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At least 919 records · Page 51Linked to original sources
PubMed1980

Sickle hemoglobin and the gravid patient: a management controversy.

It is evident that patients with sickle cell disease are now in an era when they can safely complete a pregnancy with a reasonable expectation of a good outcome for both the mother and baby. Although there are vast disagreements as to which techniques (both diagnostic and therapeutic) to employ, the use of individualized methods in various geographic areas will yield the best result. To conclusively answer the questions raised in this article, a large multi-center collaborative study must be performed. If randomized treatment regimens of "transfusion versus no transfusion" were carried out in such a study, the true risk of both approaches could be assessed. Moreover, with adequate follow-up studies many of the risks of each type of treatment could be evaluated. Only through such a large study will these controversies be resolved.

Adult↗
PubMed1980

[Use of PGF2 alpha to induce abortion in patients with risk factors in first and second thirds of gravidity (author's transl)].

Reported in this paper is the use of PGF2 alpha to induce legal abortion in 43 patients with uterine risk factors (Group 1) or with general diseases manifest before (Group 2). The abortions were induced between the eighth and 24th weeks of pregnancy. PGF2 alpha was applied extra-amniotically, intra-amniotically or by combined approach, that is intra-amniotic or intravenous with extra-amniotic. - Twenty-seven women were included in Group 1, and in 25 of them pregnancy was disrupted without any complications. Complete expulsion of foetus and placenta, caused by rupture in the posterior labium of the os uteri, occurred to one of the patients with myomatous uterus. Acute ascension developed in another patient, three days from the intervention. - Group 2 was composed of 16 patients. Induced abortion was without any complications in 15, while one patient with psychosomatic epilepsy had an epileptic fit. Her pregnancy had to be terminated by hysterotomy. - The use of PGF2 alpha is considered an effective method to induce abortion in patients with risk factors.

Abortion, Therapeutic↗
PubMed1994

Incarceration of the gravid uterus.

Retroversion of the first trimester uterus occurs in 6 to 19 per cent of all pregnancies and usually does not cause problems. If the uterus remains retroverted as the pregnancy advances, it may become wedged into the pelvic cavity. This complication is referred to as uterine incarceration which can lead to spontaneous abortion, preterm labor, uterine dystocia, and inadvertent incision into the cervix or the bladder during cesarean section in cases of unrecognized incarceration. Seven cases of uterine incarceration are presented with a detailed review including clinical signs and symptoms, physical findings, ultrasound findings, and treatment modalities for each stage of pregnancy. Moreover, we present a new method of treatment for second trimester uterine incarceration.

Adult↗
PubMed1994

[Rupture of a scarred gravid uterus at 28 weeks of amenorrhea. Conservative surgical management and results].

Rupture of a scarred uterus during pregnancy is unusual, but remains a complication with serious consequences for both mother and fetus. It usually occurs towards the term of gestation and the case reported here is of interest because, atypically, the rupture of the uterus occurred some time before term in a scarred uterus and the immediate care provided was conservative surgery. The rest of the pregnancy proceeded to a successful outcome at term under clinical and obstetrical follow-up. The authors also highlight the additional precautions required in medically-assisted pregnancies in patients over 40 years of age.

Adult↗
PubMedDate not supplied

A review of 126 cases of ruptured gravid uterus.

Ruptured uterus is a grave obstetric complication, associated with high maternal mortality and morbidity, perinatal mortality and loss of future fertility as hysterectomy is inevitable in many cases. This study reviews the incidence, causes and other factors, to define problem areas and propose preventive measures. During 1979-1988, 126 cases of ruptured uterus occurred in 46,207 deliveries; these 126 cases were retrospectively analyzed in relation to causes, age, parity, maternal mortality and morbidity, perinatal mortality and management. Some of the results were compared with other authors. The incidence was 1/367 (2.7/1000 deliveries), traumatic rupture accounted for 42.86% while spontaneous rupture accounted for 57.14%. Maternal mortality was 21.43% and the perinatal mortality was 73.19%. Supravaginal hysterectomy, repair with sterilization and repair without sterilization were the selected lines of management. Proper quick diagnosis and prompt management will reduce maternal mortality and morbidity. Finally, recommendations to reduce the occurrence of this problem are proposed.

Adult↗
PubMed1994

High-velocity penetrating wounds of the gravid uterus: review of 16 years of civil war.

OBJECTIVE: To evaluate the value of selective laparotomy in pregnant women with penetrating abdominal injuries. METHODS: A retrospective survey was carried out at our center over 16 years of civil war, extending from 1975 to 1991. Fourteen pregnant women had uterine injuries secondary to high-velocity abdominal penetrating trauma. The corresponding management was evaluated carefully with respect to maternal and fetal outcomes. RESULTS: Two maternal deaths occurred, neither resulting solely from intra-abdominal injuries. Visceral injuries were present when the entrance of the missile was in either the upper abdomen or the back. When the entry site was anterior and below the uterine fundus, visceral injuries were absent in all six women upon surgical exploration. Perinatal deaths occurred in half of the cases and were due to maternal shock or uteroplacental or direct fetal injury. Immediate cesarean delivery was performed because of either limited surgical field exposure, fetal injury, or distress. Three patients explored were managed by delaying delivery. All later delivered vaginally with successful fetal outcomes in all three. CONCLUSION: Selective laparotomy may be considered in pregnant women with anterior penetrating abdominal trauma, as the likelihood of intra-abdominal injuries may be predicted based on the location of the penetrating wound.

Abdominal Injuries↗