Zeitschrift für Geburtshilfe und Perinatologie
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Z Geburtshilfe Perinatol · Jan 1994
[Risk of neonatal acidosis and maternal respiration during labor].
The reported incidence of neonatal acidosis varies++ significantly in different obstetrical departments. We wanted to investigate to which extend neonatal acidosis is depended on maternal respiration patterns during the third stage of labor. ⋯ A mild maternal hyperventilation synchronized with uterine contractions during the third stage of labor in combination with rapid breathing when delivering the fetal head has a favourable influence on the neonatal acid-base balance. In this study there is no indication that such an obstetrical management results merely in a laboratory artifact, because according to our data there was indeed no indication of compromised fetal oxygen supply. Routine fetal blood sampling also from venous umbilical blood appears to be useful in differentiating between combined feto-maternal and isolated fetal variations in actual pH-values.
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The recurrence risk of HELLP-syndrome is reported to be between 2.6% and 24%. But yet, there are no accurate case reports about this topic available. In a retrospective study, 25 patients, which had suffered from a pre partum HELLP-syndrome, were interviewed about possible subsequent pregnancies. ⋯ Whilst all of the patients with HELLP-syndrome had been delivered by cesarean section, 50% of the patients were delivered vaginally in the subsequent pregnancy. There was no evidence of maternal or neonatal complications related to HELLP-syndrome. Nevertheless, even if the recurrence risk seems to be low, pregnancies after HELLP syndrome should be observed carefully.
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Z Geburtshilfe Perinatol · Sep 1993
Case Reports[Intracerebral subdural hematoma after delivery with peridural catheter anesthesia].
26 days past an obstetric catheter epidural anesthesia a subdural haematoma right fronto-temporal was diagnosed and relieved by operation in a primipara of 19 years of age. Already several days after the delivery the patient was suffering recurrent headaches, at first misinterpreted as post-spinal headaches. ⋯ Although the occurrence of a subdural haematoma after catheter epidural anesthesia is extremely rare, untypical headaches following spinal, epidural or caudal procedures, should call your attention towards this complication. Because of the pressing mechanisms during childbearing, delivering mothers run the risk of a subdural haematoma.
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Z Geburtshilfe Perinatol · Jul 1993
[Clinic structure and timely management of emergency cesarean section--reference values and recommendations].
This retrospective clinical study was performed to analyze the relationship between the time course of an emergency Cesarean Section and the structural, logistic and circadian aspects of the clinical environment. ⋯ The data presented in this study underline the importance of the immediate availability of a complete emergency team consisting of midwife, obstetrician, anesthesiologist, OR nursing staff and pediatrician. While not necessarily arguing in favor of a concentration of obstetrical practice in specialized centers, the following recommendations might be worth considering for any given clinical setting: 1. Immediate availability of a complete team is essential, especially during the night. 2. Well defined steps of urgency in agreement between all disciplines involved improve communication and save time. 3. The emergency C-Section in the delivery room may be a worthwhile alternative in the individual case. 4. Flexibility in the decision making process may increase efficiency. 5. Practice drills may help to identify weaknesses in the interaction and coordination of the team. 6. A functional hospital architecture is important to avoid unnecessary and uncontrollable delays. 7. Adequate training programs for the obstetrical team are essential with special emphasis on the early diagnosis of fetal distress and maternal complications.
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Z Geburtshilfe Perinatol · Mar 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Effectiveness and tolerance of tramadol with or without an antiemetic and pethidine in obstetric analgesia].
The aim of this prospective, randomised, blind study was to investigate the analgesic potency and tolerance of intramuscular Tramadol compared to a standard obstetric analgesia with Pethidine. Triflupromazine was administrated in combination with the two tested analgesics in order to study its efficacy in alleviating the emetic side effects of the tested analgesics. 66 parturients were randomly assigned to three groups: group A: 100 mg Tramadol (Tramal), group B: 100 mg Tramadol (Tramal) and 10 mg Triflupromazine (Psyquil), group C: 50 mg Pethidine (Alodan) and 10 mg Triflupromazine (Psyquil). ⋯ In all three groups the analgesic effect was equally good. Combination of the analgesic with the antiemetic showed no reduction of the incidence and severity of side effects.