American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 2015
Multicenter StudyMagnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study.
The purpose of this study was to determine the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis during pregnancy in a multiinstitutional study. ⋯ MRI is useful and reproducible in the diagnosis of suspected acute appendicitis during pregnancy.
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Am. J. Obstet. Gynecol. · Nov 2015
Comparative StudyLaparoscopic and robot-assisted hysterectomy for uterine cancer: a comparison of costs and complications.
Increasingly, robotic surgery is being used for total hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for uterine cancer. The purpose of this study was to compare the costs and complications among women undergoing robotic and laparoscopic hysterectomy for uterine cancer. ⋯ Despite the considerably greater burden of comorbidities in those undergoing robotic surgery compared with laparoscopy, the former have shorter hospital admissions, a greater rate of lymph node dissection, and similar postoperative morbidity and mortality, albeit at greater total cost.
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Am. J. Obstet. Gynecol. · Nov 2015
Characterization of the host inflammatory response following implantation of prolapse mesh in rhesus macaque.
We sought to determine the predominant cell type (macrophage, T lymphocyte, B lymphocyte, mast cell) within the area of implantation of the prototypical polypropylene mesh, Gynemesh PS (Ethicon, Somerville, NJ); and to determine the phenotypic profile (M1 proinflammatory, M2 antiinflammatory) of the macrophage response to 3 different polypropylene meshes: Gynemesh PS (Ethicon), and 2 lower-weight, higher-porosity meshes, UltraPro (Ethicon) and Restorelle (Coloplast, Humblebaek, Denmark). ⋯ The host response to mesh consists predominantly of activated, proinflammatory M1 macrophages at 12 weeks postsurgery. However, this response is attenuated with implantation of lighter-weight, higher-porosity mesh. While additional work is required to establish causal relationships, these results suggest a link among the host inflammatory response, mesh textile properties, and clinical outcomes in the repair of pelvic organ prolapse.
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Am. J. Obstet. Gynecol. · Nov 2015
The association between maternal antioxidant levels in midpregnancy and preeclampsia.
We sought to determine whether midpregnancy antioxidant levels are associated with preeclampsia, overall and by timing of onset. ⋯ Most antioxidants were more strongly associated with early-onset preeclampsia, suggesting that oxidative stress may play a greater role in the pathophysiology of early-onset preeclampsia. Alternatively, reverse causality may explain this pattern. Lutein was associated with both early- and late-onset preeclampsia and may be a promising nutrient to consider in preeclampsia prevention trials, if this finding is corroborated.
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Am. J. Obstet. Gynecol. · Nov 2015
Randomized Controlled TrialEffects of dexamethasone on quality of recovery following vaginal surgery: a randomized trial.
Dexamethasone is a corticosteroid with minimal side effects that may improve quality of recovery. We sought to evaluate standard use of this medication prior to vaginal reconstructive surgery. ⋯ Use of dexamethasone prior to vaginal reconstructive surgery was associated with less nausea/vomiting and need for antiemetics as well as greater success with voiding trials. Furthermore, quality of recovery was enhanced, suggesting use of dexamethasone should be considered for these patients.