J Reprod Med
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A pregnant woman sustained an abdominal gunshot wound during the second trimester; the bullet injured multiple loops of bowel and passed through the uterus, placenta and fetus. Although the stillborn fetus was delivered by cesarean section, a review of the literature indicated that operative delivery is not indicated when the fetus has died already. Labor and delivery are well tolerated, and an unnecessary hysterotomy is thus avoided. ⋯ Approximately 40% of fetuses will survive the initial injury. In past reviews the risk of prematurity often outweighed the benefits of delivery of those infants. Advances in neonatology now make survival routine after 28 weeks' gestation, and viable fetuses should be delivered promptly by cesarean section to decrease the risk of delayed death from fetal or placental injury.
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Halothane depresses uterine contractility and may increase cesarean blood loss during the use of general anesthesia. We retrospectively compared the medical records of 399 elective repeat cesarean section patients. We excluded medical and obstetric conditions that may predispose such patients to increased blood loss. ⋯ No patient received a blood transfusion. The incidence of low postoperative hematocrits (less than 32%) following surgery was similar with all the anesthetic methods. Low-dose halothane supplementation of general anesthesia for elective cesarean section did not increase blood loss.