1/16. The ex utero intrapartum treatment procedure for a large fetal neck mass in a twin gestation.BACKGROUND: Large fetal neck masses can make it difficult or impossible to secure airways at birth, with associated risks of hypoxia, brain injury, and death. Based on a medline search from 1966 to June 1998, using the keywords EXIT procedure, placental support, twins, and neck mass, we report the first ex utero intrapartum treatment procedure performed in a twin gestation complicated by a large fetal neck mass. CASE: A giant fetal cervical mass was diagnosed in one fetus of a 20-week twin gestation by sonography and magnetic resonance imaging. At 35 weeks' gestation, the ex utero intrapartum treatment procedure was performed successfully for delivery of the normal twin, followed by intrapartum airway access of the twin with the neck mass. CONCLUSION: Even in twin gestations, the ex utero intrapartum treatment procedure is the delivery method of choice for fetuses with giant neck masses.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/16. Cervico-isthmic pregnancy: an extremely rare case diagnosed during labour.This case report describes a cervico-isthmic pregnancy ending in a live vaginal birth at 37 2 weeks' gestation. The case remained undiagnosed throughout pregnancy when after a fairly normal labour a massive haemorrhage occurred. After an unsuccessful effort to control the bleeding conservatively, a total abdominal hysterectomy was carried out. During the operation the diagnosis of cervico-isthmic pregnancy was confirmed, which was in accordance with the pathology report.- - - - - - - - - - ranking = 9301.4017556168keywords = haemorrhage (Clic here for more details about this article) |
3/16. Hindbrain hernia masquerading as postpartum subarachnoid haemorrhage.A 29-year-old postpartum lady presented with a headache suggestive of subarachnoid haemorrhage. Investigations were negative for sources of haemorrhage, but revealed a hindbrain hernia. Hindbrain hernia should be considered as a cause of headache postpartum, as repeated Valsalva manoeuvres performed during vaginal delivery may further aggravate tonsillar decent.- - - - - - - - - - ranking = 55814.410533701keywords = haemorrhage, brain (Clic here for more details about this article) |
4/16. Intracranial haemorrhage as initial presentation of severe haemophilia B: case report and review of Mayo Clinic Comprehensive Hemophilia Center experience.A neonate who had intracranial haemorrhage (ICH) at birth received a diagnosis of severe haemophilia B at 6 months of age. ICH had been the initial presentation of his bleeding disorder. His family history was negative for haemophilia. review of our institutional experience as well as the literature indicates that intracranial bleeding as the initial presentation of haemophilia is rare.- - - - - - - - - - ranking = 50116.65378381keywords = haemorrhage, intracranial haemorrhage (Clic here for more details about this article) |
5/16. Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women.Improved acute and rehabilitative care and emphasis on integrating patients into society after spinal cord injury is likely to result in increasing numbers of cord-injured women presenting for obstetrical care. Anaesthetists providing care to these women should be familiar with the complications resulting from chronic cord injury and aware that many may be aggravated by the physiological changes of normal pregnancy. These complications include reduced respiratory volumes and reserve, decreased blood pressure and an increased incidence of thromboembolic phenomena, anaemia and recurrent urinary tract infections. patients with cord lesions above the T5 spinal level are at risk for the life-threatening complication of autonomic hyperreflexia (AH) which results from the loss of central regulation of the sympathetic nervous system below the level of the lesion. Sympathetic hyperactivity and hypertension result in response to noxious stimuli entering the cord below the level of the lesion. Labour appears to be a particularly noxious stimulus and patients with injuries above T5 are at risk for AH during labour even if they have not had previous AH episodes. morbidity is related to the degree of hypertension and intracranial haemorrhage has been reported during labour and attributed to AH. We report our experience in providing care to three parturients with spinal cord injuries. Two patients had high cervical lesions, one of whom experienced AH during labour and was treated with an epidural block. The second was at risk for AH having had episodes in the past and received an epidural block to provide prophylaxis for AH. In both cases epidural blockade provided effective treatment and prophylaxis for AH.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 12911.046761343keywords = haemorrhage, intracranial haemorrhage (Clic here for more details about this article) |
6/16. Inferior vena cava ligation for intractable pelvic haemorrhage.Inferior vena cava ligation was performed as the last resort in a case of iatrogenic injury to the common iliac veins during pelvic surgery. The post-operative recovery was satisfactory.- - - - - - - - - - ranking = 37205.607022467keywords = haemorrhage (Clic here for more details about this article) |
7/16. Orbital haemorrhage induced by labour.A case of acute orbital haemorrhage induced by labour is reported in a woman giving birth for the eighth time. The diagnosis was confirmed by computed tomography. The haemorrhage subsided spontaneously within three weeks. The mechanism of orbital haemorrhage following certain kinds of strain is discussed.- - - - - - - - - - ranking = 65109.812289318keywords = haemorrhage (Clic here for more details about this article) |
8/16. Perforation of a placental fetal vessel by an intrauterine pressure catheter.Perforation of a fetal vessel on the placental surface by an intrauterine catheter is reported. The immediate recognition of this unusual complication is important. To minimize the risks of perforation, haemorrhage and infection, several precautions should be observed when inserting the catheter.- - - - - - - - - - ranking = 9301.4017556168keywords = haemorrhage (Clic here for more details about this article) |
9/16. Do concepts of causes and prevention of cerebral palsy require revision?OBJECTIVE: My purpose was to explore the criteria of The American College of Obstetricians and Gynecologists (Technical Bulletin No. 163) for perinatal asphyxia to be linked to subsequent cerebral palsy. STUDY DESIGN: Analysis of four cases of intrapartum fetal insults with subsequent cerebral palsy and a literature review are presented. RESULTS: All of the four cerebral palsy cases had sufficient intrapartum causes of cerebral palsy, yet none fulfilled The American College of Obstetricians and Gynecologists' linkage criteria. Complications in the cerebral palsy cases were as follows: maternal intrapartum cardiac arrest, fetal skull fracture with brain infarct, intrapartum fetal stroke, and a newborn delivered after uterine rupture with only central nervous system defects. There are no well-done laboratory or clinical studies that unequivocally support the "criteria" that umbilical artery pH must be < 7.00 or the requirements of apgar score < 3, hypoxic-ischemic encephalopathy, and multiple organ dysfunction. Apparent exceptions to these criteria occur. CONCLUSIONS: The American College of Obstetricians and Gynecologists Technical Bulletin's criteria for cerebral palsy linkage and the role of parturition in cerebral palsy should be reevaluated. A rebirth of obstetric enthusiasm for cerebral palsy research, teaching, and treatment needs to occur.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
10/16. umbilical cord ulceration in association with intestinal atresia in a child with deletion 13q and Hirschsprung's disease.The case is reported of a baby boy with an interstitial deletion of the long arm of chromosome 13 who, in addition to the described associations of Hirschsprung's disease and intestinal atresia, had umbilical cord ulceration resulting in massive intrapartum haemorrhage. This case provides support for the existence of a previously reported association between umbilical cord ulceration and intestinal atresia, and suggests that it is aetiologically heterogeneous.- - - - - - - - - - ranking = 9301.4017556168keywords = haemorrhage (Clic here for more details about this article) |
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