Biomedical subjects
Publications and source records attributed to P Zourlas.
A case of thanatophoric dwarfism is reported in a 35-year-old woman. The diagnosis was made at 34 weeks gestation by ultrasound. Marked shortening of the extremities, macrocephaly, narrow thorax and polyhydramnios were observed. The importance of routine ultrasound screening in pregnancy is emphasized, since such malformations can be detected prenatally.
Maternal serum cortisol (F) and prolactin (PRL) levels were measured during labor in 20 uncomplicated pregnancies. Four pregnant women were admitted with ruptured membranes (RM group) and 16 were admitted with intact membranes (IM group), ten with spontaneous onset of labor (SL group) and 10 with induced labor (IL group), five with a prolonged for duration labor (PL group) and 15 with a normal for duration labor (NL group). Before the inset of labor F levels were statistically higher (p less than 0.05) in the RM group (x = 975 ng/ml), than in the IM group (x = 664 ng/ml), and also in the SL group (x = 783 ng/ml), than in the IL group (x = 679 ng/ml). During labor, in all twenty pregnant women a marked rise of F (from x = 726 ng/ml before the onset of labor, to x = 911 ng/ml) and a marked fall of PRL (from x = 161 ng/ml to x = 122 ng/ml) were observed (p less than 0.05). In the PL group the F elevation and the PRL drop were more pronounced (p less than 0.001). After placental separation, PRL levels increased slightly while F values remained unchanged. These changes in hormone levels before and during labor could be attributed to the emotional and physical stress of labor.
In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a period of ten years, from 1975 to 1985. In 23 cases, the delivery was normal, in 20 cases it was necessary to use a vacuum extractor and in 6 cases a forceps. In none of the above cases was there a Cesarean Section, because the cases were not regarded as a fetopelvic disproportion, but as cases which justify normal delivery. There follows a general outline of the treatment to be applied in cases of shoulder dystocia, including a generous episiotomy, the application, if possible, of a muscular relaxation by inhalation anesthesia, and the application of certain obstetric manipulations. In our cases, we applied general anesthesia in 7 cases and local in 39, whereas in 3 was no anesthesia at all. The obstetric manipulations we applied were those of McRoberts in 15 cases, of Jacquemier in 10 cases, of Wood in 15 cases, of Barnum in 5 cases, of Hibbard in 8 cases and of Couder in 6 cases. Our results also appear in tables I and II. In 36 cases, out of 49, (73.49%), the fetal weight was over 4,000 g. In 23 cases (47%) the mother had gained 12 kg during pregnancy. Also, in our study, 20% of the cases (10 mothers) were multiparous and 45% (22 mothers) had a prolonged second stage of labour by more than one hour. Class A (by White) diabetes was found in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)