Obstetrical & gynecological survey
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Pregnancy complicated by a thermal injury must be aggressively managed to provide a favorable outcome for the mother and her developing fetus. The MEDLINE database was used to search for English-language papers published after 1980 to evaluate the classification, complications, and treatment of thermal injuries in pregnancy. Additional sources were identified through cross-referencing. ⋯ The delivery of a term infant is likely when the mother recovers from a thermal injury, and there is no evidence of fetal jeopardy or labor in the first week postburn. Acute management of thermal injuries in pregnancy is essential for maternal and fetal well-being. Obstetrical management should be individualized.
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Obstet Gynecol Surv · Nov 1996
ReviewUse of the pulmonary artery catheter in severe preