RESUMO
A 26-year-old woman presented at 28 weeks' gestation with intracranial hemorrhage, stuporous mentalilty. The pregnancy was maintained with supportive care. At 35+1 weeks' gestation, a 2560 gm, healthy male baby was delivered by means of cesarean section. Maintaining adequate nutritional status is vital in achieving appropriate fetal growth and development. Maternal malnutrition may have an adverse effect on the fetus and neonate, with deleterious effect on birth weight and brain development. When the mother is unconcious, fetal well-being should be assessed by serial biophysical profile scoring. There is no neurosurgical contraindication to vaginal delivery if patient is of good neurologic grade. Nevertheless, cesarean section may be preferable if the patient is in poor neurologic condition.
Assuntos
Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Peso ao Nascer , Encéfalo , Cesárea , Desenvolvimento Fetal , Feto , Hemorragias Intracranianas , Desnutrição , Mães , Estado Nutricional , EstuporRESUMO
OBJECTIVE: The purpose of this study was to evaluate the outcome and safety of vaginal delivery after previous cesarean birth. METHODS: This study was based on 303 cases of delivery with previous cesarean birth at Masan, Fatima Hospital from May, 1997 to April, 1998. Among them, 62 cases had performed trial of labor. We had made a comparison between elective repeat section group and trial of labor group by analizing the frequency, successful rate, maternal morbidity, perinatal morbidity and mortality. RESULTS: Among 303 cases with previous cesarean birth, trial of labor was done in 62 cases(20.5%). Among trial of labor group, vaginal delivery was done in 54 cases (87.1%) and repeat section was done in 8 cases(12.9%). Indications for elective repea section before the onset of labor were refuse trial of labor(51.9%), request for tubal ligation(17.4%), and previous section > or =2(7.5%), etc. The successful rate of vaginal delivery according to indication for previous cesarean birth was 85.0%(17/20) in the cases of dystocia and 88.1%(37/42) in the cases except dystocia. The successful rate was not influenced by the indication for previous cesarean birth(P>0.05). There were no maternal death or uterine rupture in the cases of trial of labor. There were no significant difference between elective repeat section group and trial of labor group in maternal morbidity, perinatal morbidity and mortality(P>0.05). CONCLUSION: Under strict indications, vaginal delivery subsequent to cesarean birth may be safe, and can reduce the rate of cesarean section that was increased constantly.
Assuntos
Feminino , Humanos , Recém-Nascido , Gravidez , Índice de Apgar , Cesárea , Distocia , Eclampsia , Sofrimento Fetal , Feto , Idade Gestacional , Incidência , Morte Materna , Mortalidade , Parto , Parto , Mortalidade Perinatal , Pré-Eclâmpsia , Nascimento Prematuro , Respiração Artificial , Reologia , Prova de Trabalho de Parto , Artérias Umbilicais , Ruptura UterinaRESUMO
Ectopic pregnancy developing in the previous cesarean section scar is the rarest forms of ectopic pregnancy and very dangerous because of the risk of uterine rupture and hemorrhage. Hysterectomy was usually done in the management but, conservative treatment is desirable for young women who want to maintain her fertility. We present three cases of ectopic pregnancy developing in the previous cesarean section scar in which successfully treated with conservative management.