Pentalogy of Cantrell accompanied by scoliosis and pes equinovarus deformity at 12 weeks gestation.

Cantrell's pentalogy (CP) is a rare syndrome characterized by defects in the lower sternum with ectopia cordis, anterior diaphragm defects, midline supraumbilical abdominal wall defects, defects in the diaphragmatic pericardium, and congenital heart disease. The authors report a 12-weeks gestation with multiple fetal anomalies suggesting the diagnosis of CP (a large thoraco-abdominal defect with herniating liver and bowel, heart deviated anteriorly with concomitant ventricular septal defect), and the 'S' shaped fetal spine due to increased lumbar lordosis and scoliosis with accompanying pes equinovarus deformity. Chorionic villus sampling was performed due to increased nuchal translucency (3.7 mm). The fetal karotype was found to be 47, XX,+21 (trisomy 21). In the literature, three scoliosis cases have been reported accompanying the CP along with multiple anomalies and one concomitant pes equinovarus deformity has been reported previously.

Is induction of labour by Propess(®) safe? A comparison of midwife-led versus obstetrician-led labour management.

This retrospective study compared maternal and fetal outcomes after labour induction, using a dinoprostone vaginal pessary (Propess(®)) in midwife-led and obstetrician-led labour management. Labour induction outcomes, delivery mode and rates of admission to the neonatal intensive care unit were compared. A total of 405 women, 40.5% (n = 164) from midwife-led units and 59.5% (n = 241) from an obstetrician-led unit, participated. There was no statistically significant difference between the two groups in caesarean section rate or neonatal intensive care unit admission rates (p = 0.789 and 0.769, respectively). Non-reassuring fetal non-stress test and uterine hyperstimulation risks were higher in the obstetrician-led unit (p = 0.003 and 0.001, respectively, and odds ratio (OR) 0.165, 95% CI: 0.117-0.232 and OR 0.218, 95% CI: 0.078-0.611, respectively). Postpartum blood transfusion rate was higher in the midwife-led units (p = 0.002, OR 8.082, 95% CI: 1.879-39.292). Labour induction with Propess(®) is safe during both midwife-led and obstetrician-led labour management.

Gum chewing reduces the time to first defaecation after pelvic surgery: A randomised controlled study.

Post-operative ileus is a major complication that increases the morbidity in patients who had abdominal surgery. Several different procedures have been used to manage bowel function, including adequate pain control, prokinetic drugs and supportive strategies. The present study aimed to assess the effect of chewing gum on bowel recovery in patients undergoing gynaecologic abdominal surgeries. A total of 137 patients were randomised into gum-chewing and control groups. Patients in the gum-chewing group began chewing gum at post-operative 3rd h and chewed gum thereafter every 4 h daily, for 30 min each time. All patients received the same post-operative treatment. Primary outcome measures were the time to first passage of flatus and time to first passage of stool. The secondary outcome measures included the first hearing of normal bowel sounds, nausea and the time until discharge from the hospital. Compared with the control group, the time interval between operation and first flatus was shorter in the gum-chewing group (median, 33 h vs 30 h). However, the difference was not significant (p = 0.381). The first defaecation time was significantly shorter in the gum-chewing group. The median time to first defaecation was 67 (20-105) h in the control group and 45 (12-97) h in the gum-chewing group (p < 0.01). Gum chewing is safe, well tolerated and it allows early defaecation after gynaecologic abdominal surgery.

Assessment of body composition with bioelectrical impedance analysis in pregnant women with hyperemesis gravidarum before and after treatment.

More than half of pregnant women suffer from nausea and vomiting, in 0.5-1% of the pregnant women, if nausea and vomiting are severe and persistent, condition can progress to hyperemesis. We evaluated the fluid volume parameters in pregnant women with hyperemesis gravidarum, before and after treatment using the bioelectrical impedance vectors. A total of 70 pregnant women who had weight loss exceeding 5% of pre-pregnancy body weight were recruited for the study in the first trimester. The measurement of multi-frequency bioelectrical impedance analysis parameters was performed on the day of hospitalisation before any treatment and after treatment at 24 h and 72 h with the same procedure. Total body water, extracellular water, intracellular water, and fat-free mass index increased after treatment at 24 h (P < 0.01). Also, the mean pregnancy-unique quantification of emesis and nausea score was significantly lower after treatment (11.3 ± 2.1 at enrolment, 5.1 ± 1.4 at 24 h and 4.3 ± 1.1 at 72 h) (P < 0.01), which correlated with the patients' clinical improvement and changes in hydration. In pregnant women with moderate-to-severe hyperemesis gravidarum, significant body composition changes occur and fluid replacement therapy performed during a short period of time, such as 24 h, provides improvement in body composition.