ABSTRACT
Ophthalmo-acromelic syndrome type Waardenburg is an extremely rare autosomal recessive syndrome comprising eye malformations ranging from true anophthalmia to mild microphthalmia with acromelic malformations. We report a case of ophthalmo-acromelic syndrome type Waardenburg diagnosed prenatally.
Subject(s)
Ultrasonography, Prenatal , Waardenburg Syndrome/pathology , Adult , Consanguinity , Fatal Outcome , Female , Humans , Pregnancy , Respiratory Insufficiency , Waardenburg Syndrome/diagnostic imagingABSTRACT
OBJECTIVE: To determine the optimal route of delivery in breech presentation. METHOD: One-thousand and forty singleton breech deliveries among a total of 41785 deliveries that occurred at Zubeyde Hanim Maternity Hospital between 1990 and 1994 were analyzed. RESULT: The breech deliveries accounted for 2.4% of all deliveries. Of the patients, 572 (56.3%) were delivered vaginally and 468 (43.7%) were delivered by cesarean section. The mean ages of vaginal and cesarean delivery groups were 25.2 and 24.6 years, respectively. Forty-one (3.9%) of the fetuses had congenital anomaly. The leading congenital anomalies were meningocele in seven and hydrocephalus in six patients. Mullerian anomalies were encountered in 29 (6.1%) patients at cesarean section. Fetal morbidity observed in cesarean deliveries were fracture of the humerus in one and fracture of the femur in one and soft tissue injury in four cases. Fracture of the humerus was observed in two, Erb's paralysis in four, facial paralysis in one and soft tissue injury in 43 fetuses delivered vaginally. The leading causes of puerperal maternal morbidity were genital tract lacerations in vaginal delivery group and wound infection in cesarean delivery group. The overall perinatal mortality of this series was 54.8/1000 (57/1040). The corrected figures for cesarean delivery and vaginal delivery groups were 8.5/1000 (4/467) and 57.9/1000 (32/552), respectively. CONCLUSION: We favor a selective approach for mode of delivery in patients with breech presentation in order to balance the fetal morbidity associated with vaginal delivery and maternal morbidity and cost associated with cesarean delivery.
Subject(s)
Breech Presentation , Delivery, Obstetric/statistics & numerical data , Birth Injuries/etiology , Cesarean Section/adverse effects , Cesarean Section/statistics & numerical data , Congenital Abnormalities/epidemiology , Delivery, Obstetric/adverse effects , Delivery, Obstetric/methods , Female , Humans , Infant, Newborn , Pregnancy , Treatment Outcome , TurkeyABSTRACT
BACKGROUND: To determine the leading causes of maternal mortality in a large maternity hospital and to define priorities regarding this subject throughout Turkey. METHODS: Retrospective, institutional study among 100,531 live births between 1983 and 1992. RESULTS: Seventeen maternal deaths took place in this institution. Thus, the overall maternal mortality ratio was 16.9 per 100,000. The leading causes of maternal mortality were hemorrhage in seven (41.2%) and pulmonary embolism in six (35.3%) patients. The majority of deaths were observed in the 25-29 and 30-34 age groups and in patients with parity more than two. CONCLUSION: The relatively low figure of 16.9/100,000 for maternal mortality may be seen as a promising health index. However, obstetric hemorrhage is still the leading cause of this series. Pregnant women less than 20 years old and greater than 35 years old, and grand multiparous women as well as women with hypertension and heart disease are at high mortality risk. The observation of such cases demands further efforts for improved obstetric care in the hospital and throughout Turkey.
PIP: During 1983-1992 in Turkey, 17 maternal deaths occurred out of 100,531 live births at the Zubeyde Hanim Maternity Hospital in Ankara for a maternal mortality ratio (MMR) of 16.9/100,000 live births. Hemorrhage (41.2%) and pulmonary embolism (35.3%) were the leading causes of maternal death. Cases referred to the hospital after home deliveries accounted for 57% of the hemorrhage-related deaths. Other causes of maternal death were eclampsia (11.7%), puerperal infection (5.9%), and heart failure attributed to rheumatic heart disease (5.9%). The MMR fell over time from 22.6 (1983-1984) to 12.8 (1991-1992). Women younger than 20 and those 35 and older suffered from the highest MMRs. MMR increased with parity (8 for primigravida, 10 for parity 1-2, 27.3 for parity 3-4, and 62.1 for parity =or 5). Cesarean delivery was associated with a higher MMR than vaginal delivery (44.7 vs. 14.1). This association was likely a result of pregnancy complications that led to a cesarean section rather than the cesarean section itself.
