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PubMedDate not supplied

[Epilepsy and pregnancy (review of the literature)].

The relationship between pregnancy and epilepsy has often been object of particular attention and care by many epileptologists. The aim of this survey of the literature is to give an up-to-date and comprehensive review of this relation and to focalize the many related problems which still are unsolved. The following principal chapters are discussed: 1) the influence of pregnancy on epilepsy; 2) the influence of epilepsy on pregnancy and delivery; 3) the influence of epilepsy on newborns; 4) the teratogenic effects of antiepileptic medication. Many conflicting data make it very difficult to summarize the results, however it is clear that the effect of pregnancy on seizure frequency may be quite variable. Seizures, in fact, during pregnancy may be increased, decreased or remain unchanged. The most conflicting data are those related to the effects of epilepsy on pregnancy and delivery, while concordant opinions indicate an increased perinatal mortality and morbidity in offsprings of epileptic women. Special attention has to be payed to the offsprings of epileptic mothers. The presence of congenital abnormalities in fact, is about 2 times higher for newborns of mothers with epilepsy than for offsprings of mothers without the disease. Another important problem is related to the presumed teratogenicity of antiepileptic drugs. It has not yet been demonstrated that antiepileptic compounds have a teratogenic effect on offsprings. However it has been shown that this assumption is often associated to a higher presence of congenital malformations. The majority of malformations (facial clefts and heart defects) occur in association with the use of trimethadione, phenobarbital, primidone and acetazolamide, whereas they are much less frequent in association with phenytoin, carbamazepine, valproate.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Management of twin pregnancies currently--a prospective study].

On the basis of our own earlier studies, the progress of 80 twin pregnancies is followed in a prospective investigation. Early diagnosis makes possible numerous measures for prevention of premature birth--the central problem of twin pregnancies. A cerclage was carried out in 51 cases (63.75%). Tocolytics were administered only in demonstrated uterine contractions. 54 women with a twin pregnancy (= 67.5%) reached the 37th week of pregnancy. A surgical termination of labor was necessary in 51.9% of twin pregnancies, and the frequency of cesarian section was 33.75%. Only 17.5% of the twins were under the critical weight limit of 2000 g. The perinatal mortality is 3.75%. Five out of the six babies who died weighed less than 2000 g. Finally, the individual points of our intensive care program for twin pregnancies are discussed in detail taking the recent literature into consideration.

Cesarean Section↗
PubMed1978

[Premature births with special reference to delivery management].

The 1055 premature births of the last 10 years in the Altdöbern women's hospital with a centre for premature births have been summarized and analysed in groups with regard to the distribution of birth-weight, the obstetric measures and the perinatal mortality. A change of the operative procedure at the premature birth together with a marked increase of the frequency of the operative deliveries from 28,7 p.c. (group I) to 55,1 p.c. (group III) has been compared to the uncleaned mortality of the premature children of 20,0. p.c. (group I) and 16,4 p.c. (group III). The importance of the large prophylactic measures and of the improved birth-supervision and maintenance of premature births are emphasized in connection with it. Inferences for a further reduction of the perinatal mortality are drawn.

Adult↗
PubMed1983

The active management of prolonged labor.

There has been growing concern in the medical community about the rising rate of cesarean sections. Use of the modified manual rotation technique on the arrested fetal head has resulted in a decrease in the number of sections, length of hospital stay, and, consequently, the cost of care.No longer is it necessary to operate on every woman who comes to the end of the second stage of labor in the persistent occiput posterior or transverse arrest position. This technique also helps to reduce, if not eliminate, the more difficult and traumatic midforcep rotations and extractions.

Delivery, Obstetric↗