Current opinion in obstetrics & gynecology
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Decisions about the role of cesarean section, forceps, and vacuum delivery in obstetrics continue to be a challenging part of daily obstetric practice. Five interesting papers on this topic are reviewed, including a comparison of international rates of cesarean sections and vaginal births after cesarean section, the method of choice for the delivery of the low-birth-weight fetus presenting as vertex, the advantages of a prelabor cesarean section for a fetus diagnosed with meningomyelocele, and the appropriate role for the midforceps delivery in the 1990s.
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Factors influencing urinary tract infections depend on a balance between bacterial virulence (bacterial adhesion to tissues, hemolysin, and aerobactin) and on the host's defenses (local immunoglobulin production). Predisposing factors for the development of urinary tract infections in women are physiologic changes with aging, use of catheters, and genitourinary operations. ⋯ Treatment of complicated urinary tract infections is by intravenous medications. New drugs for treatment of urinary tract infections are also reviewed.