American journal of obstetrics and gynecology
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The purpose of this study was to provide evidenced-based guidance for surgical decisions during cesarean delivery. ⋯ Cesarean delivery techniques that are supported by good quality recommendations should be performed routinely. All technical aspects that have recommendations with lower quality should be researched with adequately powered and designed trials.
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Am. J. Obstet. Gynecol. · Nov 2005
A new curriculum for hysteroscopy training as demonstrated by an objective structured assessment of technical skills (OSATS).
The purpose of this study was to develop an effective curriculum to teach hysteroscopy, as well as to develop an objective assessment instrument (OSATS). ⋯ This curriculum is an effective way to impart knowledge and skill in the assembly and use of the operative hysteroscope. The checklist developed for this OSATS has excellent reliability and construct validity.
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Am. J. Obstet. Gynecol. · Oct 2005
Case ReportsThe syndrome of amniotic fluid embolism: a potential contribution of bradykinin.
Amniotic fluid embolism is a potentially fatal complication of pregnancy; although several hypotheses have been formulated, the pathophysiology of this condition is not well known. An exaggerated release of bradykinin, which is activated by products of the amniotic fluid that enter the maternal circulation, could explain the symptoms that are present in amniotic fluid embolism. The objective of this study was to assess whether bradykinin is involved in amniotic fluid embolism. ⋯ This study suggests a potential role for bradykinin release in the pathophysiology of amniotic fluid embolism.
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Am. J. Obstet. Gynecol. · Sep 2005
Multicenter StudyProgesterone for prevention of recurrent preterm birth: impact of gestational age at previous delivery.
Preterm birth occurs in 1 of 8 pregnancies and may result in significant morbidity and mortality. 17-alpha hydroxyprogesterone caproate (17-OHP caproate) has been found to be efficacious in reducing the risk of subsequent preterm delivery in women who have had a previous spontaneous preterm birth (sPTB). This analysis was undertaken to evaluate if 17-OHP caproate therapy works preferentially depending on the gestational age at previous spontaneous delivery. We hypothesized that treatment with 17-OHP caproate is more effective in prolonging pregnancy depending on the gestational age of the earliest previous preterm birth (20-27.9, 28-33.9 vs 34-36.9 weeks). ⋯ 17-OHP caproate therapy given to prevent recurrent PTB is associated with a prolongation of pregnancy overall, and especially for women with a previous spontaneous PTB at <34 weeks.
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Am. J. Obstet. Gynecol. · Sep 2005
A comprehensive ethical framework for responsibly designing and conducting pharmacologic research that involves pregnant women.
We present and defend ethically justified guidelines for pharmacologic research that involves pregnant women. ⋯ The concept of the fetus as a patient plays an essential role in the ethically justified design and conduct of pharmacologic research in pregnant women.