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Objectives Little is known about the significance of Streptococcus G or C colonization in pregnant women. The objective of this study was to assess whether vaginal Streptococcus group G or C colonization detected in late pregnancy increases the infectious morbidity of the mother or newborn. Methods A total of 15,114 rectovaginal cultures taken at 35–37 weeks of pregnancy were analyzed at Tampere University Hospital, Finland, between 2012 and 2014. From this laboratory data, all Streptococcus G or C-positive cultures were included to study maternal and neonatal infectious morbidity after delivery. This study population was compared to women with a positive Streptococcus B culture and to women with a negative culture. Results The prevalence of Streptococcus G or C colonization was 2.9%. Significantly more postpartum endometritis was found in this study group. No association was found between colonization and neonatal bacteremia. Conclusions Streptococcus G or C colonization is associated with postpartum endometritis. More research is needed to clarify if antibiotic prophylaxis is reasonable for this group during delivery.

Background The aim of the present study was to evaluate the subjective outcome of primary repair of obstetric anal sphincter injury (OASIS) at 6 months, the factors associated with the symptoms of anal incontinence (AI), and the role of a simple survey consisting in one question with three answer choices, combined with the Wexner incontinence score for the assessment of this patient population. Methods A retrospective cohort study was conducted on patients with third- or fourth-degree OASIS operated on between January 2007 and December 2013 inclusive at Tampere University Hospital, Finland. At 6 months, the patients were asked to report their Wexner’s score as well as the three-choice assessment regarding AI symptoms. Based on this assessment, the patients were divided into three groups: those, asymptomatic, those with mild symptoms who did not want further treatment and those with severe symptoms who were willing to undergo further evaluation and treatment. Results There were 325 patients (median age 30 years). A total of 310 patients answered the questionnaire. Of which, one hundred and ninety-eight (63.9%) patients were asymptomatic, 85 (27.4%) had mild AI, and 27 (8.7%) experienced severe symptoms. There was no statistical difference in the results between the two techniques used (overlapping vs. end-to-end), or the stage of specialization of the operating physician. Persistent symptoms were associated with instrumental vaginal delivery (OR 2.12, 95% CI 1.32–3.41), severity of the injury (OR 1.64, 95% CI 1.20–2.25), and increased maternal age (OR 1.07, 95% CI 1.02–1.13). The correlation between the three-choice symptom evaluation and the Wexner score was good (Spearman’s rho 0.82). Conclusions After 6 months, severe symptoms after OASIS repair were present in 9% of women and were more frequent in older women, women with high-degree tears and after instrumental vaginal delivery. A three-choice assessment of AI symptoms correlated well with the Wexner score and might be useful to triage patients who need further evaluation.

A new case of macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) syndrome is described. The patient presented typical congenital findings in utero, although the syndrome was diagnosed postnatally. The M-CMTC syndrome should be considered when there is a marked fetal overgrowth and progressive macrocephaly with no indications of maternal hyperglycemia or fetal hyperinsulinism. Our patient also had unilateral pleural effusion, curved femur and frontal bossing.

Arterial bleeding, initially negative on MRI, ultrasonography and radiographic angiography, complicated the course of pregnancy with severe and recurrent vaginal and pelvic haemorrhage in the second trimester. Bleeding from the left uterine artery was successfully terminated by angiographic embolisation. No harmful effects on the fetal well-being were recorded after the embolisation. Massive haemorrhage, most probably from the right uterine artery, recurred some days later, and Caesarean section was performed. At postpartal ultrasonography and catheter angiography, massive arterial bleeding from a pseudoaneurysmatic vessel was clearly imaged on the right side of the cervical myometrium and could successfully be treated by radiographic embolisation. Though the primary aetiology of bleeding remains uncertain, it is possible that cervical endometriosis could have been associated with this complication.

We present a pregnancy complicated by multicystic dilatation of the uterine wall during the second trimester, leading to massive uterine distension, anemia and preterm Cesarean section. The cystic changes detected by ultrasound and magnetic resonance imaging involved the whole uterine wall surrounding the entire amniotic cavity. Histopathological examination revealed the benign nature of the cystic changes, which represented dilated and thrombosed venous lacunae. Disturbed venous drainage, combined with local thrombosis, was likely to have led to the collection of a large volume of blood in the uterine wall and the subsequent multicystic change of the myometrium.

To estimate fetal volume and weight in diabetic and normal pregnancy using high-resolution magnetic resonance imaging.T1-weighted magnetic resonance imaging was combined with semiautomatic segmentation technique. The accuracy of fetal volume estimations thus obtained was compared with conventional ultrasound-based weight estimations in ten pregnant women with insulin-dependent diabetes mellitus and ten women with normal pregnancy. Examinations were made within 48 hours before delivery.Ultrasound-based estimations of fetal weight showed a correlation rate of r=0.77 with the actual birth weights in the whole material, while volume determinations based on magnetic resonance imaging showed a significantly better correlation rate of r=0.95. Diabetic women did not differ from the normal pregnancy group with regard to birth weight or the accuracy of weight estimations.High-resolution magnetic resonance imaging combined with semiautomatic segmentation software was found to be accurate in determining fetal volume and, consequently, better than conventional ultrasound-based techniques in estimating fetal weight. The use of magnetic resonance imaging in fetal weight estimation may be recommended for clinical situations where an accurate weight estimate is considered essential.

Seventy-six patients with two or more ectopic pregnancies treated at the Department of Obstetrics and Gynecology, University Central Hospital, Tampere, Finland over a period of 14 years (1972-1985) were retrospectively analyzed. Conservative tubal surgery had originally been performed in 57% of patients with a repeat tubal pregnancy, and in 41% of control patients with a single tubal pregnancy. After two ectopic pregnancies, 53 patients were actively trying to conceive. Of these patients, 25% achieved delivery, 40% had a third ectopic pregnancy, and 35% did not conceive. Ipsilateral tubal pregnancy occurred in 83% after salpingotomy, in 88% after fimbrial evacuation, and in 47% after tubal resection. Conservative surgery was performed in 16 patients with only one tube where an ectopic pregnancy occurred; 25% had a term delivery, 25% had a repeat ectopic pregnancy, and 50% did not conceive. Follow-up of 19 patients after three tubal pregnancies showed that 16% delivered, 26% had a repeat tubal pregnancy, and 58% did not conceive. There was no significant difference between fertility results after salpingectomy and those after conservative surgery.