European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2013
Increasing rates of operative vaginal delivery across two decades: accompanying outcomes and instrument preferences.
To examine rates and outcomes of operative vaginal delivery over a 20-year study period and the changing preference for various instruments during this period. ⋯ Rates of operative vaginal delivery have increased over the 20-year study period. The rate of perinatal mortality in infants who had an assisted vaginal delivery was decreased in the 5-year epoch at the end of the study compared with the period at the beginning. The rate of forceps delivery has fallen significantly, with vacuum delivery now being the choice of the majority of clinicians.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2013
Randomized Controlled Trial Multicenter StudyInduction of labour or expectant monitoring in hypertensive pregnancy disorders at term: do women's postpartum cardiovascular risk factors differ between the two strategies?
Cardiovascular disease (CVD) is the leading cause of death in women in the western world. Several studies have described the association between hypertensive pregnancy disorders and CVD in later life. Our aim was to compare postpartum cardiovascular risk factors in women who had a shorter and women who had a longer exposure to endothelial activation during their term hypertensive pregnancy. ⋯ In women with hypertensive disorders in pregnancy at term, induction of labour does not affect the clinical and biochemical cardiovascular profile at 2.5 years postpartum.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2013
Randomized Controlled TrialFive minutes of extended assisted ventilation with an open umbilical trocar valve significantly reduces postoperative abdominal and shoulder pain in patients undergoing laparoscopic hysterectomy.
Residual carbon dioxide contributes substantially to pain following laparoscopic surgery. We evaluated the effects of extended assisted ventilation (EAV) with an open umbilical trocar valve for five additional minutes following laparoscopic hysterectomy on postoperative abdominal and shoulder pain levels. We also examined whether a combination of EAV and trocar site infiltration (TSI) with lidocaine could further reduce postoperative pain levels. ⋯ EAV was found to be an effective and safe method to reduce postoperative pain levels in patients undergoing laparoscopic hysterectomy.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2013
Variation among Spanish teaching hospitals in ductal carcinoma in situ treatment: results of a national survey.
To investigate current management of ductal carcinoma in situ (DCIS) of the breast in Spanish teaching hospitals and to evaluate prognostic factors for recurrence. ⋯ Prospective randomized trials are mandatory to achieve an agreement about the best treatment for DCIS. As long as the current discrepancy exists, we should probably err on the conservative side, and not subject our patients to unnecessary therapeutic aggressiveness.