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468 placentas were studied microscopically and by gross examination. Velamentous insertion of the umbilical cord, placenta circumvallate, retroplacental hematoma in connection with ablation of the placenta, and cord prolapse were found to be causative factors in asphyxia of the newborn. The increased placental weight was characteristic in maternal diabetes, hepatosis and, sometimes, in cases of infant malformations and specific inflammations. So-called embryonal persistence was often found histologically in these changes. Small fibrous placentas and those with ramification defects were commonly encountered among cases of toxemia and prolonged gestation. Microscopical placental maturation defects were not indicative of the fetal condition. Thus, only the changes found at gross examination appeared to be a significant indicator of the fetal prognosis.
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PMID:Placenta as an indicator of fetal postnatal prognosis. 45 69

The effects of previous induced abortion on pregnancy, labor and outcome of pregnancy were measured in a prospective study of 11,057 pregnancies to West Jerusalem mothers who were interviewed during pregnancy and who subsequently delivered a single live or stillborn infant. The 752 mothers who reported one or more induced abortions in the past were more likely, at the same interview, to report bleeding in each of the first 3 months of the present pregnancy. They were subsequently less likely to have a normal delivery and more of them needed a manual removal of the placenta or other intervention in the third stage of labor. In births following induced abortions, the relative risk of early neonatal death was doubled, while late neonatal deaths showed a 3- to 4-fold increase. There was a significant increase in the frequency of low birthweight, compared to births in which there was no history of previous abortion. There were increases in major and minor congenital malformations, but no significant changes in stillbirth or post-neonatal death rates, nor in mean birthweight or sex ratio. When the effects of other variables were taken into account, there were no significant changes in frequency following an induced abortion as to: ABO and rhesus isoimmunization, toxemia, hydramnios, premature rupture of membranes, induction of labor, breech or vacuum delivery, cesarean section, breech presentation, placenta previa, placental abruption, cord prolapse, cord anomalies, fetal distress or asphyxia, post-partum hemorrhage.
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PMID:Late sequelae of induced abortion: complications and outcome of pregnancy and labor. 116 27

Polyarteritis nodosa developing during gestation has an extremely grave prognosis. To an uncertain extent, this results from a delay in recognition and therapy. The diagnosis of PAN is complicated by the expanded differential of common conditions associated with pregnancy such as pre-eclampsia and toxemia which can present with similar symptoms and signs. On the other hand, the pregnant woman with known, quiescent disease has a much better prognosis with only one of four women experiencing exacerbation. In women with Behcet's disease, convincing reports of both pregnancy-related flares and remissions involving primarily mucocutaneous manifestations are found in the literature. Gestational exacerbation of the more serious manifestations including chorioretinitis, vasculitis and CNS disease does not appear to be a problem. Also, a significant effect on fetal development or survival is not evident. The pregnant woman with the Marfan syndrome and pre-existing cardiovascular disease, particularly dilatation of the aortic root, has a substantially increased risk of developing a major complication during gestation most commonly aortic aneurysm, dissection, rupture or insufficiency. Echocardiographic determination of the aortic root diameter is prognostic with a decreased risk at a diameter of 40 mm or less. A diameter of greater than 40 to 45 mm constitutes a significant contraindication to pregnancy. All pregnancies in patients with the Marfan syndrome are considered high risk and frequent evaluations and echocardiograms are required. The EDS patient is subject to a wide range of gestational complications resulting from the basic connective tissue defect manifested clinically by hyperextensible skin, joint hypermobility, connective tissue and vascular fragility, and poor wound healing. The most serious complications occur in type I EDS (gravis) and type IV (ecchymotic) and include extensive perineal tears and hematoma after vaginal delivery, uterine prolapse and rupture, difficulty in suturing wounds and controlling hemorrhage after cesarean section, spontaneous rupture of major arteries, and bowel perforation. Management of the pregnant patient with the EDS must be individualized after identification of the particular type.
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PMID:Rare inflammatory and hereditary connective tissue diseases. 256 43

This book contains various illustrations, portraits and an exact index, testimonials proving the author's professional successes as well as an accurate list of the qualities that should be demanded from any ophthalmologist. The anatomy of the head and eye is described according to Galen's ideas and Vesalius' book. Many remedies, prescriptions and medical treatments are discussed, partly showing the mystic influences of the Middle Ages. Bartisch reports several diseases for the first time: Allergic reactions, sympathetic ophthalmia, hemeralopia, photoelectric keratoconjunctivitis, amaurosis due to toxemia of pregnancy. But most important is the part on surgery. A careful pre- and postoperative treatment is demanded in cases of cataract operations. Bartisch describes the removal of eyelashes to cure trichiasis, the operations of ptosis, blepharochalasis and the exenteration of the orbit. This book was appreciated for a long time so that in 1686 a nearly identical reprint was published.
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PMID:The first German textbook of ophthalmology "Augendienst" by G. Bartisch, 1583. 304 58

In an attempt to identify factors associated with stillbirths and those occuring in the 1st week of life, perinatal deaths in infants born in health facilities in Marondera Districts occurred during a 7 months period 1986 were recorded and analyzed. 66 such deaths out of a total of 1900 births, giving a perinatal mortality rate of 35/1000 total births. The largest groups with identifiable cause were intrapartum asphyxia (14 deaths) and severe prematurity (birthweight 1500 gm) (8 deaths). The other associated causes of perinatal deaths were antepartum hemorrhage, code prolapse, toxemia of pregnancy, ruptured uterus, severe congenital abnormalities and intrauterine infections.
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PMID:Perinatal mortality in Marondera district. 324 8

This study was conducted at a rural medical college and aimed at analysis of the perinatal mortality and its determinants in a rural environment. 58 stillbirths and 62 early neonatal deaths among 1107 consecutive deliveries effected a perinatal mortality rate of 108.4/1000 deliveries. 50% of the total deliveries were unbooked. The perinatal mortality was higher in unbooked cases (16.3%), twins (33.2%), and preterm deliveries (33.9%) as compared to that in booked cases (5.3%), singletons (9.6%), and term deliveries (6.7%). 69% of the stillbirths were the result of obstructed labor, toxemia, antepartum hemorrhage, hand prolapse, and cord prolapse where timely intervention would have reduced the perinatal mortality significantly. Early neonatal deaths were mainly associated with prematurity and were due largely to birth anoxia, intraventricular hemorrhage, aspiration, and infections.
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PMID:A study of perinatal mortality rate from rural based Medical College Hospital. 650 Jun 45