Current opinion in obstetrics & gynecology
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Curr. Opin. Obstet. Gynecol. · Dec 1991
ReviewAdvances in anesthesia and pharmacology in the puerperium.
The past year has provided us with some interesting studies concerning pharmacology and anesthesia during the puerperium. I review the prevalence of various anesthetic techniques, as well as the use of different aspiration prophylaxis regimens. I also look at innovations in the administration of epidural and subarachnoid anesthetics, including use of the Sprotte needle to prevent postoperative headache. ⋯ Furthermore, predelivery injections of glucocortoid may protect against bronchopulmonary dysplasia. I also review painstaking studies that help to better understand thyroid stimulation and regulation during pregnancy. I hope this paper helps the busy obstetrician understand some of the highlights of this year's new literature on obstetric anesthesia and pharmacology.
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Decisions about the role of cesarean section, forceps, and vacuum delivery in obstetrics continue to be a challenging part of daily obstetric practice. Five interesting papers on this topic are reviewed, including a comparison of international rates of cesarean sections and vaginal births after cesarean section, the method of choice for the delivery of the low-birth-weight fetus presenting as vertex, the advantages of a prelabor cesarean section for a fetus diagnosed with meningomyelocele, and the appropriate role for the midforceps delivery in the 1990s.