American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jan 2004
Dystocia in nulliparous patients monitored with fetal pulse oximetry.
A critical analysis of the United States randomized controlled trial of fetal pulse oximetry concluded that nonreassuring fetal heart rate patterns used for study entry may have been a marker for dystocia. We prospectively studied nulliparous women in labor whose progress was monitored with fetal pulse oximetry to examine the relationship between nonreassuring fetal heart rate patterns and operative delivery for dystocia. ⋯ Significantly nonreassuring fetal heart rate patterns predict cesarean delivery for dystocia among nulliparous patients with normally oxygenated fetuses in a setting of a standardized labor management protocol. This confirms the observations in the randomized controlled trial of fetal pulse oximetry in the United States and may provide insight into the treatment of nonprogressive labor in contemporary practice.
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Am. J. Obstet. Gynecol. · Jan 2004
Case ReportsSubcapsular liver hematoma in HELLP syndrome: Evaluation of diagnostic and therapeutic options--a unicenter study.
Subcapsular liver hematoma formation has been reported in less than 2% of pregnancies complicated by HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. The purpose of this study was to identify the main diagnostic and therapeutic options for management of these patients. ⋯ The case series shows the full diagnostic spectrum with transabdominal ultrasound, computed tomography, and magnetic resonance imaging, as well as the different therapeutic options varying from conservative therapy to operative management, including liver transplantation.
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Am. J. Obstet. Gynecol. · Jan 2004
Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight.
The purpose of this study was to determine the incidence of neurologic morbidity in preterm monochorionic (MC) and dichorionic (DC) twins. ⋯ Neurologic morbidity in the preterm MC infants was 7-fold higher than DC infants because of chronic TTTS, discordant birth weight, and cotwin death in utero.
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Am. J. Obstet. Gynecol. · Dec 2003
Comparative StudyThe safety of incidental appendectomy at the time of abdominal hysterectomy.
The purpose of this study was to assess the complication rates of incidental appendectomies in women who undergo benign gynecologic procedures. ⋯ An incidental appendectomy at the time of benign gynecologic procedures does not increase postoperative complication rates or length of hospital stay. The inclusion of incidental appendectomies in all abdominal hysterectomies could potentially decrease the morbidity and mortality rates because of appendicitis in elderly women.
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Am. J. Obstet. Gynecol. · Dec 2003
Comparative StudyAnatomy of ilioinguinal and iliohypogastric nerves in relation to trocar placement and low transverse incisions.
The purpose of this study was to map the course of the ilioinguinal and iliohypogastric nerves. ⋯ Abdominal wall surgical sites below the level of the anterior superior iliac spine have the potential for ilioinguinal or iliohypogastric injury.