American journal of obstetrics and gynecology
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We sought to characterize the distribution of the pudendal nerve branches and to correlate findings with injury risk related to common midurethral sling procedures. ⋯ The clitoral and perineal branches of the pudendal nerve should be at low risk of direct nerve injury during midurethral slings and similar procedures as they course caudal to the ventral portion of the perineal membrane. The inferior rectal nerve might be at risk of injury during procedures that involve passage of needles through the ischioanal fossa.
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Postoperative intestinal care after major gynecologic surgery has changed considerably. The purpose of this review was to describe these changes. Our findings are that (1) preoperative mechanical bowel preparation does not lower the risk of anastomotic leakage and infection, (2) elective postoperative nasogastric tube decompression increases postoperative pneumonia and does not decrease the incidence of other postoperative complications, (3) early feeding after major gynecologic surgery reduces hospital stay and does not increase (and may decrease) pneumonia and other postoperative complications, and (4) early feeding, gum chewing, bowel stimulation, alvimopan, and ketorolac may decrease the incidence of postoperative ileus.
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Am. J. Obstet. Gynecol. · Oct 2011
Prediction of outcome in dichorionic twin pregnancies at 6-10 weeks' gestation.
The objective of the study was to predict the outcome of dichorionic (DC) twin pregnancies at 6-10 weeks' gestation from intertwin discordance in crown-rump length (CRL), heart rate (HR), and gestational sac diameter (GSD). ⋯ In DC twins, intertwin discordance in CRL and GSD at 6-10 weeks can predict outcome.