J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Jan 1993
Review[Delivery after 2 previous cesarean sections. A series of 41 uterine trials].
It has been possible to consider how delivery should be carried out in view of the progress that has been made handling scarred uteruses. Over 21 months 41 tests of uterine function have been authorized in our department out of 67 cases where there were two scars in the uterus (67%). 26 patients delivered vaginally (63.4%) and 5 had Caesarean sections because of failure of the test of the scar. When the relationship between the fetus and the pelvis was satisfactory, the fact that the cervix was not ripe and the presenting part was not engaged, did not prevent carrying out a trial of scar in 78% of cases. ⋯ Epidural anaesthesia was used in 90.2% of cases. A full obstetric team must be present throughout the whole labour so that the conduct of the labour can be observed, and if necessary corrected quickly if anything in its progress is becoming abnormal. It has become reasonable to carry out tests of uterine scars even after two scars have been made in the uterus because of the absence of any maternal or fetal complications in this series or in the literature.
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J Gynecol Obst Bio R · Jan 1993
Case Reports[Acute aortic dissection during pregnancy. Surgical treatment with maternal and fetal rescue].
Acute aortic dissection (AD) seldom affects young women, but when it occurs it is, in almost one out of two cases, during pregnancy. We report a case of severe AD during pregnancy in which emergency surgery immediately saved the life of the mother and the foetus. The mother died of cardiac complications 13 days after the operation; the condition of the newborn is satisfactory.
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J Gynecol Obst Bio R · Jan 1992
Review Case Reports[Sub-capsular hematoma of the liver during pregnancy: a case report].
A sub-capsular haematoma of the liver is a rare but very serious complication of pregnancy. We report a case of a primipara whose pregnancy was first complicated by hypertension, then by a haematoma of the liver at the 28th week of amenorrhoea. It was diagnosed because of the clinical symptoms associated with the hypertension and a pain in the right hypochondrium and nausea. ⋯ Regular X-ray follow-ups showed that the lesion had regressed in six months. MRI investigation of the parenchyma of the liver showed no cause of the lesions. If there is even the slightest suspicion of a haematoma of the liver in pregnancy, ultrasound nowadays should be carried out because it is indispensable to make the diagnosis.
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J Gynecol Obst Bio R · Jan 1992
Case Reports[A complication of epidural anesthesia: cerebral pneumatocele. A case report].
Having had a case themselves the authors report a rare complication of epidural anaesthetic, namely pneumocephaly. When it occurs it is usually after a difficult puncture; and usually thought of if headaches are unusually severe of there is a picture of intracranial rise in pressure. Then a tomodensitometry will lead to the diagnosis. Literature shows that it can be a serious condition, sometimes fatal, which means that the case has to be followed up very carefully and tomodensitometry has to be repeated until complete cure has been obtained.
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J Gynecol Obst Bio R · Jan 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Use of etilefrin as local vasoconstrictor in lower gynecologic surgery ].
In this randomized prospective study the authors have compared the effectiveness and side-effects of two local vasoconstrictor agents, etilefrine (Effortil) and ornithine 8 vasopressin (Por 8) in vaginal gynaecological surgery. Thirty-three patients entered the trial and were divided into two groups: G1 (15 patients) received Effortil, and G2 (18 patients) received Por 8. The products, administered at random, were diluted in saline 40 ml and injected into the cervix through 6 points. ⋯ Diastolic BP was significantly higher in G2 than in G1 (P less than 0.002, Fisher test). Systolic BP was also elevated in that group (P less than 0.03, chi 2 test). Moderate reduction in heart rate was observed in both groups (P less than 0.3, Fischer test), but severe (48 beats/min) bradycardia was noted in one G2 patient.