International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Oct 2011
ReviewMedical, ethical, and legal considerations in fertility preservation.
The past 2 decades have seen a significant rise in cancer survival rates, and an increasing proportion of survivors at reproductive age are interested in childbearing. Although assisted reproduction provides physicians with an array of potential possibilities to help patients whose fertility is compromised by cancer treatment, there is still a dearth of regulation regarding the application of this technology. The present paper reviews the current options for fertility preservation, with a particular focus on the legal and ethical challenges that confront providers of this type of care.
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Int J Gynaecol Obstet · Oct 2011
Randomized Controlled Trial Comparative StudyLow-dose magnesium sulfate versus Pritchard regimen for the treatment of eclampsia imminent eclampsia.
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Int J Gynaecol Obstet · Oct 2011
Practice GuidelineThe combination of mifepristone and misoprostol for the termination of pregnancy.
The combination of 200mg of mifepristone followed by 25 μg to 800 μg (depending on gestational age) of misoprostol has been shown to be effective for the termination of pregnancy throughout gestation. The dose of misoprostol should be reduced as gestational age increases. ⋯ The course of treatment and prerequisites for medical abortion and recommended mifepristone and misoprostol regimens for different gestational ages are described, along with the side effects, management of complications, and postabortion care. The use of the mifepristone-misoprostol combination regimen for induction of labor in cases of fetal death is also described.
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Recent research in the USA has shown the advantages for children's welfare of open fetal surgery over postnatal treatment for myelomeningocele. However, a balance must be struck between complications of premature birth risked by prenatal surgery and the long-term advantages for affected children's health, including mobility and neurologic capacity. ⋯ Beyond fetal interests and women's preferences are state interests in fetal life, which in the USA and elsewhere have been expressed in judicially authorized cesarean deliveries. Underlying issues are the nature of fetal interests; contrasting entitlements to care from their mothers of fetuses and born children; healthcare providers' responsibilities toward fetuses; and duties of care, information, and advice to pregnant women.