[Laudation to the midwives. Midwives and the puerperal fever].

Originally published in the Hungarian Postgraduate Journal of Gynecology and Obstetrics (2016; 18: 209-2013). Reprint with the contribution and permission of the Professional Publishing Hungary Kft., Budapest.

Epidemiologic aspects of shoulder dystocia-related neurological birth injuries.

Purpose: The first part of the study involved data collection for the detection of geographic variations and chronologic fluctuations in the rates of shoulder dystocia. The second part of the research evaluated head-to-body delivery times in cases of arrest of the shoulders at birth that had resulted in fetal damage during the last four decades in the USA.

Methods: The study of geographic and chronologic changes in the rates of shoulder dystocia rested on reported statistics coming from the USA and 11 other countries.

Incidents of catastrophic overhydration (maternal and neonatal) identified through medico-legal reviews.

The authors describe two incidents where a mother postpartum and a neonate in the nursery were grossly overhydrated in tertiary care medical centers. In the first case, while receiving intensive care for HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, involving the participation of eight specialists and subspecialists, the weight of the mother increased by 54% between the 2nd and 8th postpartum days. In the second case, between the time of his birth and his demise 13 days later, the weight of the newborn child increased by 67%.

Preterm premature rupture of membranes in pregnancies complicated by human immunodeficiency virus infection: a single center's five-year experience.

Objective: The objective of this study was to describe one center's five-year experience of the management of human immunodeficiency virus (HIV) positive gravidas with preterm premature rupture of the membranes (PPROM) not in labor at
Methods: This is a retrospective chart review of all HIV positive gravidas with PPROM at
Results: We identified 228 HIV positive gravidas of whom 19 had PPROM at View Article and Find Full Text PDF

Shoulder dystocia related fetal neurological injuries: the predisposing roles of forceps and ventouse extractions.

On the basis of 333 documented cases of permanent perinatal neurological damage, associated with arrest of the shoulders at birth, the authors conducted a retrospective study in order to evaluate the predisposing role, if any, of the utilization of extraction instruments. The investigation revealed that 35% of all injuries occurred in neonates delivered by forceps, ventouse or sequential ventouse-forceps procedures. This frequency was several-fold higher than the prevailing instrument use in the practices of American obstetricians during the same years.

The risk of shoulder dystocia related permanent fetal injury in relation to birth weight.

Objective: To examine birth weight related risks of fetal injury in connection with shoulder dystocia.

Study Design: The investigation was based on a retrospective analysis of 316 fetal neurological injuries associated with deliveries complicated by arrest of the shoulders that occurred across the United States.

Results: The study revealed that the distribution of birthweights for the high risk shoulder dystocia population differs from the standard birthweight distribution.

Collection of fetal blood for stem cell research and therapy.

Stem cell research has generated novel therapeutic opportunities at the expense of new ethical and legal problems. Its promoters recommended early clamping of the umbilical cord to maximize the amount of acquired fetal blood. Fear has been expressed, therefore, that the donor could be compromised by this approach.

Erb's palsy after delivery by Cesarean section. (A medico-legal key to a vexing problem.).

Despite impressive progress in perinatology, fetal injuries from arrest of the shoulders at birth have not decreased in recent decades. Based upon sporadic reports of Erb's palsy in neonates born by Cesarean section, some obstetricians embraced the theory recently that brachial plexus lesions often derive from spontaneous forces acting in utero. Having reviewed three hundred malpractice claims involving fetal injuries attributed to shoulder dystocia at birth, the authors found only two cases connected with abdominal deliveries.

Postpartum intracranial haemorrhage in normotensive users of bromocriptine for ablactation.

The authors describe three cases of severe intracranial haemorrhage, associated with marked blood pressure elevation, which occurred between the 6th and 10th days postpartum in women taking bromocriptine for ablactation. All of these patients were young, normotensive and apparently healthy during the pregnancy. These incidents probably present the 10-12th reported cases of gross intracranial bleeding among users of bromocriptine in the puerperium.

Diabetes, hypertension and birth injuries: a complex interrelationship.

Seemingly coincidental occurrence of various pathological conditions may derive from common etiologic denominators. While reviewing 240 malpractice claims involving shoulder dystocia related fetal injuries, we found two antenatal complications in the background conspicuously often. Chronic or pregnancy induced hypertension was identifiable in 80 instances (33%).

Varicella vaccination during early pregnancy: a cause of in utero miliary fetal tissue calcifications and hydrops?

Background: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation.

Case: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fetus developed miliary fetal tissue calcifications and fetal hydrops detected by a targeted sonogram at 15 weeks gestation.

Untoward neonatal sequelae deriving from cutting of the umbilical cord before delivery.

Four cases are reported where, following the delivery of the fetal head, the physician electively cut the nuchal cord of the fetus. The extraction of the body entailed difficulties and the babies suffered irreversible damage in the process. Not unlike 5 previously described similar cases, these incidents came to the attention of the authors in connection with medico-legal reviews.

The role of hypertension in bromocriptine-related puerperal intracranial hemorrhage.

The spate of medicolegal inquiries following the disqualification of Parlodel (bromocriptine mesylate) by the Food and Drug Administration for postpartum ablactation, uncovered previously unreported side effects associated with its postpartum administration. In 1994, bromocriptine mesylate was withdrawn from the market as a milk suppressant. Since this time, over a dozen cases of postpartum intracranial hemorrhages associated with its use have been reported.

Severe cardiac dysrhythmia in patients using bromocriptine postpartum.

Used worldwide since 1980 for the prevention of breast engorgement in the puerperium, in 1994 bromocriptine mesylate was withdrawn from the American market as an agent suitable for ablactation. The relevant recommendation of the Food and Drug Administration rested on case reports that described severe vasospastic reactions among users of the drug. Some patients so affected suffered stroke, intracranial bleeding, cerebral edema, convulsions, myocardial infarction, and puerperal psychosis.