Management of the pregnant woman with spinal cord injuries
Article Abstract:
Women with spinal cord injuries can have successful pregnancies. The location of the injury to the spinal cord will determine how the symptoms of labor will be manifested. For example, if the injury is to the lower regions , then a pregnant women will still be able to feel the contractions of the uterus during labor. However, if the injury is in the middle or upper part (in the chest or neck region), then the contractions will not be felt and the voluntary use of the abdominal muscles will be absent. Muscle spasms may occur in the abdominal muscles and in the leg muscles. When the injury is to the middle to upper regions, labor may cause a condition called dysreflexia. The symptoms of dysreflexia include headache, sweating, nausea, chest pain, difficulty breathing, and high blood pressure. This article describes the case reports of 15 pregnant women with spinal cord injuries. In most of these cases, the injury was to the middle region of the spinal cord. Urinary tract infections were the most common problem, occurring in all 15 of the women. Anemia was less common, but occurred in seven of the cases. Antihypertensive drugs, such as phentolamine, hydralazine, or glycerol trinitrate were used to control blood pressure. Most of the pregnancies were carried to term, with an average birth weight of seven pounds. There were no stillbirths, neonatal deaths, or birth defects. It is concluded that women with spinal cord injuries can have normal pregnancies if proper prenatal care is provided. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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Is routine use of episiotomy justified?
Article Abstract:
Routine episiotomy during vaginal delivery may cause more harm than good, and instead should be performed in selected cases. An episiotomy is a surgical cut through the perineal tissues to prevent tearing the perineum during vaginal delivery. Episiotomies became widely used as more deliveries occurred in hospitals than in homes. A review of the medical literature revealed that rather than preventing perineal tears, routine use of episiotomy increased the incidence of such tears. Routine use of episiotomy increases the occurrence of surgical repair. It may weaken the pelvic floor, lead to future incontinence, and diminish sexual function. A selective usage rate for episiotomies of 30% or fewer deliveries is recommended.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1996
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