American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2010
Randomized Controlled TrialRandomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery.
The purpose of this study was to determine the wound complication rates and patient satisfaction for subcuticular suture vs staples for skin closure at cesarean delivery. ⋯ Use of staples for cesarean delivery closure is associated with an increased risk of wound complications. Occurrence of a wound complication is the most important factor that influenced patient satisfaction.
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Am. J. Obstet. Gynecol. · Sep 2010
Reviewvon Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment.
von Willebrand disease is caused by either a quantitative or qualitative defect in von Willebrand factor (VWF). Patients may have extensive mucosal bleeding (because of platelet dysfunction) and prolonged bleeding after surgery (because of factor VIII deficiency). Up to 6 different subtypes of the disease have been described, and diagnosis is based on clinical suspicion and laboratory confirmation. ⋯ The mainstays of therapy are desmopressin and plasma concentrates that contain von Willebrand factor. Delayed postpartum hemorrhage may occur, despite adequate prophylaxis. Frequent monitoring and continued prophylaxis and/or treatment are recommended for at least 2 weeks after delivery.
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Am. J. Obstet. Gynecol. · Sep 2010
Loop electrosurgical excision procedure with an intrauterine device in place.
Patients using an intrauterine device (IUD) who require a loop electrosurgical excision procedure (LEEP) for cervical dysplasia have traditionally had the IUD removed prior to the procedure. The only other options have been methods that lead to suboptimal sampling or risk cutting the strings. Our study suggests a procedure for performing the LEEP without removing the IUD, and review of the literature suggests that this method has not been reported before. ⋯ Ferric subsulfate is applied to the operative area to provide continued hemostasis. Follow-up for the LEEP is unchanged. This procedure may be performed on either levonorgestrel-releasing or copper IUDs.
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Am. J. Obstet. Gynecol. · Sep 2010
Anesthesia complications during scheduled cesarean delivery for morbidly obese women.
We sought to estimate the morbidity associated with regional anesthesia in morbidly obese women undergoing scheduled cesarean delivery. ⋯ Morbidly obese women have significant risk for anesthesia complications during cesarean delivery.