Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Feb 2000
ReviewDisseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress.
In pregnancy and puerperium disseminated intravascular coagulopathy may accompany abruptio placenta, intrauterine fetal demise with retained dead fetus, amniotic fluid embolism, endotoxin sepsis, preecalampsia with HELLP and massive transfusion. Clinical signs and symptoms of DIC can include oozing from venipuncture sites and/or mucous membranes, red cell lysis from activation of the complement system, hemorrhage from coagulopathy and possible uterine atony, hypotension from hemorrhage and/or bradykinin release, and oliguria from end-organ insult and hypovolemia/hypotension. Treatment of DIC consists of replacement of volume, blood products, and coagulation components and cardiovascular and respiratory support with elimination of underlying triggering mechanism.
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Arch. Gynecol. Obstet. · Feb 2000
Comparative StudyA comparison between the effectiveness of epidural analgesia and parenteral pethidine during labor.
The study was aimed to define parturients' opinion on either epidural analgesia or intravenous pethidine, and to determine the effect of both analgesics after delivery. We interviewed and examined 401 consecutive parturients who requested analgesia during the beginning of their active stage of labor. Of those, 131 women requested and underwent epidural analgesia, and 270 received parenteral pethidine. ⋯ We conclude that epidural analgesia is more effective than parenteral analgesia in pain and discomfort relief. This method is helpful also the day after delivery. Thus, epidural analgesia should be strongly recommended to all patients who do not have any medical contraindications to this method of treatment.
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Arch. Gynecol. Obstet. · Feb 2000
Case ReportsPregnancy and delivery in young woman affected by isthmic coarctation of the aorta.
Coarctation of aorta is a rare cause of hypertension in pregnancy and the case material reported in literature is limited without a univocal line of clinical conduct. A case association between isthmic coarctation of the aorta and pregnancy in a 17 year-old primigravida woman is described.