Obstetrics and gynecology clinics of North America
-
Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewRespiratory insufficiency due to pneumonia in pregnancy.
Respiratory insufficiency is a common complication of pneumonia in pregnancy. Respiratory insufficiency may progress to respiratory failure, requiring mechanical ventilation. Prompt diagnosis of the pneumonia and rapid institution of supportive care and effective antimicrobial therapy results in the best possible outcome for both mother and fetus. If the patient requires mechanical ventilation, resolution of the pneumonia usually allows for uneventful weaning from the respirator.
-
This article reviews the pathophysiologic changes of pregnancy and pulmonary edema, the clinical findings and diagnostic techniques available to diagnose this condition, and it discusses those areas of obstetrics commonly associated with pulmonary edema. A treatment approach is offered that focuses on the maternal and fetal considerations associated with pulmonary edema.
-
Any one neurologic emergency is rare during pregnancy. As a group, neurologic disorders are a major cause of maternal mortality. Optimal management requires a multidisciplinary approach and ready access to the collective experience of other clinicians. This article discusses the management of status epilepticus, eclamptic hypertensive encephalopathy, stroke, including subarachnoid hemorrhage, myasthenic crisis, porphyric crisis, acute Guillain-Barré syndrome, autonomic hyperreflexia, malignant hyperthermia, chorea gravidarum, and Wernicke's encephalopathy.
-
Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewEvaluation and treatment of the gravida and fetus following trauma during pregnancy.
The management of trauma during pregnancy requires an interdisciplinary team approach involving surgeons, emergency medicine physicians, and obstetricians. Management principles are similar to those utilized in nonpregnant patients, but a number of unique circumstances must be considered, including physiologic changes of pregnancy, diagnosis and management of abruptio placentae and fetomaternal hemorrhage, and the management of traumatic cardiac arrest during pregnancy. The routine use of cardiotocography, Kleihauer-Betke assay, and perimortem cesarean section are discussed as new principles in the management of trauma during pregnancy.
-
Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewAdult respiratory distress syndrome in obstetrics.
Despite the advances in medical technologies, ARDS is highly lethal. In the management of patients with ARDS, certain clinical conditions are common predisposing factors to the development of the syndrome. Infection, sepsis syndrome, and conditions requiring massive transfusion are the most common causes in patients initially managed by obstetricians and gynecologist. ⋯ Due to the overall relative youth of our obstetric and gynecologic patients and their lack of other underlying diseases, they should do better than most patients with ARDS. However, at least 50% of all patients succumb to the disease itself or to complications inherent in the care needed. Families and treating physicians should be apprised of this early in the course.