J Reprod Med
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To assess the value of the levonorgestrel-releasing intrauterine device (LNG-IUD) in the treatment of pelvic pain in patients with endometriosis in which previous medical and surgical treatments have failed. ⋯ In endometriosis patients with recurrent pelvic pain in whom previous medical and surgical treatments have failed, LNG-IUD insertion should be considered before radical surgery is performed.
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To determine if the DISC (Dominance, Influence, Steadiness/Submission, and Conscientious/ Compliance) assessment correlates with obstetrics and gynecology resident performance. ⋯ Residents who are successful in executing administrative duties, provide safe patient care, or obtain high scores on examinations may have a DISC profile that is high in Dominance and Conscientious/Compliance but lower in Steadiness/Submission and Influence. Implementation of programs to promote emotional intelligence may allow for increased compassionate and safe patient care.
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To evaluate the effect of functional constipation on women with and without chronic pelvic pain (CPP). ⋯ Functional constipation was significantly more prevalent in women with CPP than women without CPP; however, it does not appear to have a role in worsening the pain.
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Case Reports
Gelatin-thrombin hemostatic matrix in the management of placental site postpartum hemorrhage: a case report.
Gelatin-thrombin matrix (FloSeal, Baxter Healthcare Corporation, Fremont, California), a biodegradable hemostatic sealant, has been shown to control bleeding in multiple intraoperative scenarios and surgical disciplines. However, limited data is available regarding its use in obstetrics. A case of placental-site obstetric hemorrhage controlled with gelatin-thrombin matrix at time of cesarean delivery is presented. ⋯ Abnormal placentation is a predisposing factor of postpartum hemorrhage. In the absence of placenta accreta, profuse hemorrhage can occur from large vascular sinuses associated with a denuded implantation site in the poorly contractile lower uterine segment. In the event of unsuccessful hemorrhage control with conservative techniques, emergency hysterectomy is performed as a life-saving procedure. Multiple unit blood transfusion is often encountered. In the case presented, the use of gelatin-thrombin matrix gel for placental site hemorrhage management at the time of cesarean delivery resulted in rapid control of hemorrhage, uterine preservation and avoidance of massive blood transfusion.
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To determine if women with self-reported chronic pelvic pain (CPP) were more likely to have positive findings on two vaginal pelvic floor muscle (PFM) tests compared to women without CPP when the examiner was blinded to pain status. ⋯ PFM tenderness is found more frequently in women with self-reported CPP than in pain-free women. PFM strength did not differentiate CPP from pain-free participants. Improved standardization of the PFM examination across disciplines may be helpful in distinguishing subgroups and treating women with CPP.