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At least 145 records · Page 8Linked to original sources
PubMed2002

Surgical cleft soft palate repair in a foal.

An Anglo-Arab foal with bilateral postprandial nasal discharge was diagnosed as having a full-length defect of the soft palate. Surgical repair was attempted using a combination of two surgical approaches. Initially a mandibular symphysiotomy approach was used. The posterior portion of the defect did not heal adequately, so a ventral laryngotomy, bisecting the body of the thyroid cartilage and extending to a pharyngotomy approach, was performed 5 months later. The foal has since matured fully despite a slight unilateral nasal discharge. This case report demonstrates that these two surgical approaches used simultaneously provide surgical access that is superior to either approach used individually.

Animals↗
PubMed1991

Breech presentation and delivery.

What constitutes proper management for the singleton baby who presents by the breech at term has remained one of the most contentious subjects in obstetric practice. Perinatal morbidity and mortality are much higher in breech than in cephalic presentation. Elective caesarean section has been increasingly used in an attempt to improve the perinatal outcome. But caesarean section has immediate and late maternal complications. Some of these complications can be catastrophic. External cephalic version (ECV) at term, under tocolysis if necessary, will reduce the incidence of vaginal breech delivery and the incidence of caesarean section. Where ECV fails, the use of a selective management protocol will allow trial of breech labour in suitable cases, thus further reducing the incidence of elective section. Symphysiotomy may save the life of the baby whose head is trapped by disproportion.

Breech Presentation↗
PubMed1995

[Trans-symphyseal approach in the treatment of cervico-urethro-vaginal fistulas. Apropos of 2 cases].

We opted for a symphysiotomy approach in the management of cervico-urethro-vaginal fistulae in two patients. This approach offers an excellent exposure of the region of the bladder neck. After section of the symphysis pubis with a Gigli's wire saw, the anterior wall of the bladder was taken down to the fistulae and we excised the fistulous tract. Longitudinal closure of the fistulae and the bladder followed. Results were satisfactory and there were no urinary incontinence.

Adult↗
PubMed1980

Abdominal aortic surgery and horseshoe kidney.

Seventy cases, including the six reported here, of aortic operations in patients with horseshoe kidney were reviewed. Anomalous renal arteries were encountered in 42 (60%) of these patients. We concluded that accurate preoperative diagnosis and angiographic delineation of aberrant renal arteries facilitate preservation of renal blood supply. When accessory or anomalous arteries cannot be preserved in situ, they should be reimplanted into the aortic prosthesis. Symphysiotomy may improve operative exposure and when necessary is a safe maneuver.

Aged↗
PubMed2004

Obstructed labor: using better technologies to reduce mortality.

OBJECTIVE: To identify, from the best available evidence, underutilized and promising technologies that may reduce maternal mortality from obstructed labor. METHODS: The author sought systematic reviews of randomized trials, individual randomized trials, and, in the absence of randomized data, non-randomized studies and clinical consensus. Data were presented according to the level of the evidence. RESULTS: Obstructed labor causes approximately 8% of maternal deaths, and indirectly contributes to a greater percentage. Proven or widely accepted technologies that help reduce mortality from obstructed labor include contraception, external cephalic version, the partogram, augmentation of labor, selective amniotomy, selective episiotomy, vacuum extraction, caesarean section, symphysiotomy, and destructive procedures for non-viable fetuses. Technologies of uncertain usefulness include maternal height and shoe size, vaginal cleansing, upright posture for delivery and vaginal lubrication. Unuseful technologies include pelvimetry, estimating fetal weight, early labor induction, routine amniotomy and augmentation, routine episiotomy, and starvation during labor. CONCLUSION: Access to well-established technologies, particularly safe caesarean section, can reduce maternal mortality in resource-poor countries.

Cesarean Section↗
PubMed2006

Shoulder dystocia and injuries: prevention and management.

