B. Haeussler, E. Laimer, J. Hager, G. Putz, C. Marth, R. Haeussler
Since the introduction of cerebrospinal fluid (CSF) -shunt implantation in 1971 at the University Hospital of Innsbruck, the number of hydrocephalus patients reaching reproductive age has increased in recent years. In the last few years we were confronted with the fact that three of our patients became pregnant. Our main aim was to attend these patients throughout pregnancy, delivery and maternity. These patients have been in our care from the beginning of their disease to adulthood and we have reviewed their development with other reported patients in literature. Indications for shunt placement were in two cases postmeningitis hydrocephalus and in one case congenital hydrocephalus of undetermined origin during childhood. Because of the mental impairment of our patients, intensive follow-up and medical consultation as well as special antenatal, peripartal and postnatal circumstances had to be considered in order to ensure the optimal quality of care, like social welfare work and vocational guidance. With our multidisciplinary management of these patients, we did not experience any complications regarding maternal shunt dependency contrary to literature. All these patients are now “mother patients“ and well integrated in society and their families. We suggest that proper care of these patients can lead to normal pregnancies, deliveries and maternity.
{"title":"Pregnancy, Delivery and Postpartum Care of Women with Ventriculo-Peritoneal Shunted Hydrocephalus: a case series","authors":"B. Haeussler, E. Laimer, J. Hager, G. Putz, C. Marth, R. Haeussler","doi":"10.5580/436","DOIUrl":"https://doi.org/10.5580/436","url":null,"abstract":"Since the introduction of cerebrospinal fluid (CSF) -shunt implantation in 1971 at the University Hospital of Innsbruck, the number of hydrocephalus patients reaching reproductive age has increased in recent years. In the last few years we were confronted with the fact that three of our patients became pregnant. Our main aim was to attend these patients throughout pregnancy, delivery and maternity. These patients have been in our care from the beginning of their disease to adulthood and we have reviewed their development with other reported patients in literature. Indications for shunt placement were in two cases postmeningitis hydrocephalus and in one case congenital hydrocephalus of undetermined origin during childhood. Because of the mental impairment of our patients, intensive follow-up and medical consultation as well as special antenatal, peripartal and postnatal circumstances had to be considered in order to ensure the optimal quality of care, like social welfare work and vocational guidance. With our multidisciplinary management of these patients, we did not experience any complications regarding maternal shunt dependency contrary to literature. All these patients are now “mother patients“ and well integrated in society and their families. We suggest that proper care of these patients can lead to normal pregnancies, deliveries and maternity.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"2017 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114525614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction:Obstructed labor with high maternal morbidity and mortality is still prevalent in the developing world. It is a preventable condition and can be overcome if proper steps are taken at appropriate levels and at appropriate time.Objective: To study the present burden of obstructed labor in a tertiary care Centre in a developing country, its causes and outcome.Materials and methods:Six months prospective study was carried out in Government Lalla Ded Hospital from July 2009 to December 2009. There were 117 cases of obstructed labor amongst a total number of 10862 births during this period in LD hospital. All patients admitted with obstructed labor were included in the study and the outcome of their pregnancy, mode of delivery and complications if any were noted. Results:117 patients of obstructed labor were admitted. CPD was the commonest cause of obstruction (87.18%). Most of the women affected were primigravida within the age group of 25 – 30 years. Most of them were delivered by Cesarean Section. There was no maternal mortality, though there were some procedure related complications. Fetal mortality was high (25.64%).Conclusion:Obstructed labor is a preventable condition prevalent in the developing world only. Improving nutrition, antenatal attendance with proper utilization and standard of services will help overcome this condition.
