Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Dec 2011
Randomized Controlled Trial Comparative StudyCarbetocin versus syntometrine in the management of third stage of labor following vaginal delivery.
To assess and compare the efficacy and safety of a single intramuscular dose of carbetocin to a single intramuscular dose of syntometrine in managing the third stage of labor following vaginal delivery among women with low risk factors for postpartum hemorrhage. ⋯ Single dose of intramuscular carbetocin 100 μg may be more effective as compared to a single intramuscular dose of syntometrine in reducing postpartum blood loss with a smaller drop in hemoglobin levels and less adverse effects.
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Arch. Gynecol. Obstet. · Dec 2011
Diagnostic performance of urgent referrals for suspected gynaecological malignancies.
The objective of this study was to investigate the outcome of the urgent referrals with suspected gynaecological malignancy. ⋯ The overall predictive value of two-week wait referrals for suspected gynaecological malignancies is low. Refinement of the current referral guidelines is required with particular emphasis in the premenopausal women where the diagnostic performance of the urgent referrals is significantly poorer.
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Arch. Gynecol. Obstet. · Dec 2011
Randomized Controlled TrialThe effects of preoperative intravenous acetaminophen in patients undergoing abdominal hysterectomy.
Although intravenous acetaminophen is commonly used for the management of postoperative pain, very limited evidence supports the usefulness of preoperative administration. The aim of this study was to determine the analgesic effect of preoperative acetaminophen on opioid consumption, pain scores, and side effects in patients receiving an elective abdominal hysterectomy. ⋯ Premedication with acetaminophen reduced hydromorphone consumption and opioid-related side effect in patients undergoing abdominal hysterectomy, but did not significantly reduce pain intensity.
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Arch. Gynecol. Obstet. · Dec 2011
Letter Case ReportsFatal bilateral subdural haematoma after epidural anaesthesia for pregnancy.
CSF leak after epidural anaesthesia should be suspected after persistent headaches, which are worse on standing, suggestive of low pressure and CSF overdrainage. Subdural haemorrhage after CSF leak is a recognised complication; if suspected a CT Brain should be performed. An epidural blood-patch, and if necessary haematoma evacuation, can help prevent an unfortunate and tragic outcome.
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Arch. Gynecol. Obstet. · Dec 2011
Comparative StudyAnalyzing the impact of private service on the cesarean section rate in public hospital Thailand.
To assess the cesarean section rate and compare the risk profiles of cesarean delivery in nulliparous women between private and non-private service. ⋯ Private patients had a significantly higher rate of cesarean section than non-private patients. NICU admission was significantly lower in the private group, but postpartum hemorrhage was significantly higher. There were no significant differences in maternal mortality, low Apgar score at 5 min, perinatal death in both group. This study suggests that a significant number of cesarean sections among private services may be unnecessary. To safely reduce a cesarean section rate, an appropriate policy and guideline for auditing cesarean section among private service should be developed.