‘I look forward to the great advances in knowledge that lie around the corner, but I do sometimes wonder whether the vast sums of money now being spent on research might not produce more rapid and spectacular improvement in health…
‘You only know what you measure and what you cannot measure must be made measurable’. Galileo Introduction From the available literature, it is clear that intrapartum care is provided in many different ways and with variable outcomes, for which there…
These are a group of operations aimed at reducing the size of the head, shoulder or trunk of a dead fetus or a fetus with a lethal anomaly in order to facilitate its passage through the birth canal. Other than…
‘I believe the operation fills a most useful place in practice, and that is the opinion of many others, and if everyone would deliberately struggle against taking up an extensive extreme position with regard to the operation, that place could…
‘The child was born about an hour before I came, and the midwife in attempting to bring away the placenta, had inverted the uterus; for upon examination, I found the whole body of the uterus with the placenta, adhering to…
Perineal trauma after childbirth affects millions of women worldwide. Approximately 85% of women sustain some form of perineal trauma following vaginal delivery. Short- and long-term morbidity associated with perineal repair can lead to major physical, psychological and social problems affecting…
Measures to deal with life-threatening obstetric haemorrhage have been outlined previously, including the use of oxytocic agents, uterine tamponade, uterine compression sutures and hysterectomy. The aim of this chapter is to describe the role of major pelvic vessel ligation or…
Uterine compression sutures of an improvised type have been used for decades: for example, figure-of-eight sutures in the lower uterine segment in cases of placenta praevia. In recent years, more specific techniques for the application of compression sutures have been…
When the cause of a postpartum haemorrhage (PPH) is not immediately obvious and oxytocic agents have failed, examination under anaesthesia (EUA) is warranted. In the event of continued uterine bleeding after EUA, many clinicians used to resort to laparotomy and…
Introduction ‘I find it both amongst the ancients and moderns there have been different opinions and directions about delivering the placenta; some alleging that it should be delivered slowly, or left to come, of itself; others, that the hand should…