|
Several papers have been published during the past 10 years reviewing large series of transverse presentation, their treatment, and outcome. There has been noted a gradual change in management from that of vaginal delivery to the more frequent use of ceasrean section with a definite decrease in fetal mortality. This report is an analysis of 64 cases of transverse presentation that have occured among 2132 deliveries at Kyung Pook University Hospital in past 10 years(1955-1965). The results obtained from this study were as follows: 1. Sixty four cases of transverse presentation occuring 2132 deliveries are reported. This incidence showed 10 time`s higher than others reports. 2. Youngest gravid was 23 years old and oldest gravid was 41 years old. About equal number of cases distributed below or above 30 years old. 3. Primigravida and primipara occupied about 40% of transverse presvere presentation, and these cases showed that the course of trausverse was mainly induced abortion by bougination. 4. Length of gestation showed 24 to 43 weeks of gestation and 10 cases listed in 24 to weeks of gestation, 8 eases were 29 to 36 weeks, 34 cases were 37 to 40 weeks and 12 cases were over 40 weeks of gestation. 5. The incidence of various position of transvers presentation showed: L. Sc. A. 34.3%, R. Sc. A. 31.2%, L. Sc. P. 9.3%, R. Sc. P. 15.6%, and undesignated position 9.3%. 6. Possible courses of transverse presentation were multiparity(22 cases), placenta Previa(10 cases), twin pregnancy(8 cases), premature rupture of membrane(2 cases), abruptio placentae(2 cases). bougination(2 cases), bicornuated uterus(2 cases), previous cesarean section(2 cases) and 14 cases were undetermined the cause. 7. 32 cases of prolapse arm and 18 cases of prolapse cord were occured and 12 cases combined prolapse arm and cord. Neglected transverse presentation was 14 case, Antenatal bleeding(placenta revia and abruptio placntae) was 12 case. Preeclampsia was 4 case. Uterine rupture was 2 case and sepsis was 2 case. 8. 24 cases were delivered by vaginal manipulations and 38 cases were deliverd by classical cesarean section. Vaginal manipulations consisted of 6 cases of internal version with extraction, 6 cases of spontaneous evolution and 12 cases of embriotomy. 9. The indications of cesarean section were listed as elective procedure for delivery(20 cases), placenta previa(8 case), abruptio placentae(2 case), neglected transverse(4 case), uterine rupture rupture(2 case) and failed internal version(2 case). 10. Fetal heart tone was presented in 24 cases(37.5%) on admission and 16 cases(25%) survived following obstetric manupulations. 11. Morbidity was 93.7%, The largest incidence was uterine infection(53.1%) and urinary tract infection(20.3%) accounted for the second greatest incidence. 12. two cases of maternal death occured in this study and the course of death was septicemia.
|