Obstetrics and gynecology
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Obstetrics and gynecology · Jan 1979
Case ReportsSubarachnoid hemorrhage secondary to ruptured cerebral aneurysm in pregnancy.
Eight patients suffering ruptured cerebral aneurysms during pregnancy were managed at the University of Western Ontario hospitals between 1967 and 1977. Seven aneurysms were managed surgically. All of these patients survived, 1 with permanent neurologic deficit. ⋯ The prognosis for ruptured cerebral aneurysms during pregnancy is good for both mother and fetus. A short course of conservative therapy followed by surgical management of the aneurysm is advocated. Delivery may be managed according to obstetrical indications following surgical correction of the aneurysm.
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Sixty-six premature breech deliveries were studied retrospectively. Forty-eight patients were permitted a trial of labor, 47 of whom ultimately delivered vaginally. ⋯ When Apgar scores, perinatal mortality rates, cord prolapse, and entrapment of the aftercoming head are considered, cesarean section is probably the safer course of management for the patient with a footling breech infant, especially when the infant weighs 1500 g or less. However, the data indicate that a trial of labor can be safely undertaken in the presence of a premature frank or complete breech presentation.