[Management of labor after previous cesarean section: how dangerous is an attempt to achieve a vaginal delivery?].
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Biomedical subjects
Publications and source records attributed to M Pluta.
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At the Department of Obstetrics Berlin-Neukölln over a period of 4 years the fetal heart-rate was monitored on the operating table during 178 cesarean sections, which were indicated for arrest of labour in the pelvic inlet. After the induction of the anesthesia a clear influence on the oscillation pattern with lower oscillation frequency and amplitude - probably due to drugs - was seen in the cardiogram. The occurrence of pathological heart-rate patterns, such as decelerations and bradycardia were closely related to the depressed state and acidosis of the newborn. The cardiogram shows the danger of worsening in the infant's condition during anesthesia, and in these cases it permits a reduction in the induction-delivery-interval by changing the speed of the operation. Further, a retrospective interpretation of an unexpected clinical depression and acidosis in the newborn is possible, particularly in cases in which originally the fetus has not been at risk. For the above mentioned reasons it is recommended to carry out routine continuous registration of the fetal heart-rate on the operating table during cesarean sections.