ADVANCES IN OBSTETRICS AND GYNECOLOGY
Online ISSN : 1347-6742
Print ISSN : 0370-8446
ISSN-L : 0370-8446
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Volume 60, Issue 4
Displaying 1-5 of 5 articles from this issue
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ARTICLES
Clinical Report
  • Retrospective analysis of maternal care after 41 weeks of gestation in our clinic
    Takatoshi KINUTA, Shoko NAKAGAWA, Ryu WADA, Yuriko NAKAGAWA, Kazuya FU ...
    2008 Volume 60 Issue 4 Pages 313-319
    Published: 2008
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.11437/sanpunosinpo.60.313
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    The rate of derivery after 41 gestational weeks was 14.8%, 0.79% of which was over 42 gestational weeks. In both primigravida and multigravida, the incidence of cesarean section was higher in the observation group than in the induction group and increased with the gestational age : 8.2% for less than 41 weeks of gestation, 11.7% for 41 weeks and 37.8% for 42 weeks, excluding repeated cesarean section cases. The incidence of cesarean section was higher in primigravida than in multigravida. Obstetrical interventions, such as vacuum extraction and the Kristeller maneuver, were more frequent in the induction group than in the observation group in both primigravida and multigravida.
    The incidence of giant babies weighing more than 4000g increased with the gestational age : 0.8% for less than 41 weeks of gestation, 2.7% for 41 weeks and 10.8% for 42 weeks. The incidence of cesarean section giant babies after 41 weeks was as high as 30.4%. The incidence of turbid amnion and low apgar scores (at 1 min after delivery) was not significantly different between the two groups. In conclusion, it appears to be important to accurately evaluate fetal well-being for pregnantwomen past 41 weeks of gestation and cervical maturation in primigravida so that pregnancy does not continue beyond the 41st week. [Adv Obstet Gynecol, 60(4) : 313-319, 2008 (H20.11)]
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Clinics
  • Experience of with a Helicopter transport of pregnant women
    Kazuhiro IWASAKU, Hiroki YAMAMOTO, Tadahiro YASUO, Takeshi YAMAGUCHI
    2008 Volume 60 Issue 4 Pages 320-326
    Published: 2008
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.11437/sanpunosinpo.60.320
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    From our hospital, 59 patients were transported via helicopter between April 1994 and December 2007; 54 were carried to hospitals in Kyoto City. They consisted of 48 patients with heart disease, 4 pregnant women, and 2 newborns. We investigated the limitations of helicopter transport during the perinatal period.
    The advantages of transport via helicopter include a high speed of 200 km/h and vibration-free, smooth transport in comparison with an ambulance. As its limitations, flying at night or in bad weather is impossible, and the partial pressure of oxygen decrease with a high altitude barometric pressure, decreasing SpO2. The physical and mental influence of helicopter transport on mothers and newborns remains to be clarified. As no additional persons can ride in a helicopter, preoperative explanation can only be made after the family's arrival, even when emergency surgery is required. Therefore, the start of surgery is delayed, lessening the merit of rapid transport. The inside of a helicopter is narrow, and it is impossible to provide treatment during transport. Therefore, as a rule, all necessary treatments should be completed in the hospital from which the patient is being referred, and a helicopter must be used only for the purpose of transportation.
    The establishment of a system in which a helicopter can be smoothly utilized in the case of an emergency based on an agreement with the head office of the fire department regarding helicopter emergency medicine has facilitated the rapid transport of high-risk pregnant women to high-level medical facilities using a helicopter desired for disaster relief. In the future, perinatal coordinators should establish a broad-area transport control center to immediately determine a hospital in which emergently transported mothers will be accepted and promote the smooth, flexible management of rapid transport system with a helicopter and ambulance.[Adv Obstet Gynecol, 60 (4) : 320-326, 2008 (H20.11)]
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Case Report
  • Pilonidal sinus of the female genitalia
    Masayo UKITA, Shinya YOSHIOKA, Shigeo YURA, Ayako SUZUKI, Haruhiko YAG ...
    2008 Volume 60 Issue 4 Pages 327-331
    Published: 2008
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.11437/sanpunosinpo.60.327
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    Pilonidal sinus is generally located almost exclusively at the sacral area. We recently experienced a rare case of pilonidal sinus which occurred around the female genitalia. Herein we report the case and review of literatures.
    A 35-year-old woman, gravida 2 para 0, who complained of a tender mass at the supra-pubic area and genitalia, visited our hospital. Physical examination revealed the presence of fistula at the supra clitoral region, from which a dark brownish discharge emerged. The symptom had no relationship with the menstrual cycle. As laboratory data showed elevated inflammation markers, bacterial infection was considered. The symptoms disappeared after oral administration of an antibiotic. But six months later the same symptom recurred, and inflammation makers elevated again. With CT and fistulography, we found a cystic lesion, which reached three centimeters in depth. The symptoms and findings suggested that this case may be a pilonidal sinus. The entire mass, which contained hair shaft, was resected. The diagnosis of pilonidal sinus was confirmed pathologically. The postoperative course has been uneventful for four months.
    There have been only six cases of pilonidal sinus around the female genitalia, and this is the first case that was diagnosed before operation. In order to avoid recurrence of the disease, entire resection is necessary. Pilonidal sinus should be included in the differential diagnosis of cystic inflammatory lesions around the female genitalia.[Adv Obstet Gynecol, 60 (4) : 327-331, 2008 (H20.11)]
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