American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · May 2004
A hospital-sponsored quality improvement study of pain management after cesarean delivery.
We undertook this study to systematically assess prevailing pain management regimes used at our hospital in women after cesarean delivery. ⋯ Pain relief was superior with the morphine regimens used and was positively associated with breastfeeding and infant rooming-in.
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Am. J. Obstet. Gynecol. · May 2004
Comparative StudyEmergency peripartum hysterectomy: a comparison of cesarean and postpartum hysterectomy.
The purpose of this study was to evaluate the incidence, risk factors, indications, outcomes, and complications of emergency hysterectomy performed after cesarean deliveries (cesarean hysterectomy) and vaginal deliveries (postpartum hysterectomy). ⋯ Uterine atony is the leading indication for emergency hysterectomy performed following cesarean and vaginal deliveries.
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Am. J. Obstet. Gynecol. · Apr 2004
Is antenatal vitamin K prophylaxis needed for pregnant women taking anticonvulsants?
The objective of this cohort study of a consecutive sample of infants exposed during pregnancy to anticonvulsant drugs was to determine if the mother received late pregnancy prophylaxis with vitamin K, and if any infants had signs of hemorrhagic disease. The medical records of 204 neonates exposed to anticonvulsant drugs in utero and 77 unexposed control neonates were retrospectively reviewed. No hemorrhagic disease was observed, and the incidence of bleeding tendencies was not higher in infants exposed to these drugs compared with control infants, despite no prenatal vitamin K supplementation in all but 1 epileptic woman.
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Am. J. Obstet. Gynecol. · Mar 2004
Diet-controlled gestational diabetes mellitus does not influence the success rates for vaginal birth after cesarean delivery.
We sought to determine whether women with diet-controlled gestational diabetes mellitus who attempt vaginal birth after cesarean delivery are at increased risk of failure, when compared with their non-diabetic counterparts. ⋯ Women with diet-controlled gestational diabetes mellitus who were carrying singleton fetuses who had no more than 1 previous low flap cesarean delivery should be counseled that their disease does not decrease their chances for a successful vaginal birth after cesarean delivery. Among diet-controlled diabetic women, the overall success rate for vaginal birth after cesarean delivery remains acceptable, and attempted vaginal birth after cesarean delivery should not be discouraged solely on the basis of gestational diabetes mellitus.
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Am. J. Obstet. Gynecol. · Feb 2004
Methods of assessment of the arterial pulse wave in normal human pregnancy.
The study was undertaken to obtain normal values for characteristics of the peripheral arterial pulse wave, in nonpregnant women and in pregnant women at three different stages of gestation, with two devices, to describe cardiovascular hemodynamic variables induced by pregnancy. ⋯ The clinical findings confirm the known cardiovascular changes of pregnancy associated with vasodilatation of peripheral vessels and expansion of blood volume. The fall in augmentation pressure and index are consistent with these changes. Rapid ejection time and the time from the start of the arterial waveform to the second peak/shoulder, which should reflect similar cardiovascular physiologic events, were weakly correlated.