Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Jun 2011
ReviewControversies in the management of placenta accreta.
Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality worldwide, and abnormal placentation, including placenta accreta, is currently the most common indication for peripartum hysterectomy. Prenatal identification of these cases and early referral to centers with the capability to manage them will likely result in improved outcomes. ⋯ Prospective trials are required to validate the efficacy of this approach. Obstetricians should be familiar with current transfusion protocols, as the incidence of placental accretism is expected to increase in the future.
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Obstet. Gynecol. Clin. North Am. · Jun 2011
ReviewAntenatal exposure to magnesium sulfate and neuroprotection in preterm infants.
Cerebral palsy is a leading cause of childhood neuromotor disability and is strongly associated with preterm delivery. Basic science research and some observational studies have suggested a neuroprotective benefit from antenatal exposure to magnesium sulfate. Recent randomized controlled studies and meta-analyses suggest that antenatal exposure to magnesium sulfate before anticipated preterm birth is associated with reduction in the risk of developing cerebral palsy or its associated neurologic disabilities in surviving infants. More importantly. this benefit has been achieved without increasing the risk of perinatal mortality.