J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Apr 2000
Case Reports[Opioid spinal anesthesia at the end of labor for potentially difficult deliveries].
We report two cases of difficult delivery, one vaginal breech presentation and one vaginal twin delivery in agitated parturients who were not given epidura analgesia. Maternal agitation was caused by pain and led to the risk of difficult fetal extraction. ⋯ Spinal injection of 10 microg of sufentanil was followed by rapid analgesia, maternal sedation and atraumatic deliveries. The usefulness of this technique is discussed for analgesia during the second stage of labor when epidural analgesia has not been performed.
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J Gynecol Obst Bio R · Feb 2000
Comparative Study[Cervical adenocarcinomas: diagnostic, prognostic and therapeutic aspects in a 49 case-control study].
The aim of this study was to search for potential diagnostic, therapeutic and prognosis differences between a series of 49 adenocarcinomas of the cervix and a matched series of epidermoid carcinomas. ⋯ The incidence of adenocarcinomas is slightly increasing (absolute value in our experience) and the low stages seem to be more frequent in our experience probably by staging inaccuracy. Adenocarcinoma prognosis seems to be worse because of its poor radio-sensitivity. It seems necessary to optimize clinical staging and therapeutic protocols excluding radiotherapeutic approach, including surgical purposes or radio-surgical associations if unfavorable histological features or tumoral enlargement (T> 3 cm) are found.
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Two cases of neuralgic amyotrophy occurred 10 and 15 days after delivery, performed with a peridural anesthesia. The initial diagnosis was a brachial plexus stretching during the labor, even though the first symptoms occurred at least 10 days after the delivery. ⋯ Better knowledge of this pathology should allow an earlier diagnosis and provide reassurance for the patient concerning delayed but almost constant recovery (90%). This also should help prevent unnecessary complementary examinations and surgery, which is never recommended.
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J Gynecol Obst Bio R · Jun 1999
Clinical Trial Controlled Clinical Trial[Ultrasonography of placenta previa at the third trimester of pregnancy: research for signs of placenta accreta/percreta and vasa previa. Prospective color and pulsed Doppler ultrasonography study of 45 cases].
In a population of 45 placenta previa observed at third trimester of gestation we have tried to make the prenatal diagnosis of placenta percreta and vasa previa with color and pulsed Doppler ultrasonography. ⋯ We found the only 2 cases of abnormal adherent placental fragments and the 3 cases of vasa previa present in our population. The study of the lower segment of the uterus should be thorough as abnormal zones may be small-sized. Color Doppler is the reference technique for sighting vasa previa and gray-scale ultrasonography for abnormal adherences of the placenta.
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J Gynecol Obst Bio R · May 1999
Multicenter Study Comparative Study[Clinical importance of fetal pulse oximetry. II. Comparative predictive values of oximetry and scalp pH. Multicenter study].
To compare the predictive value of intrapartum fetal pulse oximetry to that of fetal blood analysis for an abnormal neonatal outcome in case of abnormal fetal heart rate (FHR). ⋯ The predictive value of intrapartum fetal pulse oximetry can be favorably compared with that of fetal blood analysis. Randomized controlled management trials can now be performed to assess potential clinical benefits of this new tool.