American journal of obstetrics and gynecology
-
Our purpose was to identify what anesthetic method is safer for women with a placenta previa. ⋯ In women with placenta previa, general anesthesia increased intraoperative blood loss and the need for blood transfusion. Regional anesthesia appears to be a safe alternative.
-
Am. J. Obstet. Gynecol. · Jun 1999
Comparative StudyBloodless surgery: establishment of a program for the special medical needs of the Jehovah's witness community--the gynecologic surgery experience at a community hospital.
My purpose was to describe the rationale behind the establishment of a hospital-based program instituted to enhance the health of the Jehovah's Witness community and to evaluate patient profiles and outcomes of gynecologic patients treated surgically at our institution, during the past 5 years, whose intake was through the Bloodless Surgery Program and who were not accepting of blood or most blood products. I further describe how a coordinated program dedicated to serving this particular population might improve outcomes and patient satisfaction. ⋯ A program dedicated to the special needs of the Jehovah's Witness community can be instituted in a community-based hospital with no evidence of increased morbidity, as evidenced by length of stay, hospital charges, and surgical blood loss, in a gynecologic patient population. Development of such programs is associated with a high level of patient satisfaction and the potential for improved patient care.
-
Am. J. Obstet. Gynecol. · Jun 1999
Smoking and use of oral contraceptives: impact on thrombotic diseases.
The study was intended to evaluate the effects of oral contraceptives and smoking on the risks of arterial and venous thromboembolic diseases among young women. ⋯ Among the formulations currently marketed in Denmark, where only the progestins desogestrel and gestodene are available with low-dose (20 micrograms) ethinyl estradiol (and only desogestrel was available in that form at the time of our studies), we prefer these third-generation oral contraceptives for smokers. We might also consider such oral contraceptives for women >35 years old as long as they had no other risk factors for thrombotic arterial diseases.
-
Am. J. Obstet. Gynecol. · Jun 1999
Effects of obstetrician characteristics on cesarean delivery rates. A community hospital experience.
Despite a decrease in the overall cesarean delivery rate at Ravenswood Hospital Medical Center in Chicago, a wide range of variation existed among individual obstetricians' rates. This study evaluated obstetricians' characteristics to determine whether they affected cesarean delivery rates. ⋯ Cesarean delivery rates can safely be reduced. Certain individual obstetrician characteristics influence cesarean delivery rates. Obstetricians' commitment facilitates lowering of cesarean delivery rates.
-
Am. J. Obstet. Gynecol. · May 1999
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of orally administered misoprostol with vaginally administered misoprostol for cervical ripening and labor induction.
Our purpose was to compare orally administered with vaginally administered misoprostol for cervical ripening and labor induction. ⋯ Oral administration of 50-microgram doses of misoprostol appears less effective than vaginal administration of 25-microgram doses of misoprostol for cervical ripening and labor induction. Further investigation is needed to determine whether orally administered misoprostol should be used for cervical ripening and labor induction.