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23 cases of caesarian sections in mares are presented in the article. 9 mares were operated in the clinic, 14 in field conditions. In all cases dead fetuses were found during the clinical examination performed before the operation. 3 mares were operated by the flank approach, 20 operations were carried out by midline incision. In 3 cases it was impossible to perform the incision of the uterus extraperitonealy. In one of these cases operators were forced to conduct a fetotomy during the operation. In all other mares the incision of the uterus was carried out extraperitonealy. From the 23 mares, 2 mares in a very bad condition died the during operation, a third passed away after 3 months (for unknown reasons). Other mares survived the operation but the further reproduction history of these patients is unknown. Among serious postoperative complications were: 2 abdominal hernias and one serious peritonitis with postpartum laminitis, which left permanent lameness. An approximately 86% survival rate in mares that underwent caesarian section with dead fetuses before an operation seems to be a good result. When there is no possibility of transportation of the mare to the clinic, a caesarian section can be carried out successfully in field conditions.
Introduction. Obesity is an increasing global health problem affecting 20-35% of women of reproductive age. During pregnancy obesity is considered as a high-risk factor associated with many complications. Objective. To analyze pregnancy outcomes and trial of labour in population of obese women. Material and methods. A retrospective cohort study was conducted comparing 270 women with estimated pregravid body mass index (BMI) exceeding 30 kg/m² (analyzed group) and 270 women with estimated pregravid BMI 20-24.9 kg/m2 (control group). Statistical analysis was performed using the Student’s t-test. Values p < 0.05 were considered statistically significant. Results. Mean pregnancy weight gain was statistically lower among obesewomen as compared with normal- weight women (12.6 kg vs 16.4 kg, p = 0.0009). Among women from analyzed group significant increase in the percentage of pregnancy induced hypertension (25.2% vs 7.4%, p < 0.0001), preeclampsia (5.6% vs 2.2%, p = 0.04), gestational diabetes (9.3% vs 3.0%, p = 0.002), preterm deliveries (7.8% vs 3.7%, p = 0.04) and deliveries of infants weighing > 4500 g (9.6% vs 3.7%, p < 0.006) was noted. Obese womenin comparison with normal- weight women were at greater risk of cesarean section (41.9% vs 26.3%, p = 0.0001) and postoperative wound infection (11.5% vs 2.8%, p < 0.04). Newborns of patients from analyzed group statistically more often sustained injuries after vaginal delivery as compared with newborns of patients from control group (10.2% vs 4.0%, p < 0.03). No significant intergroup differences occurred concerning time of labour stages, incidence of meconium-stained amniotic fluid and use of vacuum extractor. Indications for cesarean section, percentage of newborns weighing < 2500 g and percentage of newborns with low Apgars coreswere similar in both groups. Conclusions. Obesity during pregnancy is associated with numerous complications for both mothers and newborns. Pregravid body mass index exceeding 30 kg/m² should be considered as an important prognostic factor of pathologic pregnancy and trial of labour.
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