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Biomedical subjects

L St George

Publications and source records attributed to L St George.

5 recordsLinked to original sources

Immediate postpartum complications.

Two hundred and sixty-nine (5.4%) of the 4,998 patients who delivered in Westmead Hospital, New South Wales in 1985 had immediate postpartum complications. This analysis was compared with figures from a major institution in another state of Australia. Early detection and prompt management without procrastination was the key to a successful outcome in the fourth stage of labour (i.e. within 24 hours of delivery). Nearly three-quarters of the complications were due to postpartum haemorrhage (PPH). The contributory factors are analysed and discussed. Reappraisal of the indications for induction of labour, epidural analgesia and forceps delivery is necessary to reduce the incidence of postpartum haemorrhage. The study reinforces the need for undiminished vigilance in the fourth stage of labour even if the first 3 stages are uncomplicated.

Analgesia, Epidural↗

Low vertical uterine incision in caesarean section.

Eleven of the 3,420 Caesarean sections performed in Westmead Hospital, Sydney during a 6-year period from 1979 to 1985 were by a low vertical uterine incision. All the others were the standard transverse lower segment operation except for 1 which was a postmortem classical Caesarean section. There are indications when the preferred lower segment Caesarean section with a transverse incision should be avoided in the interest of the mother and baby. A low vertical incision has more advantages and less dangers than a classical fundal incision. It is prudent to defer the decision regarding the type of incision until the uterus is inspected intraoperatively. If access to the lower uterine segment is limited by prematurity, an obstructing lesion, a transverse lie, or if the presenting part is high and difficulty in delivering the baby is anticipated, a low vertical incision should be considered.

Adult↗