Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Nov 2011
The effect of prepregnancy body mass index on singleton cesarean delivery among term nulliparous women in Japanese population.
Overweight or obesity is a known risk factor for cesarean delivery although there is minimal data among Japanese women. The aim of the study was to examine the effect of prepregnancy body mass index (BMI) on singleton cesarean delivery among term nulliparous women using a national sample from the Human Milk Survey. ⋯ Being overweight before pregnancy more than doubled the risk of cesarean delivery independent of age, smoking, pregnancy complications, and infant birthweight among term nulliparous women. Overweight Japanese women should be advised to achieve normal prepregnancy BMI in their preconception period to prevent cesarean delivery.
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Arch. Gynecol. Obstet. · Nov 2011
Case ReportsCannabinoid hyperemesis syndrome: an underreported entity causing nausea and vomiting of pregnancy.
In the western world, cannabis is the most widely used drug of abuse. Cannabinoid hyperemesis syndrome, which seems to be a rare paradoxical reaction in individuals with a particular predisposition, is characterized by cyclic severe nausea and vomiting in long-term cannabis users. While the symptoms are unresponsive to antiemetic drugs, compulsive hot baths result in a considerable symptom relief. ⋯ Before undertaking time-consuming and expensive medical examinations to rule out other medical reasons for therapy-resistant hyperemesis in pregnancy, obstetricians should determine whether compulsive bathing or showering provides symptomatic relief and ask specific questions regarding possible/suspected cannabis consumption.
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Arch. Gynecol. Obstet. · Nov 2011
Randomized Controlled TrialUmbilical vein oxytocin in the management of retained placenta: an alternative to manual removal of placenta?
Retained placenta is potentially life threatening due to possible complications associated with manual removal. Our aim was to determine whether umbilical vein injection of oxytocin in saline reduces the need for manual removal of placenta. ⋯ Intra-umbilical vein oxytocin injection is clinically effective for the management of a retained placenta.
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H1N1 is known to induce fulminant courses in youths and young adults. We report the case of a 24-year gravida 4 para 2 with singleton pregnancy admitted to obstetrical unit for fever up to 38°C during the 20th week of a so far uncomplicated pregnancy. Ultrasound examination and urine test was inconspicuous. ⋯ As a result of the antiviral therapy, H1N1-DNA was not detectable at day 16. Despite all endeavors, the respiratory situation could not be improved significantly; the patient additionally developed multiorgan failure during the time course and died on the 28th day of treatment. The recent case illustrates a very dangerous and imposing course of an H1N1-infection during pregnancy.
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Arch. Gynecol. Obstet. · Nov 2011
Randomized Controlled TrialEffect of anesthesiological strategies on neonatal bilirubin levels during cesarean section: a prospective and randomized trial.
Neonatal jaundice, a frequent problem in neonatology, can be influenced by many factors. Here, we sought to clarify the role of anesthesia and to compare the effects of various anesthesiological strategies on neonatal bilirubin levels during cesarean section. ⋯ EA and SA at cesarean section seem to be better among the four anesthesia techniques considering neonatal hyperbilirubinemia. Our findings are consistent with the idea that anesthesia may be a risk factor for hyperbilirubinemia. Although anesthesia may not significantly increase the need for interventions such as phototherapy, it may increase the burden of time, labor and cost.