RESUMEN
It is usually recommended that swallowed foreign bodies with a length of more than 6 cm be endoscopically removed from the stomach. In this case report five cutlery knives had been ingested by a female patient with borderline personality disorder who repeatedly ingested foreign objects. It was considered too risky to remove the knives endoscopically and they were left in situ. After three years, without admission due to the knives or other swallowed foreign bodies, the patient spontaneously vomited two of the five, now very eroded, knives. Later, the remaining knives were removed at a hospital abroad.
Asunto(s)
Cuerpos Extraños/complicaciones , Trastorno de Personalidad Limítrofe/psicología , Femenino , Cuerpos Extraños/cirugía , HumanosRESUMEN
OBJECTIVE: To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery. DESIGN: Retrospective study. SETTING: University hospital in Copenhagen capital area. POPULATION: All women with a prior cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. METHODS: Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural anesthesia and mode of birth was collected. RESULTS: A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully or almost fully dilated cervix (9-10 cm) (p < 0.001). Among the women with a previous vaginal delivery prior to their cesarean section, the success rate for vaginal birth was 76.2%, in contrast to 48.9% in the group without a previous vaginal delivery (p < 0.01). CONCLUSION: Women who had a trial of labor after a prior cesarean section for dystocia done late in labor and women with a vaginal delivery prior to their cesarean section had a greater chance of a successful vaginal birth during a subsequent delivery.