ABSTRACT
Early prenatal diagnosis, intensive prenatal care, bed rest, cerclage, and preventive in-patient management are discussed. The authors present the management and outcome of 83 twin pregnancies in a 5-year retrospective study. The frequency of twin pregnancy wa 1.08%, the mean gestational age at the time of delivery was 37.5 weeks. Mean birth weight of the first fetus was 2453 grams, second 2406 grams. The incidence of preterm deliveries was 31.3% and perinatal mortality of twins came up to 54.2%. The early prenatal diagnosis of a twin pregnancy is the most important step in prenatal management. The centralization of prenatal care in the out-patient department designated for "high risk pregnancies" is recommended. Ultrasound scanning is recommended as a screening examination. Bed rest before the 25th gestational week is recommended on an individual basis though it is recommended in all cases after the 25th gestational week. Cerclage was indicated in 28.9% cases with unfavourable cervical findings. The mean gestational age of 38 weeks and the birth weight of 2659 grams found in the group who had in-patient management should be compared with 35.8 weeks and 2120.0 grams in the group managed on an out-patient basis. Perinatal mortality before 32nd week--300/1000, between 33-37th week--62.5/1000, and after 37th week--8.7/1000. The authors recommend in-patient management before the 32nd week of pregnancy in twins.
Subject(s)
Obstetric Labor, Premature/prevention & control , Pregnancy, Multiple , Bed Rest , Birth Weight , Female , Gestational Age , Hospitalization , Humans , Obstetric Labor, Premature/mortality , Pregnancy , Pregnancy Outcome , Prenatal Care , Prenatal Diagnosis , Retrospective Studies , Twins , Ultrasonography, Prenatal , Uterine Cervical Incompetence/surgerySubject(s)
Birth Weight , Body Height , Pregnancy Complications, Infectious , Urinary Tract Infections , Adult , Female , Humans , Infant, Newborn , PregnancySubject(s)
Preoperative Care , Vagina/microbiology , Adult , Aged , Escherichia coli/isolation & purification , Female , Genital Diseases, Female/microbiology , Genital Diseases, Female/surgery , Humans , Middle Aged , Postoperative Complications/prevention & control , Staphylococcus/isolation & purification , Streptococcus/isolation & purificationSubject(s)
Malpractice , Abortion, Induced/adverse effects , Adult , Cesarean Section/adverse effects , Female , Humans , Pregnancy , Uterus/injuriesSubject(s)
Mastitis/radiotherapy , Puerperal Disorders/radiotherapy , Female , Humans , Pregnancy , Radiotherapy DosageSubject(s)
Vulva/cytology , Female , Gestational Age , Humans , Methods , Pregnancy , Vaginal SmearsSubject(s)
Food Service, Hospital , Hospital Administration , Czechoslovakia , Female , Gynecology , Humans , Obstetrics , PregnancyABSTRACT
PIP: (PGs) Prostglandins with the pharmacological and biological effects are intervening in a number of physiological processes of the reproductive cycle. They influence the motility of myometrium during the menstrual cycle, and through the relaxation of myometrium, they permit the migration of sperm cells and thus allow for fertilization. PGs act as etiologic factors in primary dysmenorrhea. Their effect on oviducts is not yet quite clear. Of considerable importance is their function in steroidogenesis of the ovary, mainly in luteolysis. Their contraceptive effect is considered as well. The clinical use of PGs in obsterical practice proves their significance in obstetrical dynamics. (Author's modified)^ieng
