American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Mar 1993
Umbilical pressure measurement in the evaluation of nonimmune hydrops fetalis.
Nonimmune hydrops fetalis continues to have a perinatal mortality rate > 50%. Although many abnormalities are associated with nonimmune hydrops fetalis, the direct mechanism by which the hydrops occurs is often obscure, even after delivery. There are at least three possible mechanisms for hydrops: heart failure (whether primary or a secondary effect of obstructed venous return), lymphatic malformation, and liver or peritoneal disease. The development of safe access to the fetal circulation by cordocentesis allows for the measurement of the umbilical venous pressure, which is closely related to the fetal central venous pressure. The premise that nonimmune hydrops fetalis of cardiac origin could be distinguished from that of noncardiac origin was examined by measuring the umbilical venous pressure. ⋯ This is the first report where the measurement of umbilical venous pressure was applied to the evaluation of nonimmune hydrops fetalis. Cardiac dysfunction was the most common mechanism causing hydrops. The finding of a normal umbilical venous pressure greatly reduces the likelihood that the heart is the cause of the hydrops, even when there is a coexistent heart malformation. This immediate information allows the practitioner either to focus on therapeutic interventions that might lower the umbilical venous pressure or to look for noncardiac causes for the hydrops.
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Am. J. Obstet. Gynecol. · Feb 1993
Randomized Controlled Trial Clinical TrialThe effects of cold therapy on postoperative pain in gynecologic patients: a prospective, randomized study.
The purpose of the study was to determine the effect of cold therapy on the subjective assessment of pain, analgesic requirements, and wound complications in female patients undergoing major abdominal surgery. ⋯ We conclude that the cold pack does not improve postoperative pain control in gynecologic patients undergoing exploratory laparotomy.
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Am. J. Obstet. Gynecol. · Feb 1993
Comparative StudyA five-year experience with second-trimester induced abortions: no increase in complication rate as compared to the first trimester.
Our purpose was to compare the complication rate of first-trimester suction curettage with that of second-trimester dilation-and-evacuation abortions in the same clinical setting. ⋯ A careful approach to second-trimester dilation-and-evacuation procedures can make them comparatively as safe as suction curettages, contrary to common belief derived from large surveys done in the late 1970s.
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Am. J. Obstet. Gynecol. · Dec 1992
Comparative StudyIncreased risk for polycystic ovary syndrome associated with human leukocyte antigen DQA1*0501.
The objective of this investigation was to identify genes that confer susceptibility to polycystic ovary syndrome. ⋯ These data suggest that a polycystic ovary syndrome susceptibility allele is linked to human leukocyte antigen and that the susceptibility allele is recessive.
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Am. J. Obstet. Gynecol. · Nov 1992
Randomized Controlled Trial Comparative Study Clinical TrialChanges in coagulation and anticoagulation in women taking low-dose triphasic oral contraceptives: a controlled comparative 12-month clinical trial.
The effects of two triphasic oral contraceptives on coagulation and anticoagulation factors were compared in a 12-month open-label study. ⋯ Levonorgestrel plus ethinyl estradiol and norethindrone plus ethinyl estradiol had equivalent, minimal effects on hemostasis, and changes in coagulation factors appeared to be balanced by changes in anticoagulation factors.