Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Dec 1997
ReviewGynecology and family planning care for the woman infected with HIV.
This article reviews the interactions between HIV infection and a variety of gynecologic conditions, including lower genital tract neoplasia, pelvic inflammatory disease, menstrual disorders, sexually transmitted diseases, and vaginitis. Important considerations in choosing a family planning method for women infected with HIV-infected women will respond to standard therapy, but require multiple courses of treatment or use of innovative treatment methods. All HIV-infected women deserve careful evaluation for and treatment of gynecologic diseases.
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The epithelial lining of the anogenital tract is the target for infection by a group of mucosotropic viruses, the HPVs. Clinical or subclinical, transient or persistent, HPV infections are among the most common sexually transmitted diseases. ⋯ HPV infection is the direct cause of anogenital warts and a precursor event in the genesis of cervical cancer and other anogenital malignant tumors. Other HPV types commonly associated with anogenital warts are, for the most part, of low oncogenic risk.
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Cardiac arrest occurs rarely in pregnancy. Nevertheless, the practicing obstetrician stands a likely chance of encountering this acute condition at least once over the course of a busy career. A basic understanding of maternal-fetal physiology and the acute management of cardiac arrest are of key importance. ⋯ The critical period in management of these patients is within the first several minutes of the event. In many situations, the obstetrician may be the first to arrive and initiate therapy before the arrival of multidisciplinary assistance. Prompt initial management will give the mother and fetus the best chances for survival.
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Obstet. Gynecol. Clin. North Am. · Jun 1995
ReviewLabor and delivery management of the multiple gestation.
Labor and delivery management of multiple gestations remains controversial. The authors review issues relating to the management of labor and the administration of anesthesia in twin gestations. A comprehensive review of published data pertaining to delivery route planning for twins using fetal presentation, gestational age, and estimated fetal weight is presented. Individualization of intrapartum care in twin gestations is imperative.
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Obstet. Gynecol. Clin. North Am. · Jun 1995
ReviewEmergent obstetric management of postpartum hemorrhage.
Early PPH remains a significant problem in obstetrics with serious maternal morbidity and mortality. Many patients at risk for PPH can be antenatally identified. ⋯ This discussion provides a practical approach to establish an accurate diagnosis of PPH and an expeditious application of medical, surgical, and radiographic management. It is the responsibility of every obstetric health care provider to maintain proficiency in the diagnosis and management of PPH to reduce its incidence and associated morbidity and mortality to an unpreventable minimum.