Is there a need to limit the operation of manual removal of the placenta

In the domestic and foreign literature in recent years, as is known, a seemingly insignificant and already very old question has been raised - the question of re-evaluating the results of manual removal of the placenta. If we take into account the entire history of this issue in its sequential course, the need for revising it will become obvious.

Analysis of Delivery in Singleton Pregnancies Achieved by In Vitro Fertilization

BACKGROUND: Birth after IVF is increasingly observed in modern obstetrics, so knowledge of its features is of paramount importance for clinical practice. AIM: The purpose of our study was to compare IVF and spontaneous singleton pregnancies in terms of cesarean section rate, operative vaginal birth rate, induction of labor, manual removal of the placenta in vaginal births, severe PPH and need for blood transfusion after delivery. MATERIAL AND METHODS: We conducted a retrospective study at "Maichin Dom" University Hospital in Sofia, Bulgaria for the period from January 2013 to December 2017 and analyzed 402 singleton IVF pregnancies and compared them with 523 spontaneous singleton pregnancies RESULTS: We found a significantly higher rate of cesarean sections in IVF compared to spontaneous pregnancies [OR 1.73; 95% CI 1.4-2.14; p<0.001]. Vaginal delivery after IVF is associated with a higher incidence of operative vaginal delivery than spontaneous pregnancies [OR 2.27; 95% CI 1.14 - 4.52; p=0.018]. No statistical differences in rates of labor induction and manual removal of the placenta between two groups were estimated (p>0.05). Severe PPH and blood transfusions were three times higher in patients after IVF undergoing a cesarean section than in those with spontaneous singleton pregnancies [OR 3.0; 95% CI 1.11 - 8.11; p=0.018]. CONCLUSION: IVF singleton pregnancies are associated with a higher risk of cesarean section as well as some obstetric complications. Obstetricians should treat these pregnancies with caution in order to reduce cesarean section rate and improve the outcome.

A New Grafting Method for Watermelon to Inhibit Rootstock Regrowth and Enhance Scion Growth

Grafting is a widely used technique in watermelon (Citrullus lanatus) production. However, cost of grafted seedlings is generally high as a result of intensive labor inputs for propagation using traditional grafting methods such as the manual removal of rootstock regrowth. This study developed a new grafting tool to physically remove the epidermis of pumpkin (C. maxima × C. moschata) and bottle gourd (Lagenaria siceraria) rootstock cotyledon base during grafting; we called this a new grafting method. Compared with the traditional grafting, the new grafting method significantly decreased the pumpkin rootstock regrowth rate from 100% to 8% in hole insertion and 2% in one cotyledon grafting, respectively. These attenuated rates for bottle gourd rootstock regrowth were 23% and 9% in hole insertion and one cotyledon grafting, respectively. The scion dry weights of new hole insertion and one cotyledon grafting were increased by 78% and 74% when pumpkin was used as rootstock as compared with traditional grafting without regrown rootstock removal, while the respective values were 33% and 17% in bottle gourd rootstock grafted plants. In addition, the time used for the new hole insertion grafting method to physically remove the epidermis of pumpkin rootstock cotyledon base was significantly shorter than the time required to remove the rootstock regrowth manually three times in the traditional grafting (4.2 s/plant vs. 9.3 s/plant). Similar results were also observed in the new one cotyledon grafting (4.2 s/plant vs. 8.8 s/plant). Taken together, this study presents a new method in watermelon grafting to reduce rootstock regrowth, therefore benefiting both scion growth and plant management, thus the development of this new method is clearly useful in watermelon production.

Angular pregnancy: an under-recognised entity presenting with retained placenta

Retained placenta accounts for most of the cases of postpartum haemorrhage and occurs commonly due to contracted lower half of uterus and closed os, it can rarely also occur if it gets trapped at the cornua of the uterus due to angular implantation. A 26 year old P3L3 was got referred for retained placenta, she was diagnosed with angular pregnancy after laparotomy after manual removal failed, she was managed with hysterotomy. Angular pregnancy may lead to preterm delivery and trapping of the placenta.

CHANGE IN INDICATORS OF PHOTOSYNTHETIC ACTIVITY OF ECHINACEA PURPUREA SEEDINGS IN THE SECOND YEAR OF LIFE

The effective implementation of the plants biological potential occurs with a high culture of agriculture, as well as optimal moisture conditions and air temperature. Echinacea Purpurea has long-lasting seed germination and low competition to weeds; therefore, when cultivating it, it is relevant to determine the optimal sowing time and an effective way to combat the weed component. In this case, the study of the photosynthetic apparatus parameters is greatly important. According to the results of studies carried out in 2016 - 2018 on the chernozem-meadow soil of the experimental plot of Federal State Budgetary Educational Institution of Higher Education, Penza State Agricultural Academy, it was found that, regardless of weather conditions, the largest area of the assimilation surface is formed by sub winter crops with pre-emergent application of herbicide Lazurit and subsequent treatment with Miura in the phase of 2-4 weed leaves, and also with manual removal of segetal vegetation. On average, over three years, it reached its maximum in the flowering period and made up 50.3 and 49.9 thousand m2/ha. The photosynthetic potential on sub winter sowing in the shooting stage exceeded this indicator on early spring crops with double chemical weeding by 1.4 times, and during budding and flowering - by 1.2 times, with manual removal of weeds by 1.2, 1.1 and 1.2 times, respectively. The highest average daily net photosynthesis productivity of 2.73 g/m2 ? day was observed on early spring crops in the flowering phase, especially after a single chemical weeding with Miura’s herbicide.

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)

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.