American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Feb 2003
Cohort study of maternal views on future mode of delivery after operative delivery in the second stage of labor.
The purpose of this study was to assess maternal views on the future mode of delivery after either previous instrument vaginal delivery or cesarean delivery at full dilatation. ⋯ A high proportion of women who have had a previous difficult instrument vaginal delivery would still prefer vaginal delivery in a future pregnancy.
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The purpose of this study was to describe our 2-year experience with 483 critically ill peripartum women and to propose a blueprint for obstetric critical care. ⋯ An Obstetric Intermediate Care Unit allows for the continuation of care by obstetricians and results in fewer transfers to medical/surgical intensive care units. Patient treatment depends on hospital size and available resources. In most tertiary centers, the critically ill pregnant woman is best cared for by obstetricians in an Obstetric Intermediate Care Unit. In smaller hospitals, transfer to a medical or surgical intensive care unit may be preferable.
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Am. J. Obstet. Gynecol. · Feb 2003
Mechanical ventilation in an obstetric population: characteristics and delivery rates.
The purpose of this study was to describe the characteristics and outcomes of obstetric patients who require mechanical ventilation. ⋯ A large number of obstetric patients who receive mechanical ventilation will require delivery because of their condition. Centers that care for such women should form a treatment strategy to coordinate obstetric and medical care for this unique population
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The practice of obstetrics has changed dramatically in the last decade. Evidence exists for a marked increase in professional dissatisfaction, substance abuse, poor personal relationships, and burnout. These conditions are now being seen in younger physicians and in training programs. ⋯ A potential solution for alleviating some of these conditions is the introduction of a physician whose sole focus of practice is managing the patient in labor. This physician, called the "laborist," may be able to improve patient care and satisfaction because the laborist will have no other distractions during this time. Also, the laborist will remove from the obstetrician the need to be always available to the laboring patient, which potentially may decrease stress, improve physician well-being, increase length of professional practice, and decrease burnout.