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Labor Complication
About: Labor Complication is a research topic. Over the lifetime, 185 publications have been published within this topic receiving 1614 citations.
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TL;DR: The undergraduate student should be given every opportunity of seeing these patients in the outpatient department, of observing their preliminary investigation, of taking part in the technical examination under anaesthesia, and of interesting himself in the after-care and follow-up.
Abstract: (7) The gynxcologist should, if he so wishes (and many do), personally insert the radium with the technical assistance of the radiotherapy team. The quest for that elusive internal os can be humiliating even in cases of dysmenorrhoea and infertility. In some malignant cases it can defeat both the patience and skill of an experienced operator. False passages, perforations and total failure to insert the central tube are much more likely in the hands of the inexperienced, and for these the patient pays a heavy price. In some centres this essentially gynecological procedure is entrusted to a radiotherapy registrar. (8) Inpatients should be accommodated in gynecological beds or, at least, in beds over which the gynecologist and his team can exercise some supervision and control. A few of the beds in a radiotherapy centre might be reserved for joint research. (9) Follow-up should be a joint responsibility, and should be carried out in a gynecological department properly equipped and staffed for this intimate type of examination. There is much to be said for the system whereby these patients attend the ordinary follow-up clinics of the gynecological department. Segregation of malignant cases may have undesirable effects, psychological and otherwise. (10) The undergraduate student should be given every opportunity of seeing these patients in the outpatient department, of observing their preliminary investigation, of taking part in the technical examination under anaesthesia, and of interesting himself in the after-care and follow-up. He will thereby become imbued with the paramount importance of overall gynicological supervision, and, by the same token, will be vastly less likely after registration to refer his own patients direct to the radiotherapist.
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TL;DR: 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.
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.
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01 Nov 1961
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