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KMID : 0358419690120110023
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Korean Journal of Obstetrics and Gynecology
1969 Volume.12 No. 11 p.23 ~ p.24
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Frequency and Indication for Cesarean Sections in a Korean Provincial Capital
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Sich, D.
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Abstract
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This is a brief report about frequency and indication for cesarean sections during a 17 monthss observation period in a Korean Provincial Capital. At Chonju Presbyterian Medical Center, from the 1st of January 19688 until May 20, 1969 a total of 956 children were born. Out of these 85, i.e.8.2%, were delivered by cesarean section. The most frequent indications were a cephalopelvic disproportion (23 times) and a previous cesarean section (21 times) counting for more than half, of the indications. In 13 cases a fetal distress during the first stage of labor made surgery necessary. There were 7 cases of placenta p,.evia,. 6 of abrupdo placentae and 4 breech presentations. The remaining cases included eclampsia, uterus rupture, carcinoma of the cervix. scarified cervix due to chemicautery previous to pregnancy and extreme uterine dysfunction. One post-mortem cesarean section was performed.
Table
Cephalopelvlc disproportion 23 cases 26.9%
Previous cesarian section 21 it 24.96%
Fetal distress 13 u 15.299,/
Placenta previa 7 it 8.23%
Abrupture placentae 6 11 6.94%
Breech presentation 4 it 4.69%
Transverse lie 2 it 2.34%
Eklampsia 2 v 2.34%
Uterus rupture 2 u 2.34%
Ca colli I in pregnancy(III rdtrimester) 2 2.34%
Scarified Cervix due to chemicalcautery 1 it 1.18%
Extreme -uterine dysfunction 1 if 1. 18%
Cesarian section post-mortem 1 if 1.18%
Department, Presbyterian Medical Center, Chonju.. Cholla Pukdo, Korea
In the following the most significant cases of those given in the table on page one are briefly reviewed:
CEPHALOPELVIC DISPROPORTION: There were 23 patients wita a cephalopelvic disproportion, 19 of them were primiparous, and 4 multiparous patients. Four were overdue 14 to 26 days, all children.
showing overterm signs. Five patients were recorded ~.s having a borderline cephalopelvic disproportion, two of them had a poor obstetrical history,. the others were elderly pritnigravidae (3 patients). Two patients with a tuberculosis of the hip joint and subsequent´ pelvic deformity belong also to this group.
PREYIOJS CFSAREAN SECTION: In 21 women with previous c.~sjrian section a repeated section was. performed. As the majority of them was previously delivered elsewhere, the reason for the first. section as well as tie previously used method remained obscure in many cases. However, seven times the. primary indication was definitely CPD and it was obvious in five of the patients that previously the classical method has been used. Two of the mothers had a preeclampsia at admission. Two of the children were in breech presentation, one having a hydrocephalus and a spinabifida.
FETAL DISTRESS: Because of fetal distress 13 sections were performed. Three of the mothers had a severe preeclampsia. Fetal distress occurred after deep sedation or during induction of labor. There was one primigravida patient with advanced myasthenia gravis who carried 43 weeks and labor was .induced because she was overdue. Fetal distress occurred during the first stage of labror. The child had respiratory difficulties after delivery, but recovered with adequate substitution of Prostigmin for
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