Gynecologic and obstetric investigation
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Gynecol. Obstet. Invest. · Jan 2008
Case ReportsMetformin-associated lactic acidosis in a pregnant patient.
Metformin-associated lactic acidosis is a rare but serious condition and potentially even more hazardous during pregnancy. We reported a case of lactic acidosis in a 28-year-old pregnant woman (gravida 3, para 0, abortion 2, ante-partum 22 weeks) after ingestion of 39.50 g (approximately 80 tablets) metformin in a suicide attempt. She had no pre-existing systemic illness. ⋯ We present a case of successful management of metformin-associated lactic acidosis during pregnancy, treated simply, with intravenous sodium bicarbonate and intensive fetal monitoring. This relatively noninvasive method is an effective treatment option. However, hemodialysis still has a valuable role in the management of acidosis which proves refractory to conservative treatment, such as that described.
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Gynecol. Obstet. Invest. · Jan 2008
Case ReportsTwisted ovarian tumor causing progressive hemothorax: a case report of porous diaphragm syndrome.
Porous diaphragm syndrome is caused by a defect in the diaphragm. The defect may induce pleural effusion in a patient with an ovarian tumor. ⋯ This is the first report in which the diaphragmatic defect was identified in a patient with an ovarian tumor and hemothorax. Porous diaphragm syndrome may be involved in the pathophysiology of right pleural effusion observed in other medical conditions such as Meigs' syndrome, ovarian hyperstimulated syndrome, and ovarian cancer.
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Gynecol. Obstet. Invest. · Jan 2008
Case ReportsCranial thromboembolism secondary to patent foramen ovale and deep venous thrombosis after cesarean section.
Paradoxical embolism via a patent foramen ovale (PFO) is a rare event in the puerperium as a cause of stroke. ⋯ Patients with an unexplained arterial event should be screened for PFO and possible paradoxical embolism.
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Gynecol. Obstet. Invest. · Jan 2007
Randomized Controlled Trial Comparative StudyA double-blind randomized controlled trial of oral misoprostol and intramuscular syntometrine in the management of the third stage of labor.
The aim of this study was to compare the efficacy and safety of oral misoprostol 400 mug with intramuscular syntometrine in the management of the third stage of labor. ⋯ Orally administered misoprostol at a dose of 400 mug is an acceptable alternative in preventing post-partum blood loss, as measured by the peri-partum change in hemoglobin level and was not associated with an increased incidence of side effects.