American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Dec 1999
Comparative StudyCesarean delivery risk adjustment for regional interhospital comparisons.
The aim of this study was to determine the effect of adjustment for patient population mix on observed, expected, and standardized cesarean delivery rates in regional hospitals. ⋯ Compared with using observed (crude) cesarean delivery rates, adjustment for differences in patient risk factor mix facilitates more accurate comparison of cesarean delivery rates among hospitals within a region.
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Am. J. Obstet. Gynecol. · Dec 1999
Randomized Controlled Trial Clinical TrialA randomized, controlled trial of a eutectic mixture of local anesthetic cream (lidocaine and prilocaine) versus penile nerve block for pain relief during circumcision.
We set out to compare a eutectic mixture of local anesthetic cream (lidocaine and prilocaine) to dorsal penile nerve block with lidocaine for anesthesia during circumcision. ⋯ Distress scores and heart rates were significantly higher in infants treated with the anesthetic mixture than in infants treated with lidocaine. Dorsal penile nerve block with lidocaine is a more efficacious means of providing anesthesia for neonatal circumcision than the mixture of local anesthetics.
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Am. J. Obstet. Gynecol. · Dec 1999
Meta AnalysisPerinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis.
Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score <7, and umbilical arterial pH <7.00 in patients with antepartum or intrapartum amniotic fluid index >5.0 or <5.0 cm. ⋯ An antepartum or intrapartum amniotic fluid index of
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Am. J. Obstet. Gynecol. · Dec 1999
Intravenous infusion of magnesium sulfate and regional redistribution of fetal blood flow during maternal hemorrhage in late-gestation gravid ewes.
Even though magnesium sulfate is commonly prescribed for women with preeclampsia as prophylaxis against seizure and for women with preterm labor as a tocolytic agent there is limited information about its effects on the fetus. It is of particular concern that women with preeclampsia or in premature labor are at high risk for abruptio placentae with consequent compromise of fetal oxygenation. Magnesium sulfate is a vasodilator and thus may exert cardiovascular effects on the fetus. The goal of this study was to evaluate the effects of magnesium sulfate on fetal organ blood flow, especially regional cerebral blood flow, during the stressful condition of maternal hemorrhage. ⋯ In these initially healthy, late-gestation fetal lambs magnesium sulfate exposure did not impair cardiac output redistribution, nor did it cause fetal death in response to maternal hemorrhage.
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Am. J. Obstet. Gynecol. · Dec 1999
Atopy, the use of condoms, and a history of cesarean delivery: potential predisposing factors for latex sensitization in pregnant women.
Our purpose was to assess the prevalence of latex sensitization among women admitted for delivery and the relevant risk factors. ⋯ Given a prevalence of 2.7% of latex sensitization, all obstetric patients should be questioned about known immediate allergic reaction to latex, a predisposition to atopy, previous intra-abdominal operations, and the regular use of condoms in the past. Patients with atopy and additive risk factors should be treated in a latex-free environment.