Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Dec 2009
Randomized Controlled Trial Comparative StudyA randomized controlled trial of prophylactic sublingual misoprostol versus intramuscular methyl-ergometrine versus intramuscular 15-methyl PGF2alpha in active management of third stage of labor.
To compare the efficacy and side effects of 0.2 mg methyl-ergometrine IM, 400 microg misoprostol sublingual and 125 microg 15 methyl PGF2alpha IM in active management of third stage of labor. ⋯ Sublingual misoprostol appears to be as effective as intramuscular methyl-ergometrine and intramuscular 15-methyl PGF2alpha in the prevention of postpartum hemorrhage. It can be a good alternative in resource poor setting.
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Arch. Gynecol. Obstet. · Nov 2009
Randomized Controlled Trial Comparative StudyUtilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial.
A randomized study involving pregnant women was conducted to compare the effectiveness of a single intravenous (IV) injection of carbetocin with that of a standard 2-h oxytocin IV infusion with respect to intraoperative blood loss in the prevention of uterine atony after cesarean section (CS). The two treatments also were compared for safety and ability to maintain adequate uterine tone and to reduce the incidence and severity of postpartum hemorrhage (PPH) in women at risk for this condition. ⋯ Carbetocin makes possible to obtain, with a single IV injection, results equivalent to those of oxytocin on the maintenance of uterine tonicity and the limitation of blood losses, in the peri- and in the post-operative period, during a delivery by CS. It has in addition a comparable tolerance. Even in our series adverse events are practically of the same type and similar frequency in both study groups. Thus, the effectiveness of carbetocin consists, thanks to its long half-life, on an unique injection, whereas oxytocin requires repeated injections or a perfusion of several hours, with a variability of the administered doses.
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Arch. Gynecol. Obstet. · Oct 2009
Case ReportsMalignant pericardial effusion with cardiac tamponade in ovarian adenocarcinoma.
Malignant pericardial effusion with cardiac tamponade is an uncommon metastatic manifestation of gynecologic cancers. We describe a patient with ovarian cancer who developed pericardial effusion with cardiac tamponade and was successfully treated with pericardiocentesis and intrapericardial instillation of thiotepa. ⋯ Patients with gynecologic cancers may develop a pericardial effusion with cardiac tamponade. Malignant pericardial effusion should be included in the differential diagnosis in patients with recurrent ovarian cancer who present with cardiac tamponade.
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Arch. Gynecol. Obstet. · Oct 2009
LetterA minimally invasive technique for relaxing overtentioned midurethral slings.
Midurethral slings for stress urinary incontinence are effective surgical treatment with substantial rate of postoperative urinary retention. Different operative procedures ranging from urethrolysis to midline sling incision have been described to correct these cases. In this letter, we describe a minimally invasive technique for loosening overtensioned midurethral slings.
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Arch. Gynecol. Obstet. · Sep 2009
Case ReportsFlare-up of genital tuberculosis following endometrial aspiration in a patient of generalized miliary tuberculosis.
Genital tuberculosis is often neglected by health-care providers, but is an important cause of significant morbidity for the affected women. ⋯ To conclude, EA requires concern and a higher precision in the diagnosis of this insidious disease that primarily necessitates a clinical awareness of this serious health problem, to prevent such flare-up of TB. The clinician should be aware that isolation of TB requires special methods and this diagnosis should be considered while dealing with patients born in countries with high prevalence of TB.