American journal of obstetrics and gynecology
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Our goal was to design an inexpensive amniocentesis trainer for instruction and practice with ultrasonography-assisted needle guidance and the freehand technique. ⋯ We were able to construct an inexpensive amniocentesis trainer that facilitates instruction in the freehand amniocentesis technique. This trainer enables an operator to master the skills necessary to perform the technique of freehand ultrasonography-guided amniocentesis under direct ultrasonographic visualization without putting a patient through the discomfort of participating in the learning curve.
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Am. J. Obstet. Gynecol. · Oct 1998
Cost-effective delivery management of the vertex and nonvertex twin gestation.
The aim of the study was to determine the most cost-effective delivery management of vertex and nonvertex twin pair gestations. ⋯ There is no medical consensus regarding delivery management for vertex and nonvertex presenting twin pairs. When hospital charges are examined with clinical data, however, breech extraction of the nonvertex second twin is the most cost-effective delivery management strategy.
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The object was to determine the recurrence rate of gestational diabetes mellitus and to find various risk factors that might increase this rate. ⋯ Gestational diabetes mellitus is more likely to recur in parous, obese women who had an early gestational diabetes mellitus diagnosis and required insulin in the index pregnancy. In addition, a shorter interval (< or = 24 months) and a larger weight gain (> or = 15 pounds) between pregnancies appear to be the most significant risk factors for a recurrence of gestational diabetes mellitus.
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Am. J. Obstet. Gynecol. · Sep 1998
Clinical Trial Controlled Clinical TrialA "bloodless cesarean section" and perinatal transmission of the human immunodeficiency virus.
Perinatal transmission of the human immunodeficiency virus is the main pathway for children to become infected with this virus; however, the relative contribution and timing of this transmission, whether transplacental or by exposure through the birth process, have not yet been elucidated. An obvious question is whether the mode of delivery has an impact on this transmission rate. However, a routine cesarean section will primarily diminish the duration of exposure of maternal bodily fluids to the neonate but does not prevent the baby from being exposed to maternal blood coming from the uterine incision. The purpose of this study was to determine whether the rate of perinatal transmission of human immunodeficiency virus could be significantly lowered by delivering the baby with minimal to no exposure to maternal blood or bodily fluids by the use of a surgical technique termed a "bloodless cesarean section." ⋯ In the absence of zidovudine usage, these data show that 70% to 75% of the perinatal transmission of human immunodeficiency virus to a newborn occurs from exposure to maternal blood and bodily fluids at the time of birth. This information is important for patients unable to take zidovudine or other antiretroviral agents, but more important, it introduces the concept of other treatment options for the future.
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Am. J. Obstet. Gynecol. · Jul 1998
Randomized Controlled Trial Clinical TrialInduction of labor with misoprostol for premature rupture of membranes beyond thirty-six weeks' gestation.
Our purpose was to compare vaginally administered misoprostol (Cytotec) with intravenous oxytocin for labor induction in women with premature rupture of membranes beyond 36 weeks' gestation. ⋯ Vaginal administration of misoprostol (Cytotec) is an effective alternative to oxytocin infusion for labor induction in women with premature rupture of the membranes near term. The incidence of untoward effects is similar with use of the two agents.