PURPOSE OF REVIEW: Shoulder dystocia is an obstetric emergency that is often unpredictable and unanticipated. Despite the identification of various clinical risk factors, our ability to predict and prevent shoulder dystocia is very limited. Effective and timely clinical management is essential to offer the best chance of a satisfactory outcome. RECENT FINDINGS: Upon diagnosis of the condition, a team working in tandem to resolve the problem is very effective. Use of the McRoberts maneuver, application of suprapubic pressure, with an adequate episiotomy allow resolution of over 50% of cases, with a low risk of fetal injury. Secondary maneuvers include rotation of the shoulders and delivery of the posterior shoulder. These are technically more challenging and may be associated with a higher risk of fetal injury. More drastic action may be considered in dire cases where even secondary maneuvers fail. These include the Zavanelli maneuver, symphysiotomy or iatrogenic clavicular fracture. These techniques, while seldom required, may be lifesaving in extremely severe cases. SUMMARY: Upon resolution of the clinical event, it is essential to document the entire event, and to discuss the clinical problem and management with the parents. These actions will reduce the risk of medical litigation, and improve patient satisfaction with clinical care.

Birth Injuries↗
PubMed2005

Surgical repair of a cleft soft palate in an alpaca.

A 26-day-old entire male alpaca was referred for surgical treatment of a cleft soft palate. Mandibular symphysiotomy and three-layer closure of the palatal defect resulted in primary intention healing. Despite complications related to anaesthesia the alpaca made a full recovery.

Anesthesia↗
PubMed1977

Surgical repair of cleft soft palate in the horse.

A technique for the surgical repair of a cleft soft palate in the horse is described. A symphysiotomy approach was employed to repair the anterior end of the cleft palate, and the posterior part was approached via a pharyingotomy incision.

Animals↗
PubMed1975

Clinical experience of eclampsia at the University Teaching Hospital, Lusaka. An analysis of 50 cases.

A clinical analysis of 50 cases of eclampsia for the period June 1971-June 1973 is presented. During the same period there were 32 011 deliveries--an incidence of 0,156%. Of these 50 cases, only 8 were booked. There were 40 primigravidas. The highest number of fits recorded in any one patient was 6, and 13 patients has had fits before admission. Thirty-four patients were in established labour on admission. Only 12 patients had postpartum fits. The basis of management was heavy sedation, anticonvulsant therapy and emptying of the uterus as soon as it could be achieved. Biochemical studies and urine production measurements were important supplementary measures. Twenty patients achieved vaginal delivery and 3 had symphysiotomy, assisted by vacuum extraction, low forceps and midcavity forceps, to complete the delivery. Seventeen patients were delivered by Caesarean section. The remaining 10 had vaginal delivery assisted by vacuum extraction. One mother did not survive. Of the 51 babies, 7 did not survive the neonatal period, and 4 were stillborn.

Adolescent↗
PubMed2004

Shoulder dystocia.

Shoulder dystocia can be one of the most frightening emergencies in the delivery room. Although many factors have been associated with shoulder dystocia, most cases occur with no warning. Calm and effective management of this emergency is possible with recognition of the impaction and institution of specified maneuvers, such as the McRoberts maneuver, suprapubic pressure, internal rotation, or removal of the posterior arm, to relieve the impacted shoulder and allow for spontaneous delivery of the infant. The "HELPERR" mnemonic from the Advanced Life Support in Obstetrics course can be a useful tool for addressing this emergency. Although no ideal manipulation or treatment exists, all maneuvers in the HELPERR mnemonic aid physicians in completing one of three actions: enlarging the maternal pelvis through cephalad rotation of the symphysis and flattening of the sacrum; collapsing the fetal shoulder width; or altering the orientation of the longitudinal axis of the fetus to the plane of the obstruction. In rare cases in which these interventions are unsuccessful, additional management options, such as intentional clavicle fracture, symphysiotomy, and the Zavanelli maneuver, are described.

Birth Weight↗
PubMed2006

Successful engraftment of cultured autologous mesenchymal stem cells in a surgically repaired soft palate defect in an adult horse.

The objective of this study was to graft autologous mesenchymal stem cells (MSCs) at the site of surgical repair of a soft palate defect in an adult horse in an attempt to improve wound healing and to investigate whether the transplanted MSCs would integrate into the soft palate structure and participate in regeneration. Bone marrow was collected from an adult horse with a full-thickness soft palate defect. The MSCs were isolated, cultured in monolayers, and labeled with 5-bromo-2-desoxymidine (BrdU) and chloromethylbenzamido-DiI-derived (cm-DiI) before transplantation. The soft palate defect was repaired by mandibular symphysiotomy, and the labeled MSCs were injected into the repaired soft palate. Postmortem examination revealed that 90% of the soft palate defect had been sutured. Staining by BrdU and cm-DiI was intense in the soft palate tissue. Labeled MSCs were detected in tissue slices from the injection sites. The cells were organized in a manner similar to that in native soft palate tissue, indicating successful engraftment.

