Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Jan 1988
Comparative StudyEpidural analgesia vs. general anesthesia for cesarean section.
A prospective study based upon interviews included 92 women who had undergone cesarean section, 38% with epidural analgesia and 62% under general anesthesia. The two groups were compared with respect to anesthesiological complications, postoperative morbidity and birth experience. The puerperal period was less complicated after epidural analgesia than after general anesthesia. ⋯ Nearly half of the patients in the epidural experienced slight peroperative pain. In the case of repeated cesarean section, 86% of women who had epidural analgesia wanted the same anesthesia again. On the basis of this study, epidural analgesia is recommended for cesarean section.
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Acta Obstet Gynecol Scand · Jan 1988
Comparative StudyEffect of epidural vs. general anesthesia on breastfeeding.
In a prospective interview study, two groups each consisting of 28 sectio caesarea patients were compared concerning the course of breastfeeding. The women in the two groups were delivered under either epidural analgesia or general anesthesia. The two groups were identical with respect to age, parity, participation in antenatal preparatory courses and former breastfeeding. A significantly higher breastfeeding frequency and longer breastfeeding periods were were found after epidural analgesia than after general anesthesia.
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Peripartum cardiomyopathy is a rare form of heart disease with a high mortality rate. We report a case, refractory to intensive medical treatment, with a fatal issue 5 months post partum. In recent years the literature has provided examples of the beneficial effect of immunosuppressive therapy, either Azathioprine combined with prednisone, or prednisone alone.
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A study comprising 221 women sterilized laparoscopically with Filshie Clips is presented. The pregnancy rate was 1.36%, which is considered acceptable as the method was new in the Department and performed by 10 surgeons with different degrees of skill in laparoscopy.
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Acta Obstet Gynecol Scand · Jan 1987
Labor induction for planned vaginal delivery in patients with previous cesarean section.
The role of labor induction in patients scheduled for vaginal delivery following a previous lower segment cesarean section has been controversial. In Hong Kong, we have managed these patients by induction when there were obstetric or medical indications. A review of 137 patients who had labor induced for a trial of scar showed that induction of labor was a safe procedure and the rate of repeat caesarean section in these patients (18.2%) was similar to that in other patients with a trial of scar who had spontaneous onset of labor (12.9%). ⋯ Although the use of oxytocin in addition to amniotomy produced no difference in the outcome, we felt that it was useful in preventing a long induction delivery interval as well as avoiding a high failure rate of induction. We conclude that in patients selected for a trial of scar, planned induction of labor should be attempted when an indication for delivery arises, as a high proportion (more than 80%) of these patients gave birth vaginally. If induction were ruled out, most of these patients would have to be delivered by repeat cesarean section, with its associated morbidity and expense.