[A case of umbilical cord presentation in full term pregnancy].
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Biomedical subjects
Publications and source records attributed to N Pranchev.
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AIM OF THE STUDY: 1) To analyze the frequency of complications after elective/planned [PCS] and emergency Cesarean section [ECS]; 2) To compare the types of complications in the two evaluated groups; 3) To analyze the possible risk factors for complications after elective and emergency procedures. METHODS: The study was retrospective, hospital-based one. Data regarding complications following Cesarean section [CS] that demanded transfer of the patients to The Clinic of High Infectious Risk, State University Hospital "Maichin Dom", Sofia and prolonged hospital stay (more than 7 days after the operation) were analyzed. The incidence of complications in 574 consecutive PCS and in 292 ECS was calculated. The type of the following complications was compared in the two groups: uterine infections (endo/mio/ metrophlebitis), wound infection, subfascial hematoma, residua, sepsis, pelvic thrombophlebitis. Statistical evaluation of the results was performed by Student's t-test with p<0.05 considered statistically significant. RESULTS: In 574 PCS the frequency of postoperative complications was 1,4% while in 292 ECS it was 2,05% (p>0.05). There was not significant difference in the distribution of the different types of postoperative complications in 34 cases with PCS and 33 cases with ECS. The percentage of patients with previous CS was significantly higher in the complicated cases with PCS compared to that with ECS. The two studied groups do not differ significantly regarding the type of skin incision, operator's qualification, blood loss, drainage of the subfascial space, accompanying diseases. CONCLUSIONS: Cesarean section constitutes a major surgical procedure characterised with morbidity even if performed as a planned procedure. The risk of complications seems to be higher in cases of repeated CS. Patients that demand CS without medical indications have to be informed and be aware of these facts.
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A description of clinical approach to heavy pelvioperitonitis from genital inflammatory origin. Author emphasizes that early and precise assessment of clinical and laboratory parameters as well as the adequate treatment are of great importance for saving patient's life.
Author describes one case of septic metrothrombophlebitis and acute renal failure in pregnant woman as a result of spontaneous abortion. He discusses some clinical criteria of developing complications and proposes adequate therapeutic line of behaviour.
Authors points at that very often it is not possible to follow the routine scheme of medical behaviour in twins delivery. Every such case must be resolved individually according to concrete circumstances.
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Author provides a description of septic shock in a parturient. He analyses the clinical cause and proposes a therapeutic behaviour during labour and puerperium.
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Although the progress of the obstetrics and the availability of powerful antibiotics, the puerperal infections are main reason for the mother's morbidity and mortality. In connection with this problems are analysed the practical problems of puerperal infections in clinical therapeutical aspect.
The author describes a clinical case of a woman with tubal pregnancy and acute intraabdominal haemorrhage to emphasize the diagnostical and therapeutical problems. The initial diagnosis of the patient was intrauterine pregnancy and spontaneous abortion, proved by ultrasound examination. Due to the high qualifications and long clinical experience of the physician the exact diagnosis was made and the life of the woman was saved.
The author assessed the effect of a new medicine called Hevizos on patients with herpes simplex genital infection. He proved good therapeutic results in both pregnant and non-pregnant women as well as in parturients. Parturients needed longer period of treatment with Hevizos than pregnant and non-pregnant women.
The authors report a study on clinical and microbiological aspects of endometritis in 50 parturients. The analysis of results shows that major risk factors for the development of puerperal endometritis are urgent Caesarean section, premature rupture of membranes for more than 15 hours and surgical vaginal delivery. In conclusion the authors propose their actual clinical view on diagnosis and treatment of puerperal endometritis.
The cases of pregnancy in the rudimentary horn are probably the rarest Mullerian anomalies. More often the pregnancy ends with an abortion in the first or the end of the second trimester. Extremely rarely (1% of the cases) end with a live birth. The authors examine and describe a case which successfully ended with a birth of a live fetus in 32 gestation week after a rupture of cornual pregnancy. Special attention is paid to the diagnostical difficulties, which are characteristic for these cases. It is reasonable in the cases of extrauterine pregnancy to think of a pregnancy in the rudimentary horn as well.
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