Gynecologic and obstetric investigation
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Gynecol. Obstet. Invest. · Jan 1996
Case ReportsTwo pregnancies in a 45,X/46,Xr(X)/46,XX Turner mosaic patient. A case report.
Turner's syndrome associated with an X ring chromosome, r (X), is rare and there has been no report on pregnancy in Turner's syndrome with 45,X/46,Xr (X)/46,XX mosaicism. A patient with this karyotype who lacked the clinical manifestation of characteristic phenotype of Turner's syndrome except for short stature had two pregnancies. This is the first case of successful pregnancy in patient with X,Xr(X),XX mosaic Turner's syndrome.
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Lactate, pH, pO2, and pCO2 were determined in arterial, venous, and free-flowing mixed umbilical cord blood obtained from deliveries of apparently healthy neonates. The goals of this study were to establish reference ranges for lactate and pH against which results in cases of high-risk labor and delivery could be compared, to see how the gases correlated with these values, and to determine whether easily accessible mixed umbilical cord blood can serve as the sample in lieu of cord arterial or cord venous blood. ⋯ Differences of > 0.5 mmol/l occurred between mixed and arterial cord bloods in 21 patients, and between mixed and venous cord bloods in 6 of the 48 patients, respectively. We conclude that (1) less than 2.5% of deliveries of apparently healthy neonates have arterial, venous, or mixed cord lactates > or = 7.0 mmol/l and pH < or = 7.15, (2) neither cord venous pO2 nor pCO2 correlate well with cord venous lactate, and (3) readily available mixed cord blood is a satisfactory specimen for the measurement of venous cord latate.
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Gynecol. Obstet. Invest. · Jan 1996
Case ReportsSuccessful pregnancy in a patient with severe pulmonary hypertension.
Pulmonary hypertension carries a grave prognosis during gestation with maternal mortality rates as high as 30-50%, even in patients with a good pre-pregnancy functional status. A case of a successfully managed pregnant woman with severe pulmonary hypertension, due to a surgically repaired atrial septal defect, is reported. She was admitted at 29 weeks of gestation with severe dyspnea at rest, orthopnea, tachypnea, cyanosis and edema of the extremities (functional class IV). ⋯ The patient died 1 year later from severe cardiopulmonary insufficiency due to the gradual progression of her severe pulmonary disease. In conclusion, prevention or interruption of pregnancy should be recommended strongly for women with pulmonary hypertension. However, if a woman, despite medical advice, chooses to continue her pregnancy, she can benefit from a prompt and well-balanced management, even in the presence of severe impairment of her functional status.
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Gynecol. Obstet. Invest. · Jan 1995
Epidural anaesthesia in labour: influence on surgical delivery rates, intrapartum fever and blood loss.
We retrospectively analyzed 7,317 fully documented deliveries to assess the effect of epidural anaesthesia (EA) on surgical delivery rates, on the incidence of intrapartum fever and on peripartal blood loss. 1,056 (14.4%) had EA and 6,261 (85.6%) had no or other analgesia. The use of EA was associated with a decreased spontaneous delivery rate (50.0 vs. 79.2%), increased forceps delivery rate (30.7 vs. 4.0%) and increased vacuum extraction rate (3.5 vs. 0.7%). The caesarean section rate was not significantly changed in patients with EA (14.4 vs. 13.0%). Fever greater than 38 degrees C during labour and intrapartum haemorrhage exceeding 500 ml were associated with the use of EA.
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Gynecol. Obstet. Invest. · Jan 1994
Insidious urinary retention after vaginal delivery: prevalence and symptoms at follow-up in a population-based study.
The purpose of this study was to investigate the prevalence of postpartum urinary retention in women after vaginal delivery and to determine whether parturients with retention develop voiding problems later. During a 3-month period, all parturients in the catchment area of the University Hospital, Lund, were investigated 3 days after delivery, residual volume being measured by ultrasonography. All those with postpartal retention were contacted 4 years after delivery, when they were reexamined by ultrasonography and asked to fill in a questionnaire regarding urinary problems. ⋯ At follow-up 4 years later, the prevalence of urinary symptoms was not higher than that in the general population. Ultrasonography to detect urinary retention does not seem to have any place in the normal postpartal care. However, extended supervision may be appropriate in parturients receiving epidural analgesia or in those submitted to instrumental deliveries.