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Cardiovascular collapse after vaginal delivery in a patient with a history of cesarean section

Article Abstract:

A 38-year-old pregnant woman died from amniotic fluid embolism after a normal delivery. She delivered vaginally but had had a cesarean section six years earlier. Following delivery, her blood pressure dropped substantially and she went into cardiac arrest. Despite an hour of cardiopulmonary resuscitation, she never recovered. Her uterus had ruptured during the delivery, but the volume of blood in her abdomen could not account for her state of shock. At autopsy, bits of fetal tissue were found in the small blood vessels of her lungs. This condition, called amniotic fluid embolism, occurs when fetal tissue enters the mother's blood stream.

Author: Mark, Eugene J., Greene, Michael F., Roberts, Drucilla J.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1998
Patient outcomes, Mortality, Pregnancy, Complications of, Pregnancy complications, Amniotic fluid embolism

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Case 36-2006: A 35-year-old pregnant woman with new hypertension

Article Abstract:

A case study of a 35-year-old pregnant woman who was admitted to hospital at 19 weeks and 6 days of gestation because of the onset of hypertension and diabetes is presented. Subsequent evaluation revealed a 24-hour urinary cortisol level of 825 [mu]g, hypertension, and elevated blood glucose levels and treatment with mitotane and ketoconazole was initiated which declined cortisol level to 126 [mu]g.

Author: Klibanski, Anne, Greene, Michael F., Blake, Michael A., Stephen, Antonia E.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2006
Health aspects, Pregnant women, Hypertension in pregnancy, Gestational hypertension, Case study

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Vaginal delivery after cesarean section -- is the risk acceptable?

Article Abstract:

Women with a previous cesarean delivery who attempt a vaginal delivery in a subsequent pregnancy have 3 to 15 times the risk of uterine rupture. For this reason, all such women should be counseled about the risks and benefits of a trial of labor after a cesarean.

Author: Greene, Michael F.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2001
Editorial, Uterus, Vaginal birth after cesarean, Uterine perforation, Complications

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