J Reprod Med
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Acute fatty liver of pregnancy is a rare entity. A MEDLINE English-language search from 1966 to the present revealed no reports of acetaminophen toxicity and acute fatty liver in pregnancy. ⋯ The combination of acute fatty liver of pregnancy and acetaminophen toxicity resulted in acute liver failure. Attention to clinical and biochemical parameters can lead to diagnosis and management.
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To examine the knowledge and practice patterns of obstetrician-gynecologists concerning management of hypertensive disorders of pregnancy. ⋯ A total of 401 completed surveys were analyzed. There was no difference between respondents and nonrespondents in either sex ratio (P = .410) or age (46.9 +/- 0.4 versus 48.1 +/- 0.4 years, P = .131). Most respondents (84.5%) would manage mild preeclampsia on an outpatient basis, and most (58.6%) usually managed preeclampsia independently. There was considerable variation in clinical practice. For example, about one of four respondents (27.4%) do not use seizure prophylaxis during labor in mild preeclampsia. Among physicians who do utilize magnesium sulfate for seizure prophylaxis, the mean standard loading dose was 4.5 +/- .1 g intravenously. More than half the respondents (54.9%) would employ preeclampsia prevention procedures. Most respondents (74.6%) said that there is a role for management of severe preeclampsia remote from term. Intrauterine growth restriction would be used as an indication for immediate delivery by 60.6% of respondents; female physicians were more likely to use intrauterine growth retardation as an indication for immediate delivery (chi 2 = 5.7, P = .017).
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Randomized Controlled Trial Clinical Trial
Manual removal of the placenta and postcesarean endometritis.
To determine if manual vs. spontaneous delivery of the placenta at cesarean section affects the rate of postoperative endometritis and amount of blood loss. ⋯ We found no significant difference in either postoperative endometritis or blood loss regardless of the means used to effect delivery of the placenta. The frequency of febrile morbidity in our study cases was considerably lower than heretofore reported.
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To demonstrate the postnatal investigation, treatment and outcome of infants with hydronephrosis prenatally diagnosed by ultrasound between 1994 and 1996. ⋯ When the fetal renal pelvis was < 15 mm on prenatal ultrasound, it never progressed. Prenatally diagnosed hydronephrosis may be safely observed, and surgical correction should be performed only if renal compromise occurs.