Rupture of low transverse cesarean scars during trial of labor
Article Abstract:
The number of babies delivered by cesarean section has increased in recent decades. The tendency to perform cesarean sections on women who have already undergone a previous cesarean delivery has contributed to this increase. Normal labor with vaginal delivery is considered to be safe in women who have had cesarean sections, but rare complications can occur when this is attempted. During cesarean delivery, a cut is made in the abdomen and into uterus. Following delivery, the incision heals and forms a scar. It is possible for the scar in the uterus to rupture during a normal labor with vaginal delivery, and this can damage the fetus and even cause fetal or maternal death. Rupture of the uterus causes pain in the uterus and prevents the normal contractions of the uterus that are required for a normal labor. The cases are reported of eight women who experienced rupture of the uterus while attempting a normal labor. In all eight cases, emergency surgery was performed. The ruptures caused one fetal death, prevented breathing in two of the fetuses, caused three maternal bladder injuries, and required one woman to undergo hysterectomy (removal of the reproductive organs). It is estimated that less than 1 percent of the attempted labors resulted in uterine rupture during the period of this study. It is concluded that uterine rupture during normal labor is rare, but is has serious consequences which should be discussed by the physician and patient before a normal labor is attempted. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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Advertising in medical journals
Article Abstract:
Advertising is a major means of financial support for many medical journals. Without advertising revenues, subscription rates would increase substantially. The responsibility for policing advertising claims lies, in part, with the reader. The responsibility also resides within governmental agencies such as the Drug Advertising and Labeling Division of the Food and Drug Administration, which regulates advertising in medical journals. However, this agency receives the advertising documents at the same time they are published, not in advance. Companies may be running advertising with unsubstantiated claims for months before they are forced to produce evidence proving their claims. It is more likely, however, that such an ads will simply be discontinued when companies are asked to provide substantiation. The editors of The Journal of Obstetrics and Gynecology attempt to prescreen ads before they are published. In an effort to maintain high publishing standards, advertising with unsubstantiated claims is rejected even when the same ad may be running in other journals. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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