[Big fetus--big problems?].
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Sixty-three cases of obstructed labour encountered at the University Teaching Hospital, Lusaka, Zambia, are analysed for the period April 1972 - December 1973. For the same period there were 27 348 deliveries and 1 432 Caesarean sections. The management of choice was Caesarean section, because of a lack of experienced medical staff and the poor results obtained, together with the serious complications which follow destructive operations before vaginal deliveries. Eighty-five per cent of the babies were delivered alive. There was no maternal death. Twenty-six mothers remained in hospital for longer than 10 days. There was 1 case of a burst abdomen.
AIM: To study the changing trend in the delivery of transverse lie, and its effect on neonatal outcome, in a developing country. SUBJECTS AND METHOD: This is a retrospective study involving records of 12 years of all patients with transverse lie. Neonatal outcome of births by internal podalic version (IPV) and lower segment caesarean section (LSCS) were compared. RESULTS: In the first six years, 37.3% of transverse lie underwent IPV and 62.7%, LSCS. In the next six years, 15.8% underwent IPV and 84.2%, LSCS. 87.7% and 12.3% of live babies were delivered by LSCS and IPV respectively. 52% of the live born IPV were discharged compared to 95% of LSCS babies. Neonatal outcome was best when IPV was performed on second twin. CONCLUSION: IPV has a role in the delivery of second twin, pre-viable and dead babies.
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