Anecdotally, obstetricians have been known to sustain physical injuries whilst assisting deliveries but these are not always reported. This case describes how a mallet finger deformity was sustained by a consultant ob...Anecdotally, obstetricians have been known to sustain physical injuries whilst assisting deliveries but these are not always reported. This case describes how a mallet finger deformity was sustained by a consultant obstetrician whilst attempting to deliver a fetus with shoulder dystocia. Although this is a rare type of injury, it had significant impact on the consultant’s ability to provide clinical care for some time. Disruptions in service provision have direct financial consequences to the healthcare system. This case report highlights the importance of reporting these injuries at the workplace.展开更多
Type I Arnold-Chiari malformation (ACM) usually presents in adulthood and consists of a downward displacement of the cerebellar tonsils through the foramen magnum. A 25-year-old woman presented with a 5-month history ...Type I Arnold-Chiari malformation (ACM) usually presents in adulthood and consists of a downward displacement of the cerebellar tonsils through the foramen magnum. A 25-year-old woman presented with a 5-month history of headache associated with blurred vision, tinnitus and sickness. Imaging recognised the need for surgical intervention, but whilst awaiting for surgery she fell pregnant. Considering the risks of neurological deterioration, the woman underwent surgical decompression of type I ACM at 15 weeks gestation. She subsequently presented with progressively worsening headaches during late pregnancy from 35 weeks. The obstetric plan was initially induction of labour at term but since the onset of worsening symptoms, this date was brought forward to 39 + 1 weeks gestation. She proceeded to have a normal delivery with no neonatal complications and an uneventful puerperium followed. Since the delivery, the patient reported fewer symptoms, showed no signs of neurological deficit and a repeat magnetic resonance imaging of the head showed good relief of neural compression. This case illustrates how judicious selection of the appropriate mode of delivery of women following surgically corrected ACM and a multidisciplinary approach is critical in the successful management of the antepartum period and labour.展开更多
文摘Anecdotally, obstetricians have been known to sustain physical injuries whilst assisting deliveries but these are not always reported. This case describes how a mallet finger deformity was sustained by a consultant obstetrician whilst attempting to deliver a fetus with shoulder dystocia. Although this is a rare type of injury, it had significant impact on the consultant’s ability to provide clinical care for some time. Disruptions in service provision have direct financial consequences to the healthcare system. This case report highlights the importance of reporting these injuries at the workplace.
文摘Type I Arnold-Chiari malformation (ACM) usually presents in adulthood and consists of a downward displacement of the cerebellar tonsils through the foramen magnum. A 25-year-old woman presented with a 5-month history of headache associated with blurred vision, tinnitus and sickness. Imaging recognised the need for surgical intervention, but whilst awaiting for surgery she fell pregnant. Considering the risks of neurological deterioration, the woman underwent surgical decompression of type I ACM at 15 weeks gestation. She subsequently presented with progressively worsening headaches during late pregnancy from 35 weeks. The obstetric plan was initially induction of labour at term but since the onset of worsening symptoms, this date was brought forward to 39 + 1 weeks gestation. She proceeded to have a normal delivery with no neonatal complications and an uneventful puerperium followed. Since the delivery, the patient reported fewer symptoms, showed no signs of neurological deficit and a repeat magnetic resonance imaging of the head showed good relief of neural compression. This case illustrates how judicious selection of the appropriate mode of delivery of women following surgically corrected ACM and a multidisciplinary approach is critical in the successful management of the antepartum period and labour.
