Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Mar 2007
Labor pain and its management with the combined spinal-epidural analgesia: what does an obstetrician need to know?
Most women rate pain of childbirth as the most painful experience of their lives. Lumbar epidural analgesia is widely considered as the most effective method of providing pain relief in labor. ⋯ The onset of analgesia is rapid and reliable, and maternal satisfaction is very high. While there still remains some concern about dural puncture, and while the pros and cons of using the CSEA as opposed to traditional epidural for labor pain are still being debated, it appears certain that the CSEA technique offers many unique advantages to the pregnant woman.
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Arch. Gynecol. Obstet. · Feb 2007
ReviewThe management of accidental dural puncture in pregnant women: what does an obstetrician need to know?
Post-dural puncture headache (PDPH) also known as spinal (or post-spinal) headache still remains a disabling complication of needle insertion into the subarachnoid space. Pregnant women are at particular risk of dural puncture, and the subsequent headache, because of sex, young age, and the widespread application of regional anesthesia. ⋯ The classic symptoms of PDPH consist of photophobia, nausea, vomiting, neck stiffness, tinnitus, diplopia, and dizziness in addition to the often, severe cephalgia. This article reviews the current literature on the pathophysiology, incidence, prevention, and treatment of PDPH in pregnant women.
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Arch. Gynecol. Obstet. · Oct 2006
ReviewLabor analgesia for the parturient with prior spinal surgery: what does an obstetrician need to know?
Administration of lumbar epidural analgesia in a parturient with previous spinal surgery presents a unique challenge to the anesthesiologist. These challenges (difficulties) range from inability to identify the epidural space, multiple attempts before catheter insertion, vascular trauma, and/or subdural local anesthetic injection to accidental dural puncture. The literature documenting management of labor analgesia in pregnant women with prior spinal surgery is limited to a handful of case reports. This author is not aware of any other review articles in English literature discussing special considerations for labor analgesia in parturients presenting with history of prior spinal instrumentation.
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Arch. Gynecol. Obstet. · Oct 2006
Case ReportsSister Mary Joseph's nodule originating from endometrial carcinoma incidentally detected during surgery for an umbilical hernia: a case report.
Umbilical metastasis (Sister Mary Joseph's nodule) is rare. It is encountered in 1-3% of patients with intra-abdominal and/or pelvic malignancy, with gastric carcinoma being the commonest origin in men and ovarian carcinoma-in women. Only 27 cases of Sister Mary Joseph's nodule originating from endometrial carcinoma have previously been documented in the literature. ⋯ This is the 28th case reported in the literature of Sister Mary Joseph's nodule originating from endometrial carcinoma and the first case of Sister Mary Joseph's nodule originating from endometrial carcinoma incidentally detected during surgery for umbilical hernia. Surgeons should be aware of the possibility of Sister Mary Joseph's nodule coexisting with an umbilical hernia.
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Arch. Gynecol. Obstet. · Aug 2006
ReviewLabor analgesia for the parturient with lumbar tattoos: what does an obstetrician need to know?
Tattoos-ancient forms of permanent body ornamentation (body art) have today become popular fashion accessories worldwide. More than 50% of all tattoos are being done on women. ⋯ Although, the potential hazards of regional anesthesia in patients with lumbar tattoos remain controversial it may seem prudent to avoid a hollow needle insertion (possible tissue entrapment in its bore as the needle passes to the deeper structures) through a tattoo for neuraxial blocks. This author is not aware of any other review articles in English literature discussing implications, and complications of labor analgesia in parturients presenting with lumbar tattoos.