J Reprod Med
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Women carrying triplets are at greater risk for both anemia, due to the increased demands of the developingfetuses, and peripartum hemorrhage. Jehovah's witnesses are a unique obstetric population since women of this faith refuse blood transfusion. ⋯ rHuEpo can be safely administered, with a beneficial effect in pregnancy, and seems to be an effective option in preventing transfusions as demonstrated in this case in a Jehovah's Witness.
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To describe the obstetric characteristics and neonatal outcomes in unplanned out-of-hospital deliveries. ⋯ Unplanned out-of-hospital birth is an important risk factor for such complications as postpartum hemorrhage, low birth weight and adverse neonatal outcome.
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Ilioinguinal nerve entrapment is one of the most common nerve injuries following pelvic surgery. We present a case of intractable right lower quadrant pain successfully treated with neurectomy. ⋯ Low transverse fascial incisions risk injury to the iliohypogastric and ilioinguinal nerves. While pain from entrapment of these nerves often resolves spontaneously, neurectomy may offer resolution in recalcitrant cases.
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Carcinoma metastatic to the uterine cervix is very rare. The most frequent nongenital primary sites are the stomach and colon. ⋯ To our knowledge, this was the youngest patient in the literature with colon cancer metastatic to the cervix. This case focuses attention on the diagnostic challenge posed by an incidental finding of a cervical adenocarcinoma in the presence of an asymptomatic primary tumor.
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Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy in adult women. The most easily identifiable riskfactor is a strong family history of either ovarian or breast cancer; that may indicate the presence of an inherited germ-line mutation in either BRCA-1 or BRCA-2. Common symptoms, such as abdominal bloating and early satiety, indicate more advanced disease, involving the upper abdomen and present in approximately 70% of patients at the time of diagnosis. ⋯ For those patients who develop resistance to second-line platinum or who have difficulty tolerating this agent, multiple other options are available for relapse management, including liposomal doxorubicin, topotecan, gemcitabine and etoposide per os. Eventually the disease becomes resistant to multiple chemotherapy agents, and reorienting management toward supportive care and pain control is necessary. Ongoing efforts to identify more effective multiagent first-line regimens, to develop more effective strategies for early detection and to incorporate agents with novel mechanisms of action, such as antiangiogenesis compounds, hold promise.