scholarly journals On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev)

2021 ◽  
Vol 102 (2) ◽  
pp. 249-257
Author(s):  
L A Kozlov

The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation manual removal of the placenta with other techniques to prevent serious postpartum complications. Research methods the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Fiona Urner ◽  
Roland Zimmermann ◽  
Alexander Krafft

The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.


2020 ◽  
Vol 10 (03) ◽  
pp. e330-e334
Author(s):  
Julie R. Whittington ◽  
Megan Pagan ◽  
Kristen Daugherty ◽  
Kelly Cummings ◽  
Songthip T. Ounpraseuth ◽  
...  

Objective The main aim of this study was to characterize the duration of the third stage of labor and estimated blood loss in twin vaginal deliveries. Study Design This was a retrospective case–control study. The data was collected from deliveries at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, from January 2013 to June 2017. Women were identified who had twin gestation, were delivered vaginally, and whose maternal age was greater than 18 years old. Women were excluded if they had an intrauterine fetal demise, delivered either/both fetuses via cesarean, history of a previous cesarean or a fetus with a congenital anomaly. If a subject met criteria to be included in the study, the next normal singleton vaginal delivery was used as the control subject. Results There were 132 singleton vaginal deliveries and 133 twin vaginal deliveries analyzed. There was no significant difference in the length of the third stage of labor between twin and singleton vaginal deliveries except in the 95th percentile of the distribution. Mothers delivering twins had an increase in third-stage duration by 7.618 minutes (95% confidence interval [CI]: 0.73, 14.50; p = 0.03) compared with those who delivered singletons. The twin group had a higher estimated blood loss than singleton deliveries. The increase in blood loss in the twin group was 149.02 mL (95% CI: 100.2, 197.8), 257.01 mL (95% CI: 117.9, 396.1), and 381.53 mL (95% CI: 201.1, 562.1) at the 50th, 90th, and 95th percentiles, respectively. When the third stage of labor was at the 90th percentile or less in twin pregnancy (14 minutes), estimated blood loss was less than 1000 mL. Conclusion Twin pregnancy is a known risk factor for postpartum hemorrhage. As the duration of the third stage prolongs, the risk for hemorrhage also increases. We recommend delivery of the placenta in twin pregnancies by 15 minutes to reduce this risk. Key Points


2020 ◽  
Vol 103 (9) ◽  
pp. 850-855

Background: Cesarean section is the most common major surgery performed on pregnant women around the world. It is necessary to apply the practical skills training and current knowledge, especially in the procedure that would need to help keep mothers alive and the fetus safe. Objective: To study the efficacy of the umbilical cord traction versus manual removal for placenta delivery in the third stage of labor during the cesarean section. Materials and Methods: The present study was a retrospective comparative study conducted in Srisangwornsukhothai Hospital between January 2017 and January 2020. The purposive sample size was calculated by using a power of 80%, with a significant level of 5%. One hundred twenty pregnant women were divided into two groups, sixty pregnant women each, the cord traction as the first group and the manual removal as the second group for placental delivery during the cesarean section. The significance of the two groups were compared by using the independent t-test (p<0.05), 95% confidence interval (CI), and the Mann-Whitney U test. Results: Several outcomes of the umbilical cord traction were better than the manual removal, such as decrease time of the operation and a statistically significant decrease in hemoglobin (p<0.001, 0.049, respectively). However, there was not a statistically significant decrease of blood loss, fever after surgery, or the length of stays (p=0.839, 0.056, 0.175, respectively). Only one outcome, the time of the third stage of labor, was slightly more than the manual removal group for placental delivery during the cesarean section with statistically significance (p=0.003). Conclusion: The umbilical cord traction maneuver for the delivery of the placenta had more advantages than the manual removal maneuver. This technique should be a recommendation during the cesarean section. Keywords: Cesarean section, Umbilical cord traction, Placental delivery


Parasitology ◽  
1946 ◽  
Vol 37 (3-4) ◽  
pp. 192-201 ◽  
Author(s):  
J. F. A. Sprent

A description is given of the processes of copulation, formation of the egg and spermatozoon, cleavage, embryogeny and hatching in B. phlebotomum. These processes were found to be essentially similar to those in other strongyle nematodes.The anatomy of the first three larval stages is described and the observations of Conradi & Barnette (1908) and Schwartz (1924) were largely confirmed.Penetration of the skin of calves by the infective larva was observed histologically. The larvae were found to have reached the dermis within 30 min. and to have penetrated the cutaneous blood vessels within 60 min. of application to the skin. The larvae were found in the lung where the third ecdysis was in progress 10 days after penetration of the skin. A description is given of the growth of the third-stage larva in the lung, the changes which take place during the third ecdysis, and the anatomy of the fourth-stage larva.The fourth-stage larvae exsheath in the lungs and travel to the intestine. After a period of growth in which sexual differentiation takes place, the fourth ecdysis occurs and the adult parasite emerges. The time required for the attainment of maturity was found to be somewhere between 30 and 56 days after penetration of the skin.This paper was written at the Ministry of Agriculture and Fisheries Veterinary Laboratories, Wey-bridge, and the writer would like to express his gratitude to the Director, Prof. T. Dalling, also to Dr W. R. Wooldridge, chairman of the Council of the Veterinary Educational Trust for their help and encouragement. The writer's thanks are also due to Dr H. A. Baylis, Prof. R. T. Leiper and Dr E. L. Taylor for their advice and help on technical points, and to Mr R. A. O. Shonekan, African laboratory assistant, for his able co-operation.


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