Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Oct 2014
ReviewManagement of the pregnant woman with Marfan syndrome complicated by ascending aorta dilation.
Marfan syndrome is a disorder of connective tissue associated with progressive dilation of the aorta and potential risk for aortic dissection. Women with Marfan syndrome who are, or wish to become, pregnant represent a unique and challenging patient population due to a risk for accelerated aortic growth and aortic dissection during pregnancy. Risk for aortic complications during pregnancy is related to the dimensions of the ascending aorta. Women with an aortic diameter ≥4.5 cm at the start of pregnancy are at higher risk for aortic dissection, and an aortic dimension >4.0 cm is considered a relative contraindication to pregnancy in the setting of Marfan syndrome. ⋯ Multidisciplinary care involving specialists familiar with Marfan syndrome should be emphasized before, during, and after pregnancy with the involvement of Maternal Fetal Medicine, Genetics, Cardiology, Cardiothoracic Surgery, Anesthesia, and other specialties on a case-by-case basis. We review the important aspects of the evaluation and management of pregnant women with Marfan syndrome.
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Arch. Gynecol. Obstet. · Sep 2014
Case ReportsHemostatic gelatine-thrombin matrix (Floseal®) facilitates hemostasis and organ preservation in laparoscopic treatment of tubal pregnancy.
Laparoscopic salpingotomy has become the gold standard for the treatment of tubal ectopic pregnancy (TEP). Limitations for organ preservation in TEP can result from intra-operative bleeding or potential tubal damage due to application of thermal coagulation. Hemostatic gelatine-thrombin matrix Floseal® allows effective local hemostasis when sutures or thermal coagulation are inadequate or impossible. ⋯ Hemostatic gelatine-thrombin matrix Floseal® minimizes tissue damage and optimizes local hemostasis. The use of Floseal® enhances the chance of organ preservation in the laparoscopic treatment of TEP.
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Arch. Gynecol. Obstet. · Aug 2014
Case ReportsVulvodynia and proctodynia treated with topical baclofen 5 % and palmitoylethanolamide.
The prevalence of idiopathic vulvodynia and proctodynia is high. Pain management with anti-depressants and anti-epileptics may induce undesirable side effects. Therefore, topical baclofen cream and palmitoylethanolamide might be new therapeutic options. ⋯ Topical baclofen and palmitoylethanolamide can be a viable treatment option in chronic vulvodynia and proctodynia.
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Arch. Gynecol. Obstet. · Aug 2014
Randomized Controlled TrialEffect of local infiltration analgesia on post-operative pain following TVT-O: a double-blind, placebo-controlled randomized study.
To evaluate the effect of a protocol of local anesthesia and epinephrine associated with sedo-analgesia on post-TVT-O pain in comparison with infiltration of saline and epinephrine. ⋯ This randomized study seems to indicate that systematic infiltration before TVT-O positioning with local anesthetic may reduce immediate post-operative pain.
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Arch. Gynecol. Obstet. · Aug 2014
Randomized Controlled TrialEffect of bupivacaine-soaked spongostan in cesarean section wound on postoperative maternal health.
To investigate the efficacy of bupivacaine-soaked spongostan in cesarean section wound for postoperative anxiety level, satisfaction and early postpartum depression rate. ⋯ Placement of bupivacaine-soaked spongostan into the cesarean section wound resulted in decreased postoperative anxiety level and postpartum depression rate and increased satisfaction.