Showing papers on "Labor Complication published in 1956"

Ruptured splenic arterial aneurysm during parturition.

Abstract: Berger, Forsee, and Furst (1953) state that only 152 cases of aneurysm of the splenic artery have been reported in the literature since Crisp's description in 1847. They also note that prior to rupture the surgical mortality rate is approximately 15%, whereas after rupture the mortality rate approximates 100%. Sheehan and Falkiner (1948) state that of the cases of splenic arterial aneurysm so far recorded in patients below the age of 45, 41 were in women. Furthermore, 23 of these 41 women were pregnant, and rupture nearly always occurred at seven to nine months' gestation. These authors analysed 163 routine obstetric necropsies and found that in the three following clinical conditions the spleen was commonly enlarged in the second half of pregnancy (weighing more than 2,00 g.): (1) severe anaemia of pregnancy, (2) accidental haemorrhage of the abruptio type, and (3) puerperal thrombophlebitis or gross septic endometritis. They considered that this splenic enlargement, with the presumptive changes in splenic blood supply, might be a predisposing factor in rupture of splenic arterial aneurysms in pregnancy. It is interesting to note that eclampsia and other toxaemias of pregnancy did not appear to be associated with pathological increase in the weight of the spleen. In view of the rarity of ruptured splenic arterial aneurysm the following case is recorded.

Rupture of the rectovaginal septum at parturition.

Abstract: Isolated rupture, at parturition, of the rectovaginal septum without involvement of the perineum is a very rare obstetrical accident. In this condition the sphincter mechanism remaitis intact in contrast to the more common injury to the septum which is due to extension into it of a third-degree perineal laceration. McNulty (1952), in a series of 75 cases of third-degree laceration occurring in a total of 14,080 patients, makes no reference to rupture of the septum; neither does Hofmeister (1952) in his paper on repair of rectovaginal injury occurring at parturition, or Dodek (1954) when writing about similar accidents. Kerr and Moir (1949) mention an instance of rupture of the rectovaginal septum in a patient with a breech presentation at the Glasgow Royal Maternity Hospital. Eight years ago I saw an identical case at the Royal Maternity Hospital, Belfast, when one foot presented through the vagina and the other through the anus. A similar accident is described by Lesh (1952) as occurring with the first of twins. The only record in English that I can find of rupture of the rectovaginal septum occurring in a vertex presen:ation is that of Melody (1953), although French and German writers have described such incidents. Melody (1953) describes a case occurring in a woman following delivery of her second child by outlet forceps and medial episiotomy. The entire delivery, he states, was easily effected and there was no extension of the episiotomy. On inspection of the posterior vaginal wall, however, a complete rupture of the rectovaginal septum was discovered which extended for a distance of 10 cm. without involvement of the episiotomy or of the anal sphincter.

Appendectomy performed during the first stage of labor

Abstract: Summar A case is recorded in which signs and symptoms of acute appendicitis developed after the onset of labor in a primipara. Immediate appendectomy was performed, followed by normal termination of labor. The patient made an uneventful recovery.