{"title":"Obstructed labor – current scenario in a developing country.","authors":"S. Rather, A. Qureshi, S. Parveen","doi":"10.5580/11ac","DOIUrl":"https://doi.org/10.5580/11ac","url":null,"abstract":"Introduction:Obstructed labor with high maternal morbidity and mortality is still prevalent in the developing world. It is a preventable condition and can be overcome if proper steps are taken at appropriate levels and at appropriate time.Objective: To study the present burden of obstructed labor in a tertiary care Centre in a developing country, its causes and outcome.Materials and methods:Six months prospective study was carried out in Government Lalla Ded Hospital from July 2009 to December 2009. There were 117 cases of obstructed labor amongst a total number of 10862 births during this period in LD hospital. All patients admitted with obstructed labor were included in the study and the outcome of their pregnancy, mode of delivery and complications if any were noted. Results:117 patients of obstructed labor were admitted. CPD was the commonest cause of obstruction (87.18%). Most of the women affected were primigravida within the age group of 25 – 30 years. Most of them were delivered by Cesarean Section. There was no maternal mortality, though there were some procedure related complications. Fetal mortality was high (25.64%).Conclusion:Obstructed labor is a preventable condition prevalent in the developing world only. Improving nutrition, antenatal attendance with proper utilization and standard of services will help overcome this condition.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133543254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Arikan, A. Barut, M. Harma, M. Harma, Alper Tanriverdi
A patient referred with ruptured membrane was found, by ultrasound and magnetic resonance imaging, to be carrying conjoined thoracoadbominopagus twins. Two live male babies joined at the chest were delivered by caesarean section. The parents refused a separation operation and the twins died from cardiopulmonary arrest after 18 hours. A review of the literature suggests that early diagnosis by a combination of ultrasound and MRI is essential to management, providing prognosis for viability and success of surgical separation and the opportunity for early counselling of parents and termination if indicated.
{"title":"Conjoined twins with thoracoabdominopagus anomaly in the third trimester:A case report","authors":"I. Arikan, A. Barut, M. Harma, M. Harma, Alper Tanriverdi","doi":"10.5580/116c","DOIUrl":"https://doi.org/10.5580/116c","url":null,"abstract":"A patient referred with ruptured membrane was found, by ultrasound and magnetic resonance imaging, to be carrying conjoined thoracoadbominopagus twins. Two live male babies joined at the chest were delivered by caesarean section. The parents refused a separation operation and the twins died from cardiopulmonary arrest after 18 hours. A review of the literature suggests that early diagnosis by a combination of ultrasound and MRI is essential to management, providing prognosis for viability and success of surgical separation and the opportunity for early counselling of parents and termination if indicated.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133855282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sosa, Alinne Colín Valenzuela, José Antonio Hernández Pacheco, Ricardo Figueroa Damián
Intrahepatic cholestasis of pregnancy (ICP) is a low prevalence pathology associated with premature delivery and fetal death. Objective: To determine risk factors, clinical course and predictive factors in a cohort of ICP patients.Methods: A retrospective cohort study was performed. There were studied fifty patients with ICP and 51 healthy women. Results: ICP was more frequently found in multiparous, multiple pregnancies and ICP antecedent. Women with ICP had a greater incidence of premature delivery (76.0%, p=0.001). Meconium-stained amniotic fluid was more frequent in ICP women (p=0.002). The newborns showed differences in weight, size and gestational age, attributable to the difference in gestational age at birth. Conclusions: Advanced maternal age, multiparity, antecedent ICP and multiple pregnancies increase the risk of ICP. The consequences of ICP might be premature delivery and meconium-stained amniotic fluid at delivery
{"title":"Intrahepatic Cholestasis of Pregnancy: Evaluation of Risk Factors and Predictive Factors.","authors":"S. Sosa, Alinne Colín Valenzuela, José Antonio Hernández Pacheco, Ricardo Figueroa Damián","doi":"10.5580/1cc","DOIUrl":"https://doi.org/10.5580/1cc","url":null,"abstract":"Intrahepatic cholestasis of pregnancy (ICP) is a low prevalence pathology associated with premature delivery and fetal death. Objective: To determine risk factors, clinical course and predictive factors in a cohort of ICP patients.Methods: A retrospective cohort study was performed. There were studied fifty patients with ICP and 51 healthy women. Results: ICP was more frequently found in multiparous, multiple pregnancies and ICP antecedent. Women with ICP had a greater incidence of premature delivery (76.0%, p=0.001). Meconium-stained amniotic fluid was more frequent in ICP women (p=0.002). The newborns showed differences in weight, size and gestational age, attributable to the difference in gestational age at birth. Conclusions: Advanced maternal age, multiparity, antecedent ICP and multiple pregnancies increase the risk of ICP. The consequences of ICP might be premature delivery and meconium-stained amniotic fluid at delivery","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124954559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatima Hassan Mohamed, Muhammad Abukhater, B. A. Ahmad, A. Mohamed
Caecal volvulus is a rare, but potentially fatal cause of intestinal obstruction. Accurate diagnosis is vital as delay in the surgical treatment of this condition may lead to an increased incidence of gangrene of the caecum and a higher mortality. We report a case of caecal volvolus in a 43 years old female who presented with small bowel obstruction 10 days after a cesarean section. We also review the literature for the clinical and radiological features of the condition.
