Obstetrical & gynecological survey
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Women can undergo organ transplantation before or during childbearing years. Most pregnancies have been reported in women with renal allografts, but pregnancy is possible in women with various solid organ transplants. No specific structural malformations have been reported after immunosuppressant use in pregnancy; however, the perinatal risks of hypertension, growth restriction, and preterm delivery exist. ⋯ This review discusses the pregnancy management for women with various organ transplants. Each group of recipients must deal with specific issues related to the organ transplanted and the underlying medical condition for which the transplant was necessary. Pregnancy in women with organ transplants is now not only common, but often successful for both mother and infant.
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Obstet Gynecol Surv · Feb 2004
ReviewMisoprostol: a quarter century of use, abuse, and creative misuse.
Misoprostol is a prostaglandin E1 analog originally intended for use to prevent NSAID-induced gastric ulcers. However, because of its cervical ripening and uterotonic property, misoprostol has become one of the most useful drugs in obstetrics and gynecology. ⋯ Its use for routine prevention of postpartum hemorrhage has not been so successful, partly as the high doses required for this indication often result in troublesome side effects. Despite the large body of medical evidence about its efficacy and relative safety, the use of misoprostol in pregnant women remained off-label until the spring of 2002.
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Obstet Gynecol Surv · Jan 2004
ReviewNonobstetric surgery during pregnancy: what are the risks of anesthesia?
The need for anesthesia and surgery during pregnancy occurs in 1.5% to 2.0% of all pregnancies. Each year, over 75,000 pregnant women in the United States undergo nonobstetric surgery. ⋯ This controversy was primarily attributed to the lay press speculations that surgery and anesthesia in pregnancy could pose hazards to the mother and fetus. Despite these concerns, the safety of nonobstetric surgery and anesthesia in pregnancy has been well established, and many pregnant women are safely anesthetized everyday without ill effects for the mother or fetus.
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Obstet Gynecol Surv · Jan 2004
ReviewNeurologic complication of labor analgesia: facts and fiction.
Regional anesthesia has become a hallmark of modern obstetric anesthesia practice and a paramount technique for labor analgesia. Neurologic complications associated with present-day labor analgesia are thought to be unusual; however, they can occasionally complicate peripartum obstetric and anesthetic management of pregnant patients. ⋯ Therefore, a series of systemic literature searches (Medline) to identify the articles on neurologic complication of labor analgesia was conducted. This review article summarizes the evidence from published articles on this topic, with particular emphasis on the mechanism of neurologic injury, lidocaine-related transient neurologic symptoms, anticoagulation and vascular compromise, diagnostic evaluation, and prevention of neurologic obstetric anesthesia-related neurologic injury in pregnancy.