Hyperbaric oxygenation for rectovaginal fistula: a report of two cases.

A rectovaginal fistula after delivery is a rare complication, and its management can become difficult if infection occurs. In two such cases, we administered hyperbaric oxygenation (HBO) treatment against complicated infections, and we obtained a good outcome in each case.

[Studies on the interrelation of fetal heart rate change, placental findings and fetal outcome].

The relation between antepartum fetal heart rate (FHR) non stress test (NST), maternal serum estriol, intrapartum FHR change, birth weight, placental findings and Apgar score were studied in 168 normal gestations and 36 high-risk pregnancies including 25 EPH-gestosis cases. The frequency of placental infarcts was higher in severe gestosis than in other high-risk pregnancies and normal gestation. Abnormal NST was more frequent in high-risk pregnancy than normal. Light for date (LFD) infants were more numerous in high-risk pregnancy than normal, and also frequent in the cases of placental infarcts. Particularly in high-risk pregnancy patients with abnormal NST and placental infarcts, 3 out of 5 showed LFD infants. Intrapartum fetal distress was more common in the cases of abnormal NST than normal. The five minute Apgar score was lower in the patients with abnormal NST and in the cases of placental infarcts than normal. The placental infarct ratio was higher in high-risk pregnancies with abnormal NST than normal. The maternal serum estriol level was not changed in cases of high-risk pregnancy, abnormal NST or placental infarcts when compared to normal gestation. The cases of succeeding fetal death, however, showed a low serum estriol level. In conclusion, antepartum abnormal NST suggests severe placental dysfunction caused by its infarcts and the prognosis is poor in patients with high-risk pregnancies, particularly EPH-gestosis. Coping with abnormal antepartum NST is regarded as important in fetal management.

[A study on the relation among oxytocin challenge test, maternal serum estriol level and placental change (author's transl)].

FHR oxytocin challenge test (OCT), maternal serum estriol level, neonatal birth weight and placental findings were studied in 206 cases. 1) Maternal serum estriol levels were not always related to the results of OCTs. 2) In the cases of positive and equivocal OCTs, the birth weight and the placental weight were smaller than those in negative OCT cases. 3) Positive and equivocal OCTs were frequently related with calcification and infarction of the placentae. 4) Neonatal birth weight showed close relation to the placental weight, though insignificant relation to maternal serum estriol level was observed. 5) The frequency of positive and equivocal OCTs was high in the cases of right-posterior position of placenta, and low in the cases of left-anterior.