Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Mar 2009
Letter Case ReportsTisseel for management of traumatic postpartum haemorrhage.
Following the introduction of haemostatic agents, new opportunities are available when facing problematic bleeding. We report the first case of traumatic postpartum hemorrhage successfully controlled with a fibrin sealant. ⋯ Tisseel consists of a two-component fibrin biomatrix to stop diffuse bleeding. When the tissues are very oedematous, it can be difficult to insert sutures. We tried this innovative option with very effective results. The absence of long-term complications is reassuring and we recommend its use in similarly extreme situations.
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Arch. Gynecol. Obstet. · Feb 2009
Case ReportsA case of benign metastasizing leiomyoma treated by surgical castration followed by an aromatase inhibitor, anastrozole.
Benign metastasizing leiomyoma (BML) is a rare disease most often located in the lungs of women with a history of surgery for benign leiomyoma of the uterus. Optimum therapy for BML, has not been established. We report here an additional case of BML in the lung that was successfully treated with surgical castration followed by hormonal therapy with anastrozole, an aromatase inhibitor. ⋯ In addition to castration by bilateral oophorectomy or gonadotropin-releasing hormone agonist, the use of aromatase inhibitor is one of the treatment options for the further suppression of peripheral estrogen production in these patients.
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Arch. Gynecol. Obstet. · Jan 2009
Case ReportsCerebellar metastasis in squamous cell vulvar carcinoma.
Brain metastasis is rarely seen in gynecologic cancers. It is more rarely encountered in vulvar carcinoma. ⋯ Brain metastasis might be seen in patient with vulvar carcinoma. To the best of our knowledge, this is the first reported case of vulvar carcinoma which developed cerebellar metastasis.
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Arch. Gynecol. Obstet. · Jan 2009
Severe shoulder dystocia leading to neonatal injury: a case control study.
Severe shoulder dystocia (SD) is associated with neonatal brachial plexus injuries and skeletal fractures, with the former being the commonest cause for litigation related to birth trauma. The aim of this case-control study was to evaluate risk factors for birth injuries in cases presenting with SD. ⋯ In babies with SD, brachial nerve injuries and skeletal fractures are more likely to occur in those with greater birthweights but also larger length to weight ratios. In these babies, assessment of abdominal circumference and biacromial length by magnetic resonance imaging (MRI) may help predict the likelihood of severe SD, especially in mothers with identifiable risk factors. However, further research in larger controlled trials are still needed to determine their predictive value.
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Arch. Gynecol. Obstet. · Dec 2008
ReviewMedico-legal issues in obstetric anesthesia: what does an obstetrician need to know?
Obstetric anesthesia has become a recognized subspecialty of anesthesiology and an integral part of practice of most anesthesiologists. Perhaps no other subspecialty of anesthesiology provides more personal gratification and clinical challenges than the practice of obstetric anesthesia. However, in addition to clinical challenges obstetric anesthesia is laden with medico-legal liability. ⋯ Good perioperative evaluation of all patients, detailed review of patient's medical records, and constant vigilance can decrease the incidence of complications and subsequently medico-legal issues.