Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Apr 2006
ReviewLabor analgesia for the parturient with neurological disease: what does an obstetrician need to know?
Several neurological disorders including multiple sclerosis, myasthenia gravis, epilepsy, spinal cord injury, and subarachnoid hemorrhage are encountered with increasing frequency in pregnant women worldwide. Although there is absence of uniform anesthetic guidelines for pregnant patients with most of these (and other) neurological disorders, and the decision whether or not to administer regional anesthesia is based on an individual risk-to-benefit ratio on a case-by-case basis, few of these disorders contraindicate the use of neuraxial anesthesia. This article attempts to review the specific concerns for administration of labor analgesia posed by multiple sclerosis, myasthenia gravis, epilepsy, paraplegia and subarachnoid hemorrhage.
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Arch. Gynecol. Obstet. · Apr 2006
Obstetric admissions to the intensive care unit: a 12-year review.
The objective was to ascertain the prevalence, causes and outcome of critically ill obstetric patients admitted to the intensive care unit (ICU). ⋯ A team approach consisting treatment by obstetricians, intensive care specialists and anaesthesiologists provided optimal care for the patients. Improved management strategies for obstetric haemorrhage and hypertension may significantly reduce maternal morbidity.
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Arch. Gynecol. Obstet. · Mar 2006
Review Case ReportsAnesthesia for the repeat cesarean section in the parturient with abnormal placentation: what does an obstetrician need to know?
Placenta accreta is an abnormal adherence of the placenta to the uterine wall owing to an absent or faulty decidua basalis. The incidence of this devastating problem is increasing secondary to the increased incidence of Cesarean section. Although rare, the diagnosis of placenta accreta may lead to life-threatening complications (e.g., fatal hemorrhage) and significantly impact the obstetric and anesthetic management of these parturients. I herein present the case of a pregnant patient with abnormal placentation and review the current state-of-the-art obstetric and anesthetic management of this complication.
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Arch. Gynecol. Obstet. · Feb 2006
Review Case ReportsSuccessful of the B-Lynch compression suture in the management of massive postpartum hemorrhage: case reports and review.
The authors describe three patients who developed massive primary postpartum hemorrhage and review the case reports. In two patients, primary postpartum hemorrhage was due to uterine atony, and in one patient it was due to atony and thrombophilia. ⋯ B-Lynch suture is an efficient, safe, and simple method for the treatment of primary postpartum hemorrhage during cesarean section, which successfully reduces the number of urgent postpartum hysterectomies, also preserving subsequent fertility. In our opinion, the method should be included in the algorithm of primary postpartum hemorrhage management at all obstetric departments.
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Arch. Gynecol. Obstet. · Feb 2006
Comparative StudyPrelabor rupture of membranes at term in low-risk women: induce or wait?
To compare the outcomes of expectant versus induction of labor management of patients presenting with prelabor rupture of membranes (PROM) at term. ⋯ In the absence of other obstetric and maternal or fetal risk factors, PROMs at term does not seem to constitute additional obstetric risks. Furthermore, expectant management of PROM at term enhances the patient's chance of normal vaginal delivery without an increase in fetal and/or maternal morbidity.