Lack of correlation between a high caesarean section rate and improved prognosis for low-birthweight twins (less than 2500 g).

The impact of birth by caesarean section on perinatal mortality was estimated for 9368 low-birthweight twins (less than 2500 g) born in Sweden between 1973 and 1985, by using national data from the Medical Birth Registry, National Board of Health and Welfare, Stockholm. During this period the caesarean section rate increased from 7-10% to 45-50% while concomitantly a sharp decrease in the perinatal mortality rate occurred. A causal relation between the increased rate of abdominal delivery and the improved prognosis for low birthweight twins might be expected.

Successful late repair of anal sphincter rupture caused by delivery.

Successful surgical treatment of anal incontinence due to anal sphincter rupture of 14 years duration is described. Objective evaluations were performed with anal profilometry.

Long-term ailments due to anal sphincter rupture caused by delivery--a hidden problem.

Questionnaires concerning ailments were sent postpartum (mean two years) to 62 women with anal sphincter ruptures (ASR), who were compared with a matched control population. The frequency of anal sphincter rupture at the hospital during delivery in the period, 1978-82, was 0.7% (n = 63).

Anal sphincter function after delivery rupture.

Questionnaires were sent to 63 women with anal sphincter rupture that occurred during vaginal delivery two to seven years earlier. Half of them had significant trouble, such as incontinence for gas, dyspareunia, and pain. We performed anal pressure profilometry in 14 of these women and in ten controls for comparison, and found a significant reduced strength in the external anal sphincters of the studied group.

Routine hospital care does not improve prognosis in twin gestation.

The effects of routine hospital care in twin gestation were evaluated by comparing the gestational outcome in two neighbouring university departments in southern Sweden. In Malmö, 79% (175/223) of all women with a twin pregnancy were given routine hospital care between the 26-28th and 35th gestational week, whereas in Lund only 4% (16/409) received such treatment. Hospitalization averaged 9 weeks in Malmö, versus 2 weeks in Lund.