American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Dec 2011
Association between preterm delivery and subsequent C-reactive protein: a retrospective cohort study.
We sought to determine whether giving birth preterm is associated with raised maternal C-reactive protein (CRP) in later life and whether the association is specific to indicated or spontaneous delivery. ⋯ Women who undergo indicated preterm delivery are at increased risk of raised CRP in later life.
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Am. J. Obstet. Gynecol. · Dec 2011
ReviewCutting-edge advances in the medical management of obstetrical hemorrhage.
Hemorrhagic shock is the most common form of shock encountered in obstetric practice. Interventions that may limit transfusion requirements include normovolemic hemodilution, use of recombinant activated factor VII, selective embolization of pelvic vessels by interventional radiology, and the use of the cell saver intraoperatively. Current understanding of the mechanisms of acute coagulopathy calls into question the current transfusion guidelines, leading to a tendency to apply massive transfusion protocols based on hemostatic resuscitation despite lack of prospective data.
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Placental mesenchymal dysplasia is a benign condition that can be confused with a molar pregnancy by ultrasound scanning and gross examination. Conservative management should be considered with a normal-appearing singleton fetus and a cystic-appearing placenta. We present a case of placental mesenchymal dysplasia with a favorable outcome.
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Obstetrician/gynecologists often are the initial management clinicians for pelvic neuropathic pain. Although treatment may require comprehensive team management and consultation with other specialists, there are a few critical and basic steps that can be performed during an office visit that offer the opportunity to improve quality of life significantly in this patient population. ⋯ Experimental methods to characterize more precisely the nature of the nerve dysfunction exist to diagnose and treat neuropathic pain; however, additional scientific evidence is needed to recommend these options unanimously. In the meantime, an approach that was adopted from guidelines of the International Association for the Study of Pain has been tailored for gynecologic pain.
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Am. J. Obstet. Gynecol. · Nov 2011
Anesthetic management as a risk factor for postpartum hemorrhage after cesarean deliveries.
This population-based study aimed to compare the risk of postpartum hemorrhage (PPH) for patients who underwent cesarean section delivery (CS) with general vs spinal/epidural anesthesia. ⋯ The odds that women will experience cesarean PPH with general anesthesia are approximately 8.15 times higher than for women who undergo CS with epidural anesthesia.