International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
-
Int J Gynaecol Obstet · Jan 1993
ReviewMaternal tetanus: magnitude, epidemiology and potential control measures.
Maternal tetanus, defined as tetanus occurring during pregnancy or within 6 weeks after any type of pregnancy termination, is one of the most easily preventable causes of maternal mortality. It includes postpartum or puerperal tetanus resulting from septic procedures during delivery, postabortal tetanus resulting from septic abortion and tetanus incidental to pregnancy, resulting from any type of wound during pregnancy. This review of published and unpublished hospital and community studies concludes that between 15,000 and 30,000 cases of maternal tetanus occur each year. Complete coverage of reproductive-aged women by tetanus toxoid is the most cost-effective way to eliminate this often neglected cause of maternal death.
-
Int J Gynaecol Obstet · Jul 1989
Review Case ReportsPneumoperitoneum due to peritoneovaginal fistula following hysterectomy.
A patient with pneumoperitoneum that developed due to peritoneovaginal fistula following hysterectomy is presented. In addition, we have reviewed the literature and formulated guidelines for the management of this problem. ⋯ Laparotomy may be avoided if the cause of the fistula is suspected. Surgical closure of the fistula may be unnecessary since spontaneous closure occurs frequently.
-
Int J Gynaecol Obstet · Jun 1989
ReviewRisk factors for fever, endometritis and wound infection after abdominal delivery.
Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). ⋯ By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.