ABSTRACT
Ruptured ectopic pregnancies are life-threatening emergencies, especially in developing countries, where many patients do not consult until rupture, sometimes with the patient already in hemorrhagic shock. In this situation, immediate blood transfusion is essential. Homologous blood products are not always available. Furthermore, homologous transfusion carries the risk of transmitting viruses such as HIV and hepatitis B and C. Autologous transfusion (intraoperative blood salvage) may thus be helpful. The authors present 6 cases of autologous transfusion performed at the Yaounde University Hospital (Cameroon) and recommend this method in developing countries where good quality blood cannot always be obtained rapidly.
Subject(s)
Blood Transfusion, Autologous , Pregnancy, Ectopic/therapy , Adult , Cameroon , Female , Hospitals, University , Humans , Pregnancy , Rupture, Spontaneous/therapy , Young AdultABSTRACT
Instrumental deliveries are believed to be associated with increased maternal and, especially, fetal morbidity and mortality. Hence, it is less practiced in many developing countries. The aim of this retrospective study, conducted between 1 January 2007 and 31 December 2008, was to assess the prevalence, indications, neonatal wellbeing and maternal complications of instrumental deliveries. Of 3623 vaginal deliveries, 84 (2.3%) instrumental deliveries were conducted. The most common indication was a prolonged second stage of labour. Fetal wellbeing, measured by the Apgar score, was good and was similar in the group who had forceps delivery and that of the vacuum extraction delivery group. Maternal complications, usually minor, were vaginal and perineal tears. Instrumental delivery should be encouraged and taught in order to reverse the rising caesarean section rate.
Subject(s)
Birth Injuries/epidemiology , Delivery, Obstetric/methods , Extraction, Obstetrical/methods , Obstetrical Forceps/statistics & numerical data , Pregnancy Outcome , Vacuum Extraction, Obstetrical , Adolescent , Adult , Cameroon , Delivery, Obstetric/adverse effects , Delivery, Obstetric/mortality , Delivery, Obstetric/statistics & numerical data , Extraction, Obstetrical/adverse effects , Extraction, Obstetrical/instrumentation , Extraction, Obstetrical/statistics & numerical data , Female , Hospitals, Teaching , Hospitals, University , Humans , Infant, Newborn , Pregnancy , Retrospective Studies , Treatment Outcome , Vacuum Extraction, Obstetrical/adverse effects , Vacuum Extraction, Obstetrical/methods , Vacuum Extraction, Obstetrical/statistics & numerical data , Young AdultABSTRACT
Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 34 weeks in a 35 year old patient. The case was managed at the University Teaching Hospital of Yaounde (Cameroon). She had past history of two uterine curettages. She presented with abdominal pain of sudden onset. After ultrasound scan, uterine rupture was diagnosed and an emergency laparotomy done. The entire amniotic sac was found in the peritoneal cavity with a rupture of the uterine fundus. Spontaneous uterine rupture occurs when there is an upper segment uterine scar. This case report shows that past history of curettage is a risk factor for the presence of uterine scar.