American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Feb 2003
Mechanical ventilation in an obstetric population: characteristics and delivery rates.
The purpose of this study was to describe the characteristics and outcomes of obstetric patients who require mechanical ventilation. ⋯ A large number of obstetric patients who receive mechanical ventilation will require delivery because of their condition. Centers that care for such women should form a treatment strategy to coordinate obstetric and medical care for this unique population
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The practice of obstetrics has changed dramatically in the last decade. Evidence exists for a marked increase in professional dissatisfaction, substance abuse, poor personal relationships, and burnout. These conditions are now being seen in younger physicians and in training programs. ⋯ A potential solution for alleviating some of these conditions is the introduction of a physician whose sole focus of practice is managing the patient in labor. This physician, called the "laborist," may be able to improve patient care and satisfaction because the laborist will have no other distractions during this time. Also, the laborist will remove from the obstetrician the need to be always available to the laboring patient, which potentially may decrease stress, improve physician well-being, increase length of professional practice, and decrease burnout.
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Am. J. Obstet. Gynecol. · Jan 2003
Randomized Controlled Trial Clinical TrialFetal electrocardiography in labor and neonatal outcome: data from the Swedish randomized controlled trial on intrapartum fetal monitoring.
Cardiotocography plus automatic ST analysis of the fetal electrocardiography has been shown recently to reduce both the operative delivery rate for fetal distress and the cord artery metabolic acidosis rate. The purpose of this study was to analyze findings that were related to cases with a complicated/adverse neonatal outcome in the Swedish randomized controlled trial. ⋯ Cardiotocography plus ST analysis provides accurate information about intrapartum hypoxia and may prevent intrapartum asphyxia and neonatal encephalopathy by giving a clear alert to the staff members who are in charge.
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Am. J. Obstet. Gynecol. · Jan 2003
Randomized Controlled Trial Clinical TrialEndometritis does not predict reproductive morbidity after pelvic inflammatory disease.
We investigated the association between endometritis and reproductive morbidity. ⋯ Among women with clinically suspected mild-to-moderate PID treated with standard antibiotics, endometritis/UGTI was not associated with reproductive morbidity.
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Am. J. Obstet. Gynecol. · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialOral misoprostol or vaginal dinoprostone for labor induction: a randomized controlled trial.
The objective of the study was to compare the effectiveness, safety, and side effects of low-dose oral misoprostol with vaginal dinoprostone for cervical ripening and labor induction. ⋯ We found no difference in terms of effectiveness and safety between low-dose oral misoprostol and vaginal dinoprostone used for induction of labor. This regimen avoids the excessive uterine contractility noted in previous studies, where higher doses of misoprostol were administered at longer intervals.