Archives of gynecology and obstetrics
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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.
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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.