C. Papp

I. Hypogastric artery ligation for intractable pelvic hemorrhage

To assess the outcomes of bilateral hypogastric (internal iliac) ligation performed to control intractable pelvic hemorrhage and avoid hysterectomy.

Quality and quantity ratios of obstetric care in the Gypsy and non-Gypsy population in Hungary

For years now, perinatal statistics have been compiled all over the world on computer [l-3]. We have recently analyzed the data of 63 496 pregnancies that have ended with deliveries, mid-trimester abortions or mid-trimester terminations during 1988 and 1990 in three district counties of Hungary, using our database program which holds obstetric, genetic and neonatal care records [4]. The data have given a realistic survey of statistical ratios in current Hungarian obstetric practice and have separately highlighted the perinatal problems of pregnant women claiming to belong to the Gypsy minority. A total of 63 496 pregnancies ending from the 16th through to the 42nd weeks of gestation have been analyzed. The survey compiled data on pregnant women who were residents of the three counties. The population of the three counties represents one-sixth of the total population of Hungary. Gypsies constitute a significant percentage (10%) of Hungary’s population, and differ from the non-

Computer follow-up system for obstetric, genetic and neonatal care in Hungary.

The Hungarian system is known to be the first nationwide register of obstetric data in the world [2]. Statistical processing of our obstetric results originates in noble traditions. Ignac Semmelweis was the first person to justify his epoch-making discoveries with statistics while Vilmos Tauffer was the one to initiate and in fact achieve through perseverance and organization the practical implementation of the supply of obstetric data. Vilmos Tauffer set out to collect data in 1801 almost on his own initiative with incredible energy and unbroken faith and he established the Book of Regulations with his 1891 study entitled The Position of Obstetrics in Hungary. It was in 1932 that Professor Tauffer, who had retired by then, organized Obstetric Rules in his function of ministerial commissioner responsible for obstetric affairs. His work earned due international recognition [3]. Our starting point in designing our computerized system was what we termed ‘modified Tauffer statistics’, but we have disregarded issues that are not topical any more and have excluded data when they were considered inaccurately limited. We have constructed and introduced a data registration system which allows us to follow and determine statistically important parameters in obstetric genetic and neonatal care in three counties in Hungary (namely: Hajdu-Bihar, Szabolcs-Szatmir-Bereg and Jasz-NagykunSzolnok) between 1 January 1988 and 3 1 December 1990).

P248: Chorionic villus sampling: our experience

The authors describe experiences gained over the period of 1984 and 1999 at two medical centers with chorionic villus sampling (CVS). Altogether 1149 CVSs had been performed between the 10th and 32nd gestational week. Prior to 1993 the transcervical approach (TC-CVS), after 1994 the transabdominal method (TACVS) was used. Analysis of data collected within the framework of this study was based on the following factors: indications for sampling, complications and incidence of pregnancy loss. 91.6% of the CVSs was carried out for the purposes of cytogenetic examination of the fetus. Over the past few years an increasing number of procedures had been carried out for molecular-genetic tests (7.6% of the total number of cases). Although the primary indication for cytogenetic tests was the advanced age of the mother, a remarkable increase in the number of samplings had taken place for the purpose of examining ‘‘suspicious ultrasound findings’’, minor anomalies detected by ultrasound. In this group the proportion of pathological cases was significantly higher (14%) than in all the other samplings, carried out for other indications. This data in itself underlines the importance of ultrasound-screening performed in the 18–20th weeks of gestation. Over the first half of the period being reviewed (1984–1993, TC-CVS), a fetal loss of 4.8% occurring within three weeks from the date of sampling, dropped to 1.7% in the period subsequent to year 1994 (TA-CVS). In cases of TA-CVS, both the complications and spontaneous abortions were less. In 74.1% of the cases, birth had taken place after the 37th week of gestation. Premature births (6.4%) and still birth-rate (1.1%) did not exceed normal rates observed in the general population. On the basis of our results, it is safe to say that in prenatal diagnosis, TA-CVS is a real alternative method of mid-trimester amniocentesis and it is recommended for use at any stage of the pregnancy.