Clin Exp Obstet Gyn
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Clin Exp Obstet Gyn · Jan 2006
Randomized Controlled TrialPostoperative analgesia after cesarean section by continued administration of levobupivacaine with the On-Q Painbuster system over the fascia vs ketorolac + morphine i.v.
This study aimed to detect if continuous local infusion of levobupivacaine with the On-Q Painbuster system provided postoperative analgesia of similar quality to morphine + ketorolac i.v. in patients undergoing cesarean section. ⋯ The i.v. system with morphine and ketorolac is more effective than levobupivacaine subcutaneous infusion in reducing postoperative pain associated with cesarean section.
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Clin Exp Obstet Gyn · Jan 2006
Comparative StudyThe influence of the mode of anaesthesia in the incidence of neonatal morbidity after an elective caesarean section.
We conducted a study of all the cases of elective caesarean section over a three-year period from 1 July 2001 to 30 June 2004, with the aim to compare general, epidural and spinal anaesthesia in respect to the incidence of neonatal respiratory morbidity. ⋯ The different anaesthesia techniques in elective caesarean section do not seem to influence neonatal respiratory morbidity.
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Clin Exp Obstet Gyn · Jan 2006
Randomized Controlled TrialPlacental umbilical cord blood transfusion: a new method of treatment of patients with diabetes and microalbuminuria in the background of anemia.
Diabetes mellitus is the commonest endocrine disease in all populations and all age groups. It is a syndrome of disturbed intermediary metabolism caused by inadequate insulin secretion or impaired insulin action, or both. Anemia is a common accompaniment of diabetes, particularly in those with albuminuria justifying tubulointestitial injury or reduced renal function. ⋯ We have not encountered any clinical, immunological or non-immunological reaction so far in either group. Fetomaternal cell traffic has been implicated as the cause of scleroderma in mothers delivering male babies. In the present series, we did not see any such rare and unusual complication due to neonatal blood transfusion in the adult system in Group B patients in the six years from the initiation of the study.
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Clin Exp Obstet Gyn · Jan 2006
Case ReportsPrenatal diagnosis of vasa previa through color Doppler and three-dimensional power Doppler ultrasonography. A case report.
Vasa previa occurs in pregnancy when one of the membrane vessels extends down to the level of the internal cervical os, ahead of the fetal presenting part and unsupported by the placenta tissue or umbilical cord. The rupture of the vessels might happen spontaneously or artificially and frequently results in fetal exsanguination and demise. Ultrasound prenatal diagnosis is highly important as it allows the identification of patients at risk, thus an elective cesarean can be performed before rupture the membranes. We report a case of vasa previa diagnosed through color Doppler mode in the 30th week of gestation, emphasizing the contribution of three-dimensional power Doppler to the adequate mapping of aberrant vessels, which greatly contributed to the success of the perinatal result.
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Clin Exp Obstet Gyn · Jan 2006
Screening of foetal distress by assessment of umbilical cord lactate.
Studies on umbilical cord blood for determination of lactate indicate that high levels seem to be correlated to foetal metabolism for anaerobic glycolysis taking place in oxygen-deprived tissues of the foetus. These findings may be of particular-deprived clinical importance when foetal distress or foetal hypoxemia is caused by perinatal events. ⋯ Lactate and pH values provide the best parameters to distinguish between asphyctic and normal newborns, with lactate having the most discriminating power. The prospective value of the discrimination functions derived from lactate and pH data is good when the foetuses are allocated into normal parameters but poor when an attempt is made to allocate the foetuses into pathologic ones, with a high false-negative rate. However, the discriminating ability is improved when pathologic foetuses are included into one single abnormal group. These results confirm the potential use of rapid foetal blood lactate measurements for the early diagnosis of intrapartum foetal distress.