European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 1996
ReviewReduction of maternal and perinatal mortality in rural and peri-urban settings: what works?
The purpose of this article is two-fold: (i) to lay out conceptual frameworks for programming in the fields of maternal and neonatal health for the reduction of maternal and peri/neonatal mortality; (ii) to describe selected MotherCare demonstration projects in the first 5 years between 1989 and 1993 in Bolivia, Guatemala, Indonesia and Nigeria. In Inquisivi, Bolivia, Save the Children/Bolivia, worked with 50 women's groups in remote rural villages in the Andean mountains. Through a participatory research process, the 'autodiagnosis', actions identified by women's groups included among others: provision of family planning through a local non-governmental organization (NGO), training of community birth attendants, income generating projects. ⋯ Birthing homes with radios were established in ten of the 27 villages in the district, where trained nurse/midwives provided maternity care on a regular basis. In Nigeria professional midwives were trained in interpersonal communication and lifesaving obstetric skills, while referral hospitals were refurbished and equipped. While reduction in maternal mortality after such a short implementation period is difficult to demonstrate, all projects showed improvements in referral and in reduction in perinatal mortality.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialS-adenosylmethionine versus ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy: preliminary results of a controlled trial.
To evaluate the efficacy of S-adenosylmethionine (SAMe) and ursodeoxycholic acid (UDCA) in intrahepatic cholestasis of pregnancy (ICP). ⋯ These findings show that UDCA is more effective than SAMe in controlling pruritus and total bile acids, which are considered a prognostic parameter in ICP with respect to the fetus. Nevertheless, before UDCA is introduced as an effective and safe treatment for ICP, which also has a beneficial effect on fetal prognosis, we believe these results should be confirmed and extended in other clinical trials.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Aug 1996
Transvaginal sonographic findings of chronic ectopic pregnancy.
Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and/or postoperatively. ⋯ Transvaginal sonography is sensitive in diagnosing chronic ectopic pregnancy, but not specific. The combined use of transvaginal ultrasonography and beta-hCG assay increases diagnostic accuracy. However, it should be kept in mind that a negative beta-hCG value does not rule out chronic ectopic pregnancy.
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This study defines the current modes of treatment of patients with uterine fibromas with a review of the literature. Progesterone treatments appear to be principally used in cases of minor functional symptomatology and we discuss recent studies of mifepristone. ⋯ The indications and results of hysteroscopic resection and laparoscopic myomectomy are compared to those of classic myomectomy and hysterectomy. The indications for myolysis are discussed.
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Evaluate gasless laparoscopic gynecologic surgery as an alternative to conventional technique with carbon dioxide insufflation. ⋯ Gasless laparoscopic gynecologic surgery seems to be a reliable alternative to conventional laparoscopy for selected indications.