ABSTRACT
Aspirin has shown efficacy in preventing PE with a 10 % incidence reduction. The treatment must be started between the 12(th) and 14(th) week of amenorrhea with a dose of 75 to 160 mg once daily. This treatment is all the more effective as it is given to a high risk population. The supplementation with 1,5 g of calcium per day appears effective as well in the prevention of PE, especially in the malnourished and young patents. Insufficient data is currently available to recommend antioxidant supplementation. Low molecular weight heparin is potentially beneficial in the prevention of PE, however its efficacy remains to be demonstrated and indications determined. Nitric oxide (NO) or NO releasers are not effective and can cause headaches. Diuretics reduce the birth weight without improving the incidence of PE.
Subject(s)
Pre-Eclampsia/prevention & control , Adolescent , Adult , Anticoagulants/therapeutic use , Antioxidants/therapeutic use , Aspirin/administration & dosage , Aspirin/therapeutic use , Calcium Compounds/therapeutic use , Diuretics/adverse effects , Diuretics/therapeutic use , Female , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Male , Malnutrition/complications , Nitric Oxide Donors/adverse effects , Nitric Oxide Donors/therapeutic use , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/therapeutic use , Pregnancy , Risk , Young AdultSubject(s)
Aorta, Abdominal/surgery , Carcinoma/surgery , Laparoscopy/methods , Lymph Node Excision/methods , Uterine Cervical Neoplasms/surgery , Aorta, Abdominal/pathology , Carcinoma/pathology , Female , Humans , Lymphatic Metastasis , Neoplasm Staging , Para-Aortic Bodies , Prognosis , Treatment Outcome , Uterine Cervical Neoplasms/pathologyABSTRACT
OBJECTIVE: To determine if a trial of labor in twin pregnancy with previous cesarean section is an acceptable alternative to systematic cesarean section. PATIENTS AND METHODS: Based on a retrospective and comparative study from 1st January 1996 to 30th June 2003 in Maternite Jeanne-de-Flandre (Lille) and Pavillon Paul-Gelle (Roubaix), 35 trials of labor in twin pregnancies with previous cesarean section have been compared with 35 twin gestations attempting vaginal delivery without a prior cesarean. This comparative study has been led by sorting out the patients according to their gestational age, parity and maternity. RESULTS: Twenty-seven women (77%) delivered vaginally and eight (23%) by elective caesarean section. Postpartum hemorrhage was more frequent for caesarean section (75%). No scare dehiscence or rupture occurred. There was not any haemostasis hysterectomy or embolisation related to postpartum haemorrhage. Neonatal outcome was similar in both groups. DISCUSSION AND CONCLUSION: Twin trial of labor after a previous cesarean section seems to be a safe alternative to routine repeat cesarean delivery as maternal and fetal morbidity and mortality are safe.
