American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Jul 2001
Randomized Controlled Trial Clinical TrialA randomized controlled trial of fentanyl for abortion pain.
Our aim was to find out whether intravenous fentanyl was effective in reducing the pain of first-trimester abortion. ⋯ Fentanyl, when compared with the placebo, reduced abortion pain by 1.0 point on an 11-point scale. This reduction was of questionable clinical significance and was less than desired by the women included in the study.
-
Am. J. Obstet. Gynecol. · Jul 2001
Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study.
Among women diagnosed with pelvic inflammatory disease, we examined the associations between hormonal or barrier methods of contraception and upper genital tract infection or inflammation. ⋯ No hormonal or barrier contraceptive method was related to a reduction in upper genital tract disease among women with clinical pelvic inflammatory diseases.
-
Am. J. Obstet. Gynecol. · Jul 2001
Comparative StudyHeparin-induced thrombocytopenia is rare in pregnancy.
The indications for heparin use during pregnancy are expanding; however, heparin is associated with serious adverse effects including heparin-induced thrombocytopenia. Low-molecular-weight heparin is expensive but is associated with less frequent occurrences of heparin-induced thrombocytopenia in the nonpregnant population. However, the incidence of heparin-induced thrombocytopenia during pregnancy is unknown. The purpose of this study was to compare the incidence of heparin-induced thrombocytopenia in pregnant and nonpregnant women. ⋯ Heparin-induced thrombocytopenia is extremely rare in pregnant women.
-
Am. J. Obstet. Gynecol. · Jul 2001
Assessing symptoms before hysterectomy: is the medical record accurate?
Our purpose was to evaluate the agreement between the documentation of symptoms leading to hysterectomy and the assessment of those symptoms by the patient. ⋯ Physician overestimation of symptoms could lead to overuse of hysterectomy, whereas underestimation could result in underuse. Our results suggest that both underestimation and overestimation occur for patients with abnormal bleeding, pain, or both. If physicians accurately assess symptoms but fail to document them, examinations of appropriateness will be faulty unless patients are interviewed.
-
Am. J. Obstet. Gynecol. · Jul 2001
Does epidural analgesia prolong labor and increase risk of cesarean delivery? A natural experiment.
More than 50% of pregnant women in the United States are using epidural analgesia for labor pain. However, whether epidural analgesia prolongs labor and increases the risk of cesarean delivery remains controversial. ⋯ Epidural analgesia during labor does not increase the risk of cesarean delivery, nor does it necessarily increase oxytocin use or instrumental delivery caused by dystocia. The duration of the active phase of labor appears unchanged, but the second stage of labor is likely prolonged. (Am J Obstet Gynecol 2001;185:128-34).