Incision-to-delivery interval and neonatal wellbeing during cesarean section.

AIM: The aim of this study was to investigate the effect of variation of the incision-to-delivery interval on neonatal wellbeing during cesarean delivery. METHODS: In this prospective study, 71 women, hemodynamically stable and without severe comorbidities, undergone an antepartum cesarean delivery; acid-base status, umbilical arterial oxygen content and Apgar score were used as indicators of neonatal wellbeing. Umbilical cord blood gas, the Apgar score of each neonate, the interval between skin incision and delivery and the interval between hysterotomy and fetal extraction of 71 cesarean deliveries were assessed in our level III University Hospital. RESULTS: Neither variation of skin incision-to-delivery interval nor variation of the interval between hysterotomy and delivery of the fetus is associated with a variation of indicators of neonatal wellbeing. CONCLUSION: A longer skin incision-to-delivery interval in cesarean birth does not compromise neonatal acid-base balance. Similarly, a longer interval between hysterotomy and delivery of the fetus is not associated with a variation of indicators of neonatal wellbeing. Awareness of this fact could give the surgeon more tranquility and help to prevent part of the iatrogenic complications associated with cesarean delivery.

Fertility after non-surgical management of the symptomatic first-trimester spontaneous abortion.

AIM: The aim of this study was to assess clinical outcome after a non-surgical management of the symptomatic spontaneous abortion in the first-trimester of pregnancy in a level III maternity hospital and to assess the subsequent fertility of the study population. METHODS: A prospective study in which 70 women with a symptomatic early pregnancy loss undergone an expectant management of miscarriage was performed. If resolution was not obtained after 4 days, medical treatment with misoprostol was administered. The patients were followed-up after the first menstrual cycle with a medical examination and an ultrasound scan. After 12 months, the patients were interviewed by phone to investigate on possible complications of abortion and on the occurrence of new pregnancies. RESULTS: The non-surgical management of miscarriage was successful in 68 out of 70 women (97%). Surgical intervention was necessary in 2 of 70 women (3%). Bleeding and pain were described as slightly more than a normal menstrual cycle. Among the 60 patients that answered at the 12-month follow-up (85.7%), none reported gynecological troubles and the subsequent pregnancy rate of the women was 81%. CONCLUSION: Expectant management of selected cases of spontaneous abortion, associated to medical treatment in indicated cases, could offer a valid alternative to dilatation and curettage.