The Australian & New Zealand journal of obstetrics & gynaecology
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Medical decision-making is based upon mathematical probability in determining the significance of variables involved. Truth is often not absolute and medical decisions often require reconsideration of information, reanalysis and possible change. Litigation based upon error negates the ordinary practice of medicine. ⋯ A creative process needs to replace a judgmental, rigid and punitive system. A committee involving specialist groups in selecting expert witnesses, a health counsellor and a patient representative may be most suitable. Criminal acts, where error is performed deliberately, assault or sexual misdemeanors, would still be subject to the common law.
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Aust N Z J Obstet Gynaecol · May 1998
Case ReportsThyroxine abuse: an unusual case of thyrotoxicosis in pregnancy.
Eating disorders and the associated behavioural problems and drug abuse are uncommon in pregnancy. When they do occur they are often unrecognized because of denial but when significant may pose a risk to both the mother and her fetus. This case illustrates a number of problems that may be encountered in women with eating disorders in pregnancy, including prolonged and recurrent metabolic disturbances and diuretic abuse. In particular it illustrates the derangements of thyroid function seen in pregnant women with eating disorders and reminds us that when a cause for thyrotoxicosis remains obscure, thyroxine abuse should be considered and explored.
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A regimen of morphine, paracetamol and aspirin administered orally was evaluated in 20 patients following Caesarean section; 18 of 20 reported no or mild impairment in their ability to care for their babies. There was a high level of satisfaction with 18 of 20 being very satisfied with their postoperative analgesia. There was a low incidence of side-effects with this regimen. It was acceptable to both patients and staff.