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 · Dec 2011
Randomized Controlled TrialEffect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery.
To assess the effect of intravenous tranexamic acid on blood loss during and after cesarean delivery. ⋯ Intravenous tranexamic acid decreased intra- and postoperative blood loss and oxytocin administered in patients delivered by cesarean.
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Int J Gynaecol Obstet · Nov 2011
Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus.
Gestational diabetes mellitus (GDM) is increasingly recognized as an opportunity for early prevention of diabetes and other diseases over the lifespan, and may be responsible for up to 30% of cases of type 2 diabetes. A newly developed mathematical model (the GDModel) provides provisional estimates of the cost and health impact of various GDM screening and management choices, and calculates averted disability-adjusted life-years (DALYs). The model was piloted in 5 different healthcare facilities in India and Israel. ⋯ Some input values are currently being refined. Nevertheless, the current findings of cost-savings or favorable cost-effectiveness are robust to a wide range of plausible input values, including highly unfavorable values. The GDModel will be further developed into a user-friendly tool that can guide policy-makers on decisions regarding GDM screening strategies and guidelines.
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To review the use of blood cell salvage performed during cesarean delivery. ⋯ Cell salvage was acceptable, beneficial, and without adverse events in both high-risk elective cesareans and emergency cesareans for unexpected hemorrhaging. The skills refined during use of cell salvage in elective cesareans were crucial for successful implementation during emergency situations.
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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.