J Reprod Med
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The Accreditation Council for Graduate Medical Education (ACGME) accredits U. S. institutions that offer graduate medical education, including that in obstetrics and gynecology. ⋯ The RRC for obstetrics and gynecology has identified 18 common problems in obstetrics-gynecology residency programs. Upon identifying one or more of these problems in an obstetrics-gynecology residency program, the RRC can withdraw accreditation or grant probation or continued probation.
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Comparative Study
Increased neonatal risk from the use of general anesthesia in emergency cesarean section. A retrospective analysis of 374 cases.
Three hundred seventy-four consecutive cases of cesarean section were reviewed retrospectively for differences in neonatal outcome with respect to method of anesthesia used. In 205 elective sections no difference in neonatal outcome was observed irrespective of anesthesia method. ⋯ These preliminary results suggest that general anesthesia may increase the degree of central depression of the fetus already compromised by hypoxia before surgery. An investigation of this question on other sets of data and in a prospective trial should be done.
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Five insulin-dependent diabetics in the third trimester of pregnancy were first stabilized on morning and evening injections of both short- and long-acting insulin. Blood sugars were determined hourly from 7 A. M. to 7 P. ⋯ Three patients were managed with long-term home and in-hospital use of the continuous subcutaneous insulin infusion pump. It proved to be efficacious and safe in establishing euglycemia. This study of a portable insulin infusion pump affirms its ability to maintain glycemic control and its safety for long-term therapy during pregnancy.