RESUMO
When intravenous magnesium sulfate is infused in women with pregnancy-induced hypertension, the hypermagnesemia does not result in lower Apgar scores. The mean maternal serum and cord magnesium levels at delivery were 5.3 +/- 0.72 and 5.3 +/- 1.1 mEq/dl, respectively. The most common negative Apgar score was assigned for color, not for muscle tone.
Assuntos
Índice de Apgar , Hipotensão/tratamento farmacológico , Sulfato de Magnésio/uso terapêutico , Complicações Cardiovasculares na Gravidez , Cesárea , Feminino , Sangue Fetal , Idade Gestacional , Humanos , Concentração de Íons de Hidrogênio , Magnésio/sangue , Gravidez/sangueRESUMO
A review of 393 patients undergoing trial of labor after one or more previous cesarean sections was performed. Three hundred patients had an unknown uterine scar, 88 patients had a documented low cervical transverse incision, and five patients had a prior low vertical incision. The rate of vaginal delivery and maternal and fetal morbidity was no different in those patients with an unknown prior uterine incision compared with those having a known prior low cervical transverse incision. In 66 of the patients with a documented low cervical transverse incision, the original operative record was reviewed in regard to single-layer closure of the uterine incision versus double-layer closure or imbricating technique. No patient with a double-layer uterine closure had a subsequent dehiscence, whereas three patients with a prior single-layer closure exhibited scar separation. These data suggest that neither an unknown scar nor a single-layer uterine closure places the mother or fetus at greater risk.
Assuntos
Cesárea , Cicatriz/patologia , Prova de Trabalho de Parto , Útero/patologia , Cesárea/efeitos adversos , Cesárea/métodos , Cicatriz/etiologia , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Induzido , Ocitocina/uso terapêutico , Gravidez , Infecção Puerperal/etiologia , Ruptura Uterina/etiologia , Útero/cirurgiaRESUMO
Fifty-five patients with a history of two or more cesarean sections underwent a trial of labor. Forty-two had had previous uterine incisions of unknown type, 11 had had low cervical transverse incisions, and two had had low vertical incisions. Twenty-five women (45%) had successful vaginal deliveries, and 30 (55%) received oxytocin augmentation of labor. The incidence of vaginal delivery was significantly lower in patients who required oxytocin augmentation (30 versus 64%, P less than .01). Three of the 55 patients had scar separation detected at the time of delivery. Two patients underwent hysterectomy. There were no maternal or neonatal deaths. A history of multiple cesarean sections need not exclude the patient from the option of trial of labor.
Assuntos
Cesárea , Prova de Trabalho de Parto , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Ocitocina , Gravidez , Reoperação , Estudos RetrospectivosRESUMO
A case of small-cell carcinoma of the ovary occurring in a 33-year-old patient is described. At no time did the patient develop hypercalcemia. Despite aggressive cytoreductive surgery and multiagent chemotherapy, the patient expired after 13 months. These lesions must be differentiated from germ cell tumors or lymphoma. Review of the literature fails to reveal effective adjuvant therapy.
