Trauma during pregnancy]

Mortality due to trauma in pregnancy is not very common in the Netherlands. More often a pregnant woman presents herself for examination after trauma. Blunt trauma is more common in the third trimester. Minor trauma also needs good care, with special attention for solutio placentae. Maternal mortality after penetrating trauma is low because of the protection of vital organs by the uterus. With good treatment the mortality in pregnant trauma patients will not be higher than in nonpregnant patients. A rapid and effective resuscitation of the mother will give the foetus the best chance of survival.     

Urinary incontinence in pregnancy and puerperium]

In a study of 421 patients questioned in immediate post-partum the author observed a urinary incontinence during pregnancy in 30.6% of the cases, this figure is comparable to those found in literature. The post-partum incontinence was not observed when forceps, vacuum extraction or caesarean section have been used. The urinary disorders observed during post-partum regresses spontaneously in 68% of the cases. However, one can ask the question on whether it is not reveal a light pelvic alteration which could cumulate at each delivery, so it would be necessary to use a pelvic training.     

Successful pregnancy after liver transplantation]

Two women aged 32 and 30 years became pregnant following orthotopic liver transplantation. The time intervals between transplantation and conception were 9 years and 9 months, respectively. Both women had immunosuppressive prophylaxis. The course of both pregnancies was uneventful; there were no signs or symptoms of graft rejection. At term, both women were delivered vaginally of female infants, weighing 2510 g (2.3rd-5th percentile) and 3200 g (50th-75th percentile), respectively. The second woman had a normal postpartum period while the first one needed blood transfusion for anaemia due to postpartum haemorrhage. From the literature to date it is concluded that apart from an increased likelihood of opportunistic infections, hypertension, diabetes mellitus, osteoporosis, impaired renal function and foetal growth restriction the outcome of pregnancy in women after a liver transplantation is generally favourable. However, the possible long-term effects of medical treatment on maternal and infant health are unknown.