Ginekol Pol
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Conduction anaesthesia is regarded as a very safe method for the mother and for a newborn. This kind of anaesthesia reduces the risk of gastric contents aspiration and does not cause the respiratory depression. However in every case it is essential to take into consideration the woman's opinion, for whom delivering of the child is the particularly important event. ⋯ Most of pregnant women preferred epidural anaesthesia during delivering of the child by caesarean section.
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Review Case Reports
[Delayed delivery in multiple gestations--a case report and review of the literature].
The incidence of multiple pregnancies increases with concomitant increased risk in maternal and fetal complications. Delayed delivery is still a rare occurrence in the literature despite advances in reproductive medicine and increasing number of multiple gestations. Authors report a case of delayed delivery in a dichorionic, diamniotic twin pregnancy. ⋯ The baby was discharged home in good condition on the 64th day after the delivery. The conclusion was, that using tocolysis, antenatal steroids to stimulate lung maturation, antibiotics and cervical cerclage after delivery of the first fetus we can improve the life-expectancy of the retained fetus. Delayed delivery is a reasonable option for patients with multifetal pregnancies and premature delivery of the first baby or preterm rupture of membranes in the second trimester.
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Comparative Study
[Comparison of indications for cesarean section in 1985-86 and 2000-01. Analysis of changes].
The aim of this research was a retrospective analysis of indications for caesarean section during last fifteen years and assessing recent trends. ⋯ (1) Caesarean section is the surgical method of delivery for women with high risk pregnancy and complicated labor to protect mother and the foetus from the anticipated complications of delivery through natural passages. (2) The overall rate of caesarean section has risen because of widening of the indications. (3) Fetal distress has been the most frequent indication for caesarean section in last fifteen years. (4) Index of indications for cesarean section other than obstetric--ophthalmic, cardiological, neurological and orthopaedic, increased as a result of better health care of pregnant women. (5) Decision to perform caesarean section should be taken in consideration of present clinical situation and future consequences of abdominal delivery.
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The purpose of our study was to assess the relationship between previous cesarean section and placenta previa accreta and to estimate the incidence of placenta accreta et previa accreta as the indication for peripartum hysterectomy. ⋯ The association between placenta previa accreta and prior cesarean section was confirmed. The incidence of placenta accreta increased as the number of previous cesarean sections increased. Patients with an antepartum diagnosis of placenta previa, who have had a previous cesarean section should be considered at high risk for developing placenta accreta. The most common indication for peripartum hysterectomy in this study was placenta previa accreta.
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Obstetrical brachial plexus palsy (OBP) complicates a small proportion of births. The incidence is believed to be 0.35 to 5 cases per 1000 live births. Risk factors of OBP included: 1/ large birth weight, 2/ shoulder dystocia and prolonged second stage of labour , 3/ instrumental vaginal delivery (forceps delivery, vacuum extraction), 4/ diabetes mellitus and mother's obesity, 5/ breech presentation, 6/ delivery an infant with OBP in an antecedent delivery. ⋯ Intrauterine factors may play some role in the etiology of the OBP. Many strategies have been proposed to prevent the occurrence of OBP--control of the birth weight, induction of labour, cesarean delivery, intensified management of gestational diabetes. About 10-20% of patients with injuries of the brachial plexus require surgical intervention for optimal results.