal mortality rate (MMR) in 10 hospitals scattered all over Anambra State in a 5-year period was studied. The hospitals covered urban, semi-urban and rural areas. ⋯ The causes of and various factors influencing this high mortality rate are examined as well as the avoidable factors. Suggestions are made for its reduction based on accurate data collection, improved health facilities, improved socio-economic status and basic education.
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Int J Gynaecol Obstet · Dec 1988
Serum lipids and lipoproteins in women with polycystic ovarian disease with different body mass index.
A study to determine serum lipids and lipoproteins in 54 women with polycystic ovarian disease (PCOD) who had varying body mass index (BMI) compared to the normal regular menstruating women was carried out. All patients had similar hormonal profiles of PCOD and differed from the control group. ⋯ No significant correlation between lipids, lipoproteins and testosterone levels was observed. It appeared that the alteration of serum lipids and lipoproteins in PCOD is due to the effect of obesity.