American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jul 1993
Comparative StudyVariation in hysterectomy rates across small geographic areas of Massachusetts.
Our objective was to determine whether small-area variation in hysterectomy rates exists within Massachusetts and, if so, whether regions with persistently high or low rates can be identified. ⋯ Possible explanations for these rate variations include indigenous population factors, supply of health care resources, income, insurance coverage, methodological problems in data analysis, and variation in professional judgment with regard to the indication for hysterectomy. Only a combination of the study of local causes of high and low rates and the study of the clinical outcomes of different treatment decisions will allow physicians to develop an informed consensus on appropriate indications for surgery.
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Am. J. Obstet. Gynecol. · Jun 1993
The use of fine-needle aspiration in the evaluation of persistent palpable dominant breast masses.
Our purpose was to determine if fine-needle aspiration can decrease the necessity for open surgical biopsy in the diagnosis of a persistent palpable dominant breast mass. ⋯ Fine-needle aspiration of persistent palpable dominant breast masses allows expeditious and potentially cost-effective management of most cases and decreases the necessity of open surgical biopsy for definitive diagnosis.
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Am. J. Obstet. Gynecol. · May 1993
Frequency of glove perforations and subsequent blood contact in association with selected obstetric surgical procedures.
One purpose of this prospective investigation was to assess the frequency of glove perforations and subsequent blood contact associated with selected obstetric procedures. The second purpose was to assess the relative risk of perforation among different members of the surgical team and determine if time of day or urgency of the procedure affected the frequency of perforation. ⋯ Glove perforations occur in approximately 12% of obstetric surgical procedures. Surgical nurses are at greatest risk for perforation. Double gloving reduces the likelihood of penetrating injury to the inner glove and subsequent risk of blood contact.
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Am. J. Obstet. Gynecol. · May 1993
Effect of rapid intravenous crystalloid infusion on uteroplacental blood flow and placental implantation-site oxygen delivery in the pregnant ewe.
Our purpose in this study was to investigate the effects of rapid intravenous crystalloid infusion on placental implantation-site blood flow and oxygen delivery in the near-term pregnant ewe. ⋯ Rapid intravenous crystalloid infusion selectively increases placental implantation-site blood flow in the near-term pregnant ewe and may improve oxygen delivery to the fetus, especially if hemodilution occurs.
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Am. J. Obstet. Gynecol. · Mar 1993
Multicenter StudyIncreased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant therapy.
The null hypothesis of our study is that the incidence of vitamin K deficiency in mother-infant pairs exposed to anticonvulsant drugs is not higher than in controls. ⋯ The incidence of vitamin K deficiency is increased in neonates exposed to anticonvulsant drugs prenatally. Their mothers, however, are rarely vitamin K deficient.