It is safer to postpone IUD insertion until 6 months after delivery.

A well integrated, population-based scoring will decrease the number of unnecessary testing but still diagnose 85-100% of GDM cases.

It is safer to postpone IUD insertion until 6 months after delivery.

Abnormal fetal presentation, multiparity, low birth weight, prematurity, polyhydramnios, and spontaneous rupture of membranes, in particular with high Bishop scores, are risk factors for umbilical cord prolapse. Early amniotomy increases the variable decelerations and hence increases the rate of cesarean section because of fetal distress, but it may prevent pregnant women from umbilical cord prolapse, which has a high mortality rate. However, large randomized trials are needed to prove that early amniotomy decreases the incidences of umbilical cord prolapse.

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BackgroundMature cystic teratomas, often referred to as dermoid cysts, are the most common germ cell tumors of the ovary. In the recent years, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. We retrospectively reviewed the outcome of laparoscopic surgery for suspected ovarian dermoid cysts.Patients and MethodsThe preoperative findings, operative techniques and post-operative complications were retrospectively reviewed in women who underwent laparoscopic surgery for dermoid cysts, between January 2000 and May 2003.ResultsIn 47 women aged 21 to 53 years (median, 38.8 years), 93.6% had a unilateral cyst with a diameter of 17 to 108 mm (median, 51 mm). Clinical presentations were pain (62%), abnormal vaginal bleeding (21%) and ovarian torsion (2%), whilst 17% were diagnosed incidentally during routine examination. Surgery included cystectomy (57%), total (36%) or partial oophorectomy (6.4%) and laparoscopy-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (2%). During the cyst extraction, minimal spillage occurred in 42.5% of the cases and none developed chemical peritonitis. In 2 patients, conversion to laparotomy (4.3%) was required, one for sigmoid colon injury and one for malignant ovarian tumor detected via frozen section. The median operating time was 80 minutes (range, 35–180 minutes).ConclusionUsing strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure.

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Increasing cesarean section rates concomitantly carries increasing maternal and neonatal adverse outcomes including operative complications as genitourinary fistulae.