J Reprod Med
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In the absence of hypertension and proteinuria, pregnant women with hemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) present a diagnostic and therapeutic problem. ⋯ Pregnant women with hemolysis, elevated liver enzymes and thrombocytopenia who do not have hypertension or proteinuria should undergo complete diagnostic evaluation. If other etiologies are ruled out, the patient should be managed as appropriate for severe preeclampsia complicated by the HELLP syndrome.
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To review the peripartum clinical course of patients whose pregnancies are complicated by umbilical cord prolapse at a large teaching hospital and to evaluate the time from diagnosis to delivery and its impact on neonatal outcome. ⋯ Our review indicated that umbilical cord prolapse continues to be associated with poor perinatal outcomes in some cases despite emergency delivery in a modern, high-risk obstetric unit. The asphyxiated neonate had a shorter-than-average time from diagnosis to delivery, suggesting that the time from diagnosis to delivery may not be the only critical determinant of neonatal outcome, particularly with frank cord prolapse. Occult cord prolapse was associated with less perinatal morbidity when compared to frank prolapse.
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To examine the occurrence of multiple births among adolescents using birth as the unit of analysis and to examine the association between maternal race/ethnicity and parity and the occurrence of multiple births among women less than 20 years of age. ⋯ This is the first study showing ethnic and racial differences in the rates of multiple births among teenage mothers. As in older women, increased age and a higher parity were associated with a higher probability of multiple birth among adolescents.
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Case Reports
Conservative obstetric management of a gunshot wound to the second-trimester gravid uterus. A case report.
Gunshot wounds to the abdomen during pregnancy are becoming increasingly common. When the gravid uterus is injured but repairable and the fetus is either previable or dead, conservative management is an option, even if laparotomy is required for management of other injuries. ⋯ Conservative obstetric management is indicated in most such cases in which the fetus is previable or dead, although the clinician undertaking such management should be aware of the risks and possible complications.
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To compare outcome differences and responses to treatment in pregnancies complicated by either major fetal malformations or previous fetal death in the second trimester. ⋯ Patients who undergo second-trimester induction of labor for major fetal malformations using intravaginal PGE2 should be counseled that the dosage of the drug is greater and that labor may last longer than in pregnancies complicated by a previous fetal death.