Animals↗
PubMed1991

Surgical management of collapsed pelvis in a jaguar.

An immature jaguar was surgically treated for severe constipation caused by a narrow pelvic canal. This narrowing was attributed to nutritional secondary hyperparathyroidism. The ventral floor of the pelvis was widened by placing a piece of high density polyethylene between the 2 sides of the pubis after symphysiotomy and stabilizing the implant with orthopedic wires. This procedure provided stable fixation and permanent enlargement of the pelvic canal. The technique was easy to perform and could be used to treat pelvic collapse in other species.

Animals↗
PubMed1986

Surgery of the horseshoe kidney--an experience of 24 patients.

A decade (1973-83) of surgical experience in the management of the diseases of horseshoe kidney is presented. Calculus disease was the major pathological entity (80%) followed by ureteropelvic junction obstruction, nephrocarcinoma and polycystic disease, respectively. Three patients with calculi had, in addition, pyonephrosis and squamous cell carcinoma. Aortography offers maximum information about abnormal vasculature and other anatomical details in proper planning of surgical intervention. It is felt that a symphysiotomy and nephropexy may be considered when the horseshoe kidneys are being operated for calculus disease.

Adult↗
PubMed1994

Surgical repair of iatrogenic soft palate defects in two horses.

A 4-year-old Thoroughbred filly was referred for evaluation of a soft palate defect that had been created several weeks earlier during surgical correction of epiglottic entrapment, performed transorally. Surgical correction of the defect was performed via mandibular symphysiotomy. At 85 days after repair, the horse raced successfully. A 2-year-old Thoroughbred filly was admitted for evaluation and treatment of epiglottic entrapment. The soft palate was lacerated during transnasal division of the entrapping membrane. A 2-cm full-thickness soft palate laceration was repaired transorally.

Animals↗
PubMed1993

Penetrating lingual foreign bodies in three horses.

Three horses examined for complaints of ptyalism and dysphagia were found to have metallic lingual foreign bodies. Metallic foreign bodies were located by oral examination combined with radiography. In 1 horse clinical signs resolved without removal of the foreign body. The foreign body was extracted via an oral approach in the second horse; a mandibular symphysiotomy and radiographic guidance were necessary for removal in the third horse. In all 3 cases, the presenting clinical signs subsided.

Animals↗
PubMed1993

[Congenital prepubic sinus: blind epispadial duplication of the urethra].

Presentation of one case of congenital epispadial urethral duplication in a 1-year old child. The malformation consisted on one normal urethra and the other one a prepubic epispadial accessory urethra, with the proximal end finishing blind into the anterior side of the bladder. The mictional cystography performed showed normal bladder and urethra, while the retrograde urethrography through the dorsal sinus showed a 3 cm long tract with no communication to the urethra or the bladder. Treatment consisted in total exeresis of the accessory urethra by way of suprapubic approach, with no symphysiotomy. Up to the present date, the patient remains asymptomatic.

Epispadias↗
PubMed1996

Outcome of 441 breech singleton deliveries at the Catholic Hospital, Oluyoro, Ibadan.

Breech presentation at delivery occurred in 441 of 21,243 deliveries giving an incidence of 2.1% in Oluyoro Catholic Hospital, Ibadan. The fresh stillbirth rate was 7.8% and this was six times the cephalic (1.2%) fresh stillbirth rate for the same period. The incidence of breech presentation was lowest between parity 1 and 3, and rose above parity 5. Majority of the stillbirths occurred in primigravidae and grandmultiparous patients. Caesarean section was performed in 15.7% of breech singleton, while 79% were delivered by assisted breech delivery. The commonest indication for caesarean section was fetal distress. Low birth weight (2.5 kg) or less breech singleton occurred in 22% cases, and accounted for 45% of all breech stillbirths. The lowest risk to the fetus was between 3kg and 4kg birth weights. Congenital abnormalities of the Central Nervous System occurred in 2.7% of breech babies as compared to 0.2% in cephalic presentation. Low birth weight, prematurity, primigravidity and grandmultiparity were the identified factors associated with stillbirths. Early identification and management of these factors will reduce the high incidence of perinatal deaths in breech deliveries. We advocate the use of symphysiotomy in the management of the entrapped aftercoming head of the breech.

Breech Presentation↗