The journal of obstetrics and gynaecology research
-
J. Obstet. Gynaecol. Res. · Jul 2015
Adverse airway events in parturient compared with non-parturient patients. Is there a difference? Results from a quality management project.
The fear of airway problems often leads to prolonged attempts to obtain neuroaxial (spinal anesthesia or epidural anesthesia) anesthesia in obstetric anesthesia. The aim of this institutional quality management study was to revisit existing anesthesia care in the obstetric department, focusing on the frequency of delayed or failed neuroaxial anesthesia as well as the risk of airway problems in parturient and non-obstetric patients. ⋯ The rate of failed intubations in patients undergoing cesarean delivery may be equivalent to non-obstetric patients. In time-challenging cesarean deliveries, delay of conversion from non-successful neuroaxial anesthesia to general anesthesia in order to avoid adverse airway events does not appear to be justified.
-
J. Obstet. Gynaecol. Res. · Jul 2015
Comparative StudyNeuraxial blockade for external cephalic version: Cost analysis.
Neuraxial blockade (epidural or spinal anesthesia/analgesia) with external cephalic version increases the external cephalic version success rate. Hospitals and insurers may affect access to neuraxial blockade for external cephalic version, but the costs to these institutions remain largely unstudied. The objective of this study was to perform a cost analysis of neuraxial blockade use during external cephalic version from hospital and insurance payer perspectives. Secondarily, we estimated the effect of neuraxial blockade on cesarean delivery rates. ⋯ Neuraxial blockade is associated with minimal hospital and insurer cost changes in the setting of external cephalic version, while reducing the cesarean delivery rate.
-
J. Obstet. Gynaecol. Res. · May 2015
Hysteroscopic transcervical resection is useful to diagnose myometrial invasion in atypical polypoid adenomyoma coexisting with atypical endometrial hyperplasia or endometrial cancer with suspicious myometrial invasion.
Management of atypical polypoid adenomyoma (APAM) is complicated because it can sometimes coexist with atypical endometrial hyperplasia (AEH) or endometrioid adenocarcinoma. It is often difficult to assess myometrial invasion in APAM complicated with endometrial cancer. We encountered three patients who, contrary to magnetic resonance imaging, did not have myometrial invasion on hysteroscopic transcervical resection (TCR) and therefore could have fertility preserved, and consequently could become pregnant. ⋯ In patients with APAM and AEH or EMG1, TCR may aid accurate diagnosis when myometrial invasion is unclear on diagnostic imaging.
-
J. Obstet. Gynaecol. Res. · Apr 2015
Adverse pregnancy outcomes associated with adenomyosis with uterine enlargement.
The aim of this study was to elucidate the risk of poor pregnancy outcomes in women with adenomyosis by comparing their outcomes to those of women without uterine abnormalities. ⋯ Pregnancies in women with adenomyosis were associated with a higher preterm delivery rate and more frequent occurrences of fetal growth restriction and fetal malpresentation, such that both pregnancy and delivery outcomes were poor.
-
J. Obstet. Gynaecol. Res. · Mar 2015
Randomized Controlled Trial Comparative StudyComparison of desogestrel/ethinyl estradiol plus spironolactone versus cyproterone acetate/ethinyl estradiol in the treatment of polycystic ovary syndrome: a randomized controlled trial.
To compare the effects of ethinyl estradiol (EE) 30 mcg/desogestrel 150 mcg plus spironolactone 25 mg/day (group A) versus EE 35 mcg/cyproterone acetate 2 mg (group B) on hyperandrogenism and metabolism in PCOS. ⋯ Both regimens had quite similar efficacy on hyperandrogenism after three cycles of therapy and without any changes in metabolic parameters.