Vacuum extraction and symphysiotomy in difficult vaginal delivery in a developing community.

Gebbie, Donald A. M.

doi:10.1136/bmj.2.5528.1490

Cited by 13 publications

(10 citation statements)

References 4 publications

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“…Against the background of previous reports [16,17] and the present study on patients in Botswana and Mozambique it seems that symphysiotomy merits a place in the arsenal of methods needed for handling moderate cephalopelvic disproportion, not only in remote areas in the third world but also in urban hospital settings [22][23][24][25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Value of Symphysiotomy in Obstructed Labour Management and Follow-Up of 31 Cases

Bergström

Lublin²,

Molin³

1994

Gynecol Obstet Invest

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Experience of 32 cases of symphysiotomy carried out in Mozambique and in Botswana is reviewed. Of all cases only 1 was lost to follow-up. The observation period varied from 7 days to 6 months. Among 31 cases examined at discharge or on return for check-up few complications occurred. Vaginal laceration occurred in 3 cases, haematuria in 1 case and wound infection in 1 case. In 2 cases there was significant postoperative pain causing gait problems, but in no case were there significant problems with pain at discharge or at follow-up. It is concluded that the intervention is seldom complicated by severe sequelae, provided strict adherence to given indications is respected. In rural areas in the third world symphysiotomy is a life-saving and simple surgical intervention, which should be regarded as an adjunct measure in some cases with a moderately contracted pelvic outlet incompatible with normal vaginal delivery.

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Section: Discussionmentioning

confidence: 99%

Value of Symphysiotomy in Obstructed Labour Management and Follow-Up of 31 Cases

Bergström

Lublin²,

Molin³

1994

Gynecol Obstet Invest

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“…The combination of vacuum extraction and symphysiotomy was first introduced in East Africa by Gebbie 37 and by Bird and Bal 26 . The above Lancet editorial strongly recommended this combination to ''those going beyond the reaches of the safer, well-equipped labour ward'' 4 .…”

Section: Management Of Labour and Mode Of Deliverymentioning

confidence: 99%

“…Obstetric fistulae were reported in 35 (1.8%) of the 1933 patients, 33 being vesico-vaginal and two vesico-cutaneous fistulae. According to the respective authors, 12 of the fistulae were caused by pressure necrosis 26,28,29,37,39,67 (0.6% out of 1933); 11 by faulty technique, including surgical errors such as cutting the bladder or urethra, sometimes because of omitting the mandatory procedure of inserting a urinary catheter and pushing the urethra to the side 36,39,60,63,65 -67 (0.6%); six due to traumatic delivery such as tears from forceps 28,29,37 (0.3%) and in six cases (0.3%) the reason was not stated 7,25,36,63 .…”

Section: Complicationsmentioning

confidence: 99%

“…The baby died, the mother survived a puerperal sepsis but developed a vesico-vaginal fistula and drop foot. The third case was a woman who used walking sticks when she left the hospital four weeks after the operation, but recovered within three months 37 . In 1982 Gebbie, having supervised more than 500 symphysiotomies, wrote that ''almost all patients find walking difficult for the first few days .…”

Section: Referencesmentioning

confidence: 99%

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Minimally invasive surgery for obstructed labour: a review of symphysiotomy during the twentieth century (including 5000 cases)

Björklund¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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“…These authors have published the results of 1,200 operations (1963). Since that time there have been sporadic reports of the operation, mostly from Africa (Cox, 1966;Gebbie, 1966;Bird and Bal, 1967).…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Symphysiotomy — Time for a Reappraisal?

Hartfield

1973

Aust NZ J Obst Gynaeco

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A series of 138 patients in whom symphysiotomy had been performed is presented. The vicissitudes of this operation are reviewed and an evaluation has been attempted of its role in the management of moderate disproportion. Early and late complications were few and rarely serious if recommended guidelines were adhered to.In the 200 years since symphysiotomy was repeat Caesarean sections. The next stage in first performed it has provoked considerable the operation's rehabilitation occurred about emotion amongst obstetricians. In our own 12 years ago when doctors working in Africa time, uncritical advocacy and uninformed con-began to realise the dangers connected with demnation have combhed to so bemuse the delivery following lower segment Caesarean average obstetrician that if he ever considers section. A maternal mortality rate of the operation at all it is with indifference. 2.37% was reported from East Africa (Mit-The operation's zenith occurred at the turn of the century. Unfortunately it was undoubtedly misused at the time because of the great dangers of Caesarean section. But even at the height of its popularity it was not used very much in Britain and North America. With the increasing safety and popularity of Caesarean section as the mainstay of treatment in cephalopelvic disproportion, symphysiotomy fell into disrepute. However, in 1920 the operation was resurrected by Zarate of Argentina (1955). He improved the technique and delineated the indications for its performance. He had a number of followers in Spain and South America. After the Second World War the operation was taken up again in Eire (Spin, 1949). In these predominantly Roman Catholic countries where sterilization and contraception were theologically suspect and large families were common, symphysiotomy was of special use in avoiding multiple 1. Obstettic and Gynaecological Surgeon.

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Vacuum extraction and symphysiotomy in difficult vaginal delivery in a developing community.

Cited by 13 publications

References 4 publications

Value of Symphysiotomy in Obstructed Labour Management and Follow-Up of 31 Cases

Value of Symphysiotomy in Obstructed Labour Management and Follow-Up of 31 Cases

Minimally invasive surgery for obstructed labour: a review of symphysiotomy during the twentieth century (including 5000 cases)

Subcutaneous Symphysiotomy — Time for a Reappraisal?

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