Fetal Anesthetic Requirement (MAC) for Halothane
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Abstract:
We asked whether the anesthetic requirement (MAC) of fetal lambs is lower than that of pregnant ewes. In five pregnant ewes anesthetized with a subarachnoid block, a fetal foot was withdrawn through a hysterotomy. The ewe then breathed 1.5% halothane and a clamp was applied to the fetal foot at 2-min intervals. We concomitantly obtained arterial blood from previously implanted catheters. When fetal movement in response to clamping the foot ceased, halothane was discontinued and the stimulus and sampling continued until the fetus began to move. Anesthesia was again resumed and continued until movement stopped. Anesthesia was then deepened and MAC was determined in the mother (stimulus--ear clamp). The fetal blood concentrations of halothane at MAC were 48 +/- 28 mg/L; they were 133 +/- 5 mg/L in the mother. This difference was highly significant (P less than 0.001). Calculated end-tidal concentrations were 0.33% and 0.69%, respectively. In two animals delivered by cesarean section, MAC increased progressively over the first 12 h of life. Progesterone levels concomitantly decreased.Keywords:
Hysterotomy
Fetal movement
Clamp
OBJECTIVE To explore the result of the delivery after one hysterotomy. METHODS To analyze 435 gravidas in our hospital three years who deliver successfully after their husterotomy. RESULTS The persent of delivery after one hysterotomy is 6.44% in all the delivery while the placenta previa is 3.10% and the success of the usual delivery is 75.17%. CONCLUSIONS The periodicity of after one hysterotomy is increasing obviously. If a gravida had not any problems of usual delivery after one hysterotomy,we should let her deliver from the usual way again to decrease the periodicity of hysterotomy.
Hysterotomy
Cesarean delivery
Placenta previa
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Objective To analyze the obstetric causes of uterus removal and relevant factors,and to explore the possibility of reducing hysterectomy. Methods The data on 18 obstetric patients who had undergone hysterotomy within 6 years in our hospital were retrospectively analyzed. Results The rate of hysterectomy for obstetric causes was significantly increased in multiparas, as compared with primiparas. Pacental factors and uterine inertia were the major cause of uterus removal.ConclusionsHysterectomy is an important procedure to control obstetric hemorrhage and save puerpera's life. But the surgical indications should be strictly controlled, prenatal care should be enhanced, and obstetric complications should be strictly prevented to lower cesarean section rate so that the incidence of obstetric hysterectomy can be reduced.
Key words:
Hysterotomy; Relevant factors; Massive obstetric hemorrhage
Hysterotomy
Uterine Inertia
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The conclusion reached by Drs. W.M. Clow and A.C. Crompton (February 10, p. 321) that there is a substantial risk of uterine rupture in pregnancy after hysterotomy is reinforced by a case recently under my care. The patient, an unmarried 16-year-old, had had her 1st pregnancy terminated by abdominal hysterotomy at another hospital when she was 14 years of age. She was admitted to this hospital at 38 weeks' gestation (before the onset of labor) with signs and symptoms suggestive of intraabdominal hemorrhage. At laparotomy the upper end of the "classical" hysterotomy scar had ruptured completely and a portion of the underlying placenta was protruding through it. There was about 2 1/2 l of fluid and clotted blood in the peritoneal cavity. Caesarian supravaginal hysterectomy was performed and both mother and child survived, but the former required blood transfusions totaling 3 l. While fully agreeing with the authors' suggestion that hysterotomy should in general be eschewed unless sterilization is also performed, there may be circumstances in which hysterotomy is urgently indicated but sterilization is undesirable. In such cases, if the operation is performed after the 18th-20th week, the lower uterine segment is often sufficiently developed to permit evacuation through a transverse incision at this level. It would seem likely by analogy with classical and lower segment Casarean section incisions that the risk of uterine rupture in a subsequent pregnancy will be considerably reduced by this technique, which I now use whenever possible instead of the vertical upper segment incision usually employed for hysterotomy.
Hysterotomy
Uterine rupture
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The purpose of this study was to investigate in the rabbit, the
possibility of a relationship between fetal movement and the development of ossification.
Fetal movements were investigated in a number of ways. After maternal cervical dislocation Movements were studied for
as long as the fetuses responded to stimulation (except at ages after
day 25 when 45 minutes was considered sufficient) after being exposed
by hysterotomy. Movements both in and out of the amniotic sac were
recorded by cine-photography. Two types of movements were studied:
spontaneous and reflex (after surface stimulation). At least two
litters were studied for each day of gestation from day 14 to day 30. [Continues.]
Hysterotomy
Fetal movement
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Hysterotomy
Cesarean delivery
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Hysterotomy
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Hysterotomy
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