Obstetric and gynaecologic case records and commentaries

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University of Dar es Salaam
This book has three parts.The first part consists of ten Obstetrical cases the second part 10 Gynaecological cases and the last part consists of a long Obstetrical commentary. The cases presented are a few among the many cases managed by the author. Standard management has been followed unless where facilities were limited. Criticism, comments and a short review of literature follow each case. In the long commentary the perinatal outcome of twin pregnancies was studied. There were increased incidences of E.P.H. Gestosis, polyhydramnios and caesarian section rate among twin pregnancies than in singletons. Increased rates of premature deliveries and low birthweight babies are noted. 44.8 percent of the deliveries were premature and 61.1 percent were low-birthweight babies. The highest perinatal death and low Apgar Score rates were noted in these categories of babies. Higher rates of low Apgar Score babies and perinatal death were found in primiparas than in parous women and the differences in these rates were statistically significant (p <0.05). There were more low Apgar Score babies and a higher rate of perinatal mortality among the second twins than the first twin however the differences were not statistically significant. Mode of delivery did not appear to affect the perinatal outcome of the babies significantly although breech deliveries had higher rates of Apgar Score babies and perinatal mortality than vertex deliveries. Perinatal mortality and low Apgar Score rates were higher for second twins who were born more than 30 minutes after delivery of the first twin, however the number was too small for statistical calculation. Recommendations on the management of twin deliveries are given after a review of literature on the topic.
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Obstetric, Gynaecology, Cases, Clinical reports, Statistics
Rutayungulwa, J. (1989) Obstetric and gynaecologic case records and commentaries, Masters dissertation, University of Dar es Salaam. Available at (