Blunt maternal trauma: a review of 103 cases.

One hundred three pregnant women hospitalized following blunt trauma had injuries classified as: major (20%); minor (17%); or significant (63%). Maternal mortality related only to the severity of maternal injuries: 24% of women who sustained major injuries died. Pregnancy ended unsuccessfully in 18% of all women with known pregnancy outcome. The incidence of unsuccessful pregnancy was 61% following major injuries and 27% following minor injuries. Insignificant maternal injuries did not affect pregnancy outcome. Fetal survival did not relate to gestational age per se. Pregnancy uniformly ended unsuccessfulla in the presence of maternal death, placental injury, uterine injury, and direct fetal injury, and occurred in 80% of women admitted in hemorrhagic shock. An understanding of the ways that the anatomic and physiologic changes of pregnancy alter the nature and frequency of maternal injuries and that maternal response to injury is altered is essential. The best chance for fetal survival is to assure maternal survival.

Diagnostic peritoneal lavage for blunt trauma in pregnant women.

Twelve pregnant women underwent diagnostic peritoneal lavage for suspected blunt abdominal trauma. Peritoneal lavage was both safe and accurate. The lavage was negative in four patients. Two of these patients survived without clinical evidence of abdominal injuries. The absence of abdominal injuries was confirmed at autopsy in the two patients who subsequently died. Peritoneal lavage was positive for hemoperitoneum in eight patients. All eight had significant abdominal injuries.

Acute reversible renal failure following jejunoileal bypass for morbid obesity: a clinical and pathological (EM) study of a case.

A patient who underwent jejunoileal bypass for morbid obesity developed servere renal failure associated with hyperoxaluria and renal oxalosis. Renal function improved and oxalate excretion decreased following hemodialysis and restoration of gastrointestinal continuity.

Prophylactic use of tetracycline for first trimester abortions.

Because the efficacy of prophylactic antibiotic therapy has yet to be established and because numerous variables often hamper studies of such therapy, the results of prophylactic antibiotic therapy were studied in a homogeneous gynecologic population. The patients were 4000 women undergoing first trimester abortions. The surgical procedure, the gynecologists' skill, and the hospital environment were relatively uniform, as was the patient age range. Two groups of 1000 patients each received tetracycline; the other 2000 patients served as controls. The complications associated with abortion were then analyzed in those receiving tetracycline and in the 2000 controls. Complications were less frequent among patients receiving tetracycline. This finding supports the argument of those who favor the prophylactic use of antibiotics in the management of various high-risk surgical problems.

PIP: An evaluative study of the prophylactic use of tetracycline in 1st-trimester abortions is presented. 2 groups of 1000 patients received 1.5 gm of tetracycline hydrochloride, orally, 2-3 hours before the abortion procedure, followed by 500 mg every 6 hours for 4 days. 2 groups of 1000 patients served as controls. The patient population and operative conditions were relatively uniform. The total complication rates for the antibiotic groups were 3.4% and 2.9%, and 9.1% and 8.8% for the controls. 118 of the control group patients experienced major complications compared with 45 patients in the antibiotic group. The results tend to support the arguments for the use of antibiotics in managing high-risk surgical procedures.