[Uterine rupture in pregnancy--case study]. / Ruptury delohy v tehotenství--kazuistiky.

OBJECTIVE: Analysis of two cases uterine rupture following caesarian section. SUBJECT: Two case studies. SETTING: Gynecological obstetrics clinic, First Medical Faculty and Faculty Hospital Bulovka, Prague. SUBJECT AND METHODS: The authors in their article describe two cases of rupture of the uterus in pregnancy prior to delivery. In both cases there was a history of cervicocorporal caesarian section. CONCLUSION: In the first case the patient was admitted from her home with bleeding, and signed a nonconsent form. The second case concerned a hospitalized patient, in which the first signs of uterine rupture were indicated by fetal heart rate. Both women underwent hysterectomy, paradoxically, in the first case the child was saved and discharged home in good health.

Adhesive bowel strangulation after caesarean section, the rare puerperal complication.

Caesarean section is the most frequent abdominal operation carried out in obstetric practice. Parturients undergoing this operation are still exposed to a substantial rate of short- and long-term complications. The incidence of re-laparotomy after caesarean section is 0.12-0.70%. The most common indication for re-laparotomy is intra-abdominal bleeding, uterine atony, eventration, haematoma in the muscle and intra-abdominal abscesses. We present the case report of an unusual life-threatening complication of caesarean section that led to re-laparotomy. Caesarean section rate has been continually increasing globally in the last few decades, thus we also have to take into account unusual complications e.g. intestinal complication.

Human sexuality during pregnancy and the postpartum period.

Sexual problems and dysfunctions during pregnancy are often led by the anxiety of hurting the fetus. Males are also afraid of hurting a female and females are afraid of insufficient satisfaction of a male partner. Just 12-14% of couples deny sexual problems after the childbirth. The main postpartum risk factor for dyspareunia is the extent of a birth injury. Breastfeeding is linked to a low coital activity, low sexual desires and low sexual satisfaction of females and their partners. Breastfeeding females start with a sexual life later; more often suffer from dyspareunia and indicate a lower satisfaction with the sexual intercourse. Further, episiotomy is associated with a higher prevalence of a postpartum dyspareunia. Low interest of antenatal and postnatal care providers in the issues of sexuality is documented. Lack of relevant information is the common reason for avoiding this topic. 76% of pregnant females would recommend a discussion on sexuality during pregnancy as a topic in an antenatal clinic and almost a half of pregnant women evaluate the information received from health care providers as insufficient (Ref. 48). Full Text (Free, PDF) www.bmj.sk.

Urinary incontinence in a group of primiparous women in the Czech Republic.

BACKGROUND/AIM: Not only the process of childbirth itself, but also processes during pregnancy seem to be strongly associated with urinary incontinence (UI). According to some epidemiological studies, UI during pregnancy occurs in 23-70% of the pregnant women. These studies also documented some risk factors (e.g., race, age, or body mass index). The aim of our study was to explore the prevalence of UI during pregnancy in the Czech Republic. METHODS: 474 primiparas who gave birth at our maternity ward from June 14, 2004, through January 31, 2005, received a questionnaire. The questionnaire concentrated on the occurrence and presentation of UI before and during pregnancy. RESULTS: 339 women (72%) completed the questionnaire. UI and the length of pregnancy are significantly related. We found a baseline UI prevalence before pregnancy of 17%, but before delivery one of 64%. We did not find any statistically significant relation between the prevalence of UI during pregnancy and body mass index before pregnancy as well as before delivery, weight gain during pregnancy, age, and birth weight. CONCLUSION: Our results show that pregnancy is a risk factor for the development of UI.