J Reprod Med
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A study was conducted on 40 patients with abruptio placentae complicated by intrauterine death of the fetus, consumption coagulopathy and uterine inertia. All patients had severe hyperfibrinolysis (FDP > 300 microgram/ml). Following correction of shock, amniotomy was performed, intrauterine pressure catheters were placed, and oxytocin infusions were begun in all cases. ⋯ Thirteen patients in group B did not show prepartum improvement in consumption coagulopathy or a resumption of uterine activity. These patients required cesarean section. There were two maternal deaths in group B; the overall complication rate in this group was greater than in group A.
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Septic shock is an acute medical and surgical emergency with a devastating mortality rate. It may occur in both debilitated, immunosuppressed patients and young, healthy patients undergoing genitourinary instrumentation. This paper reviews the intricate pathophysiology of septic shock and presents a comprehensive plan for the management of this life-threatening illness.
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The use of conduction anesthesia has made childbearing a vastly more pleasant experience for the mother and certainly made the practice of obstetrics safer and easier. However, its safety to the fetus and newborn, once unquestioned, has become the subject of much study and concern in recent years. It is the purpose of this article to examine the fetal effects of local anesthetic agents and review some of these agents as well as the regional techniques most commonly employed in the perinatal period with respect to their fetal and maternal safety.
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The two factors that probably contributed most to the bowel burns that have occurred during monopolar laparoscopy were the use of higher-than-necessary voltages and the electrical isolation of the salpinx. Preferably, low-peak voltages should be used. If the two-burn technique is used, desiccation should be from distal to proximal to avoid electrical isolation of the salpinx. ⋯ Bipolar forceps that can make a mechanical cut after desiccation are available for those who desire this feature. Metal trocar sleeves are recommended for use with the monopolar, single-puncture technique only. They are not necessary for the bipolar or double-puncture monopolar techniques.