Geburtsh Frauenheilk
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Infections are still the most frequent peripartal complications. Very often they are nosocomial (hospital acquired) infections. Diagnosis and therapy of severe conditions may pose considerable problems. ⋯ The choice of antibiotics has to be done in consideration of the bacteriology of the vagina (endogenous infection). Removal of the infection site (uterus with or without adnexae) is the therapeutic procedure with the highest success rate in cases with sepsis or bacterial shock. Prophylaxis of infectious morbidity following caesarean section seems to be possible and advisable in patients with certain risk factors (labour, rupture of membranes, repeated vaginal examinations).
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A case of Caesarean section on a deceased pregnant woman is described. Medical Ethics dictates to carry out this operation as long as their is hope for the delivery of a live infant. ⋯ One scalpel is all that is needed for the operation. Resuscitation methods in the clinically dead mother have to be continued until the infant has been delivered.
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Geburtsh Frauenheilk · Jan 1982
Case Reports[Amniotic fluid embolism with coagulation disorder--a case report (author's transl)].
A case of amniotic fluid embolism during the delivery of a twin pregnancy is reported. After immediate resuscitation with artificial ventilation the mother and the neonates survived the acute episode. As a result of hyperfibrinolysis with premature separation of the placenta a dramatic postpartum haemorrhage occurred, which could be controlled by Fritsch' manoeuvre. Meanwhile it was possible to restore the coagulation disorder with fresh whole blood, fibrinogen and an antifibrinolytic agent (Aprotinin).
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Geburtsh Frauenheilk · Nov 1980
[The problem of the increased perinatal mortality in premature breech deliveries, compared to premature vertex deliveries (author's transl)].
The perinatal mortality of 115 premature breech deliveries is compared to that of 843 vertex deliveries. No difference is found when birth weights at 100 gram intervals are compared. These results are statistically checked. ⋯ The investigations lead to the conclusion that the mode of delivery has no essential influence on the neonatal prognosis. Mere breech presentation by itself is no indication for different delivery than for all premature deliveries. It is not so important to treat the breech presentation as it is to prevent premature deliveries.