Sait Yücebilgin

Post-mortem Caesarean section performed 30 minutes after maternal cardiopulmonary arrest.

During the past century post-mortem Caesarean sections were held in ill repute because infant salvage rates were very poor among the reported cases. Over the past 50 years as the nature of maternal mortality has changed, the potential for infant survival has increased. Changes in common causes of maternal deaths from chronic diseases and infection to acute causes, such as anaesthetic complications, embolism and cerebrovascular accidents in a previously healthy mother, have increased the potential for infants survival. In addition, improvements in neonatal care have led to a strong motivation that, with appropriate and timely management, a healthy infant can be saved by perimortem Caesarean delivery. The actual percentage of post-mortem Caesarean sections remains difficult to ascertain, probably because of underreporting of unsuccessful cases. Nevertheless, because of the potential for survival of normal infants, obstetricians must consider a Caesarean delivery in a woman who has a cardiopulmonary arrest in the third trimester. We present a case of post-mortem Caesarean section performed 30 mins after maternal cardiopulmonary arrest. The infant survived with minimal neurological sequelae.

Recurrent uterine rupture after hysterescopic resection of the uterine septum

INTRODUCTION Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 1-2.7%. Uterine perforation and monopolar resection during hysteroscopy are well-known risk factors for subsequent uterine rupture during pregnancy. PRESENTATION OF CASE We present a case of recurrent uterine ruptures during consecutive pregnancies in a patient who had undergone hysteroscopic septum resection for recurrent pregnancy loss. DISCUSSION Recurrent uterine rupture due to hysteroscopic septum resection in pregnancy is a very rare condition. In the present case we noted that the first two uterine ruptures resulted from uterine contractions; however, the third rupture occurred spontaneously and earlier in gestation. As each uterine rupture occurred earlier than the rupture in the previous gestation, a history of uterine rupture during pregnancy should raise provider suspicion about the possibility of earlier uterine rupture recurrence. CONCLUSION Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent pregnancies. The patient must be informed about both the risks of uterine rupture during pregnancy after hysteroscopic septum resection and that recurrent ruptures may occur at earlier gestational weeks than during previous pregnancies.

Effects of coasting on the outcome of intracytoplasmic sperm injection-embryo transfer cycles

Objectives:  To determine the effects of ‘coasting’ on the outcome of controlled ovarian hyperstimulation (COH) and intracytoplasmic sperm injection–embryo transfer (ICSI–ET).