{"title":"Post Cesarean Section Caecal Volvulus: Case Report And Literature Review.","authors":"Fatima Hassan Mohamed, Muhammad Abukhater, B. A. Ahmad, A. Mohamed","doi":"10.5580/2092","DOIUrl":"https://doi.org/10.5580/2092","url":null,"abstract":"Caecal volvulus is a rare, but potentially fatal cause of intestinal obstruction. Accurate diagnosis is vital as delay in the surgical treatment of this condition may lead to an increased incidence of gangrene of the caecum and a higher mortality. We report a case of caecal volvolus in a 43 years old female who presented with small bowel obstruction 10 days after a cesarean section. We also review the literature for the clinical and radiological features of the condition.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116752248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kumar, Lubna Sadaf, Shivanjali Raghuvanshi, S. Patne
Leiomyoma is the most common benign mesenchymal tumor of the vagina. However, leiomyoma with epithelioid features are very uncommon in the vagina. We report a rare case of epithelioid variant of leiomyoma in a 40-year old woman who presented with a painless vaginal mass. Immunohistochemistry against smooth muscle actin was done for confirmation.
{"title":"Epithelioid Leiomyoma of Vagina","authors":"M. Kumar, Lubna Sadaf, Shivanjali Raghuvanshi, S. Patne","doi":"10.5580/2483","DOIUrl":"https://doi.org/10.5580/2483","url":null,"abstract":"Leiomyoma is the most common benign mesenchymal tumor of the vagina. However, leiomyoma with epithelioid features are very uncommon in the vagina. We report a rare case of epithelioid variant of leiomyoma in a 40-year old woman who presented with a painless vaginal mass. Immunohistochemistry against smooth muscle actin was done for confirmation.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129529590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although the bladder is an inaccessible organ, various types of foreign bodies have been removed from it. A 20-year-old married female, who underwent vaginoplasty, accidentally placed the vaginal mould into the bladder per urethra. The vaginal mould was removed from the bladder under anesthesia. The vaginal length was normal. Vaginal mould in bladder has not been reported earlier.
{"title":"Accidental Placement of a Vaginal Mould into theUrinary Bladder","authors":"S. Singhal, S. Nanda, P. Chaudhry, S. Singhal","doi":"10.5580/1ddc","DOIUrl":"https://doi.org/10.5580/1ddc","url":null,"abstract":"Although the bladder is an inaccessible organ, various types of foreign bodies have been removed from it. A 20-year-old married female, who underwent vaginoplasty, accidentally placed the vaginal mould into the bladder per urethra. The vaginal mould was removed from the bladder under anesthesia. The vaginal length was normal. Vaginal mould in bladder has not been reported earlier.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130048305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haemodilution and changes in various protein levels have been associated with pregnancy and in order to assess the fibrinolytic activity and changes in plasma proteins during pregnancy, 100 pregnant and 100 non – pregnant subjects (controls) of age range 18 40 years were studied. Standard manual techniques were used to estimate plasma fibrinogen concentration (PFC), euglobulin lysis time (ELT), total proteins and albumin. The values of PFC and ELT were 3.2±0.8g/l and 358.3±84.7 minutes respectively for pregnant women as against 2.3±1.2g/l and 270.5±170.6 minutes respectively for non-pregnant women and the differences were statistically significant at p 0.05) . The differences in the values of PFC, ELT, total proteins, albumin and globulin in pregnancy with regard to the three age groups (19 – 25 years, 26 – 32 years and 33 – 39 years) were not statistically significant (P> 0.05). In conclusion, fibrinolytic activity in pregnant women differ from non – pregnant subjects due to significant increase in PFC and prolonged ELT which confirms hyperfibrinogenaemia and reduced fibrinolytic activity in this condition which therefore makes it necessary to monitor PFC and ELT in pregnancy since they are prone to thrombosis and haemorrhage.
