Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Sep 2010
Multicenter StudyApplication of uterotonics on the basis of regular ultrasonic evaluation of the uterus prevents unnecessary surgical intervention in the postpartum period.
Ultrasonographic evaluation of the postpartum uterus to prevent retained placental tissue complications is still a matter of debate, and it is difficult to interpret its necessity on the basis of previous studies. We hypothesized that the application of uterotonics on the basis of regular postpartum ultrasound scanning of the uterus may reduce the number of unnecessary curettages in a large unselected population. ⋯ In this study, routine ultrasound evaluation of the uterus in the postpartum period with regular application of uterotonics decreased the rate of surgical interventions. We strongly advise the introduction of postpartum uterine scanning into obstetrical practice, most suitably provided around day 3 after delivery.
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Arch. Gynecol. Obstet. · Sep 2010
Case ReportsSuccessful photodynamic therapy with topical 5-aminolevulinic acid for five cases of cervical intraepithelial neoplasia.
Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia. The purpose of this study was to assess the feasibility and effectiveness of PDT in patients with CIN and high-risk HPV infection. ⋯ PDT seems to be a non-invasive, repeatable procedure for CIN and cervical HPV infection with minimal side effects and can be easily performed on outpatient basis.
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Parturients with lumbar tattoos are often proposed to neuroaxial blocks (NB). There are no guidelines for this situation, and no reports of major complications derived from NB through tattoos. We conducted a survey of a sample of anaesthetists, to find out about their approach when facing NB on parturients with lumbar tattoos. ⋯ A tendency towards performing NB on pigment free skin, seems to exist. Literature has been the backup for anaesthetists confronted with the above scenario, while personal opinion seems to have been the basis for the remainders. The nonexistence of guidelines as well as the controversy regarding the risks involved in performing NB over tattoo, probably explain the diverse actions taken by the anaesthetists.
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Arch. Gynecol. Obstet. · Sep 2010
Case ReportsManagement of maternal hydrocephalus requires replacement of ventriculoperitoneal shunt with ventriculoatrial shunt: a case report.
Women with ventriculoperitoneal (VP) shunt require special care during pregnancy, although they develop few complications related to hydrocephalus. ⋯ We recommend VA shunt implantation as a treatment option for the management of VP shunt malfunction during pregnancy. We further propose that patients in whom the VP shunt is replaced with a VA shunt can achieve spontaneous vaginal delivery.