Archives of gynecology and obstetrics
-
Arch. Gynecol. Obstet. · Jul 2009
Case ReportsFactor VIIa treatment of DIC as a clinical manifestation of amniotic fluid embolism in a patient with fetal demise.
A pregnant patient, with term intrauterine fetal demise, who developed cardiopulmonary arrest during labor, followed by disseminated intravascular coagulation (DIC) secondary to amniotic fluid embolism (AFE) that was treated with Recombinant Factor VIIa, is presented. ⋯ Recombinant Factor VIIa may be a treatment option for hemorrhage in patients with DIC related to AFE.
-
Arch. Gynecol. Obstet. · Jun 2009
Case ReportsSpontaneous renal forniceal rupture due to advanced cervical carcinoma with obstructive uropathy.
To report and describe the clinical presentation and outcome of a woman presenting with gross perinephric urinary extravasation (due to spontaneous renal forniceal rupture), secondary to malignant obstructive uropathy caused by advanced cervical carcinoma. To review the etiopathogenesis, approach to diagnosis and management of 'spontaneous renal forniceal rupture. ⋯ To the best of our knowledge, this is the second case of spontaneous renal forniceal rupture secondary to ureteral obstruction caused by advanced cervical carcinoma to be reported in the published English literature. A high clinical index of suspicion is warranted in any patient of advanced cervical carcinoma that presents with sudden uremia or oliguria with flank pain and swelling in order to arrive at an early diagnosis. A decompressive nephrostomy may provide the much needed comfort and succor towards prolonging the life of such unfortunate patients.
-
Arch. Gynecol. Obstet. · Jun 2009
Case ReportsFetal macrosomia in African women: a study of 249 cases.
To determine the incidence and risk factors of macrosomia in a Nigerian centre, and to assess the relation of maternal body mass index (BMI) at birth and of the total weight gain during pregnancy to macrosomia and adverse pregnancy outcome. ⋯ The higher the total body weight at birth, the higher the rate of macrosomia. Macrosomia had implications for high morbidity and mortality in the mothers and their infants. Delivery methods need to be evaluated. Caesarean section should be more readily used.
-
Arch. Gynecol. Obstet. · May 2009
Pregnancy in chronic renal insufficiency: single centre experience from North India.
Renal disease during pregnancy is relatively uncommon. The diagnosis of renal disease before or during pregnancy was only 0.03% in a population-based study of pregnant women with kidney disease. However, there is a paucity of scientific data regarding the general topic of renal disease in pregnancy on which to base clinical management and counselling recommendations. ⋯ Most women with chronic renal disease will have a successful outcome if they receive proper prenatal care. Pregnant women with moderate or severe renal insufficiency have increased rates of complications due to worsening renal function, hypertension, and other obstetrical complications, but fetal survival is high.
-
Arch. Gynecol. Obstet. · May 2009
Comparative StudyWho's asking? Patients may under-report postoperative pain scores to nurses (or over-report to surgeons) following surgery of the female reproductive tract.
To determine if postoperative pain reporting via standardised visual analogue scale (VAS) is affected by which member of the healthcare team collects the information. ⋯ This study identified important variances in subjective pain reporting by patients that appeared to be influenced by who sampled the data. We found patients gave lower VAS pain scores to RNs compared to MDs; the reverse pattern was never observed. Post-surgical patients may communicate pain information differently depending on who asks them, particularly in the early post-operative period. Accordingly, patient pain data gathered over time by a care team with a heterogeneous composition (i.e., RNs, MDs) may not be fully interchangeable. Patient projections of pain severity and/or intensity appear to vary as a function of who evaluates the patient.