American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsEffect of mitral valve prosthetic surgery on the outcome of a growth-retarded fetus. A case report.
Mitral valve prosthetic surgery was performed at 29 weeks' gestation in a woman who had reoperation for a thrombotic mitral valve prosthesis and pulmonary edema. Concomitant severe preeclampsia was also present. During operation fetal bradycardia developed and the fetus died. Because the findings differ from those previously reported with regard to normal pregnancies, their implications are discussed.
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Am. J. Obstet. Gynecol. · Aug 1990
The impact of a quality assurance process on the frequency and confirmation rate of hysterectomy.
A criteria-based quality assurance process for hysterectomy was instituted at a large teaching hospital. After this process was initiated, the overall frequency of hysterectomy decreased by 24%, p less than 0.001. Significant reductions were seen in hysterectomy rates for the following indications: chronic pelvic pain (77%, p less than 0.0001), recurrent uterine bleeding (46%, p less than 0.001), preinvasive disease of the uterus (55%, p less than 0.005), and severe infection (70%, p less than 0.025). ⋯ This increase, however, was completely reversed during the last 2 years of the study. This quality assurance process also resulted in a significant increase in the histologic verification rate (i.e., 82% vs 93%, p less than 0.001). These observations suggest that using such a criteria-based process can reduce the number of hysterectomies performed and improve the accuracy of the preoperative diagnosis.
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsDiabetic ketoacidosis and insulin resistance with subcutaneous terbutaline infusion: a case report.
Diabetic ketoacidosis may occur in women treated with intravenous beta-sympathomimetic agents for tocolysis. We describe diabetic ketoacidosis and transient severe insulin resistance in a woman with diabetes who was treated with subcutaneous terbutaline infusion. Subcutaneous terbutaline infusion may precipitate transient insulin resistance and diabetic ketoacidosis in women with diabetes.
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsSuccessful treatment of postpartum shock caused by amniotic fluid embolism with cardiopulmonary bypass and pulmonary artery thromboembolectomy.
We report the successful treatment of a moribund patient as a result of amniotic fluid embolism with cardiopulmonary bypass and open pulmonary artery thromboembolectomy. Review of the literature indicates that this is the first reported case of treatment of amniotic fluid embolism with cardiopulmonary bypass and pulmonary thromboembolectomy.
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsRupture of unscarred uterus in primigravid woman in association with cocaine abuse.
Cocaine use in pregnancy has been associated with preterm labor and abruptio placentae. We report a case of rupture of an unscarred uterus necessitating hysterectomy in a patient after cocaine abuse.