The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Oct 2010
Case ReportsFulminant herpes simplex virus hepatic failure in pregnancy requiring liver transplantation.
Herpes simplex virus hepatitis is a rare but potentially fatal condition that usually affects the immunocompromised, including pregnant women. This case report details the course of fulminant hepatic failure in a woman at 31 weeks gestation resulting in emergent delivery of the fetus and liver transplant in the mother.
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Aust N Z J Obstet Gynaecol · Aug 2010
Audit of severe acute maternal morbidity describing reasons for transfer and potential preventability of admissions to ICU.
Maternal mortality is a rare event in the developed world. Assessment of severe acute maternal morbidity (SAMM) is therefore an appropriate measure of the quality of maternity care. ⋯ An audit of SAMM cases describing reasons for transfer to ICU and preventability is feasible. We recommend that a prospective national SAMM audit process be introduced in New Zealand as a quality of care measure.
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Aust N Z J Obstet Gynaecol · Aug 2010
Clinical TrialLignocaine gel in minimally invasive surgery - A pilot cohort study.
The administration of local anaesthetic at the conclusion of minimally invasive procedures has been shown to reduce postoperative pain. However, it is often not feasible to reach target surgical sites using a needle, making it difficult to administer injectable local anaesthetic. Formulations currently available for topical use are also not sterile, adhere poorly, and are not adjusted to neutral pH at the time of use. To address these limitations, a new sterile, aqueous 4.8% lignocaine gel was formulated for topical application on surgical wounds. ⋯ A sterile lignocaine gel can be safely used in minimally invasive surgery.
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Aust N Z J Obstet Gynaecol · Aug 2010
Complications of laparoscopic myomectomy: A single surgeon's series of 1001 cases.
The objective of this retrospective study was to evaluate the safety, intra-operative and post-operative morbidity of laparoscopic approach for myomectomy. ⋯ Laparoscopic myomectomy is comparable to laparotomy myomectomy in terms of duration of surgery, blood loss and complication rates. This large single surgeon series on laparoscopic myomectomy also shows a low complication rate suggesting that laparoscopic myomectomy is a safe and reliable procedure, even in the presence of multiple or large myomas.
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Aust N Z J Obstet Gynaecol · Jun 2010
Perinatal risk factors for the neonatal abstinence syndrome in infants born to women on methadone maintenance therapy.
Neonatal abstinence syndrome (NAS) occurs in more than 50% of infants exposed to intrauterine opiates. Maternal opiate dosing has been investigated with conflicting results. ⋯ Our data suggests that timing and mode of delivery as well as last maternal methadone dose are significant risk factors for the development of NAS requiring treatment. Based on these clinical parameters, risk stratification for perinatal management of pregnancies associated with opioid dependency and risk prediction for the neonate might now be possible.