{"title":"Changes In Plasma Proteins And Fibrinolytic Activity In Pregnant Women In Calabar, Nigeria","authors":"M. Imoru, A. Emeribe","doi":"10.5580/1f8f","DOIUrl":"https://doi.org/10.5580/1f8f","url":null,"abstract":"Haemodilution and changes in various protein levels have been associated with pregnancy and in order to assess the fibrinolytic activity and changes in plasma proteins during pregnancy, 100 pregnant and 100 non – pregnant subjects (controls) of age range 18 40 years were studied. Standard manual techniques were used to estimate plasma fibrinogen concentration (PFC), euglobulin lysis time (ELT), total proteins and albumin. The values of PFC and ELT were 3.2±0.8g/l and 358.3±84.7 minutes respectively for pregnant women as against 2.3±1.2g/l and 270.5±170.6 minutes respectively for non-pregnant women and the differences were statistically significant at p 0.05) . The differences in the values of PFC, ELT, total proteins, albumin and globulin in pregnancy with regard to the three age groups (19 – 25 years, 26 – 32 years and 33 – 39 years) were not statistically significant (P> 0.05). In conclusion, fibrinolytic activity in pregnant women differ from non – pregnant subjects due to significant increase in PFC and prolonged ELT which confirms hyperfibrinogenaemia and reduced fibrinolytic activity in this condition which therefore makes it necessary to monitor PFC and ELT in pregnancy since they are prone to thrombosis and haemorrhage.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117194353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this retrospective study, we looked into the number of women under 25 years old who had CINIII and the intervention rate. We looked into the percentage of abnormal smears, number of women under 25s referred to Colposcopy clinic, number and percentage of patients with CIN, number of patients diagnosed with micro-invasive and advanced stage Cervical Cancer. Out of 12132 cervical smears performed over 5 years for women under 25s, 81 women had CIN III (801 referred to Colposcopy). This study highlights that high grade lesions and CINIII in particular are common in the age group 20-24 and can occur at very young age.
{"title":"Study Of Cervical Screening For Women Under Age Of 25 Years Old, A Retrospective Data Analysis","authors":"G. Botros, N. Haddad, J. Brooks, J. Scalnan","doi":"10.5580/6c7","DOIUrl":"https://doi.org/10.5580/6c7","url":null,"abstract":"In this retrospective study, we looked into the number of women under 25 years old who had CINIII and the intervention rate. We looked into the percentage of abnormal smears, number of women under 25s referred to Colposcopy clinic, number and percentage of patients with CIN, number of patients diagnosed with micro-invasive and advanced stage Cervical Cancer. Out of 12132 cervical smears performed over 5 years for women under 25s, 81 women had CIN III (801 referred to Colposcopy). This study highlights that high grade lesions and CINIII in particular are common in the age group 20-24 and can occur at very young age.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121628495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to evaluate the performance of Kiwi OmniCup to achieve vaginal delivery by trained clinicians. A prospective study of all ventouse deliveries by Kiwi OmniCup was undertaken between January and March 2006 at Northwick Park hospital, a large DGH in London. During this 3 month period, 1045 deliveries took place. OmniCup deliveries were attempted in 116 cases (11%). Successful vaginal delivery was achieved in 104 (90%) cases. This outcome was comparable to that reported in other studies of rigid cup vacuum delivery. 31% of successful deliveries had incorrect placement of the cup. Third and fourth degree perineal tears were reported in 10 cases (9.8%).One infant developed subdural haematoma requiring blood transfusion. Shoulder dystocia was encountered in 5 cases of which one developed Erb’s palsy. This study demonstrated that Kiwi OmniCup is an efficient device for assisted vaginal delivery and training in its correct use consistently improves outcome.
{"title":"Performance Of Kiwi Omnicup. Does Training Improve Outcome","authors":"Bhavna Pandey, S. Patni, T. Rudra, B. Bhatkal","doi":"10.5580/1857","DOIUrl":"https://doi.org/10.5580/1857","url":null,"abstract":"The objective of this study was to evaluate the performance of Kiwi OmniCup to achieve vaginal delivery by trained clinicians. A prospective study of all ventouse deliveries by Kiwi OmniCup was undertaken between January and March 2006 at Northwick Park hospital, a large DGH in London. During this 3 month period, 1045 deliveries took place. OmniCup deliveries were attempted in 116 cases (11%). Successful vaginal delivery was achieved in 104 (90%) cases. This outcome was comparable to that reported in other studies of rigid cup vacuum delivery. 31% of successful deliveries had incorrect placement of the cup. Third and fourth degree perineal tears were reported in 10 cases (9.8%).One infant developed subdural haematoma requiring blood transfusion. Shoulder dystocia was encountered in 5 cases of which one developed Erb’s palsy. This study demonstrated that Kiwi OmniCup is an efficient device for assisted vaginal delivery and training in its correct use consistently improves outcome.","PeriodicalId":158103,"journal":{"name":"The Internet journal of gynecology and obstetrics","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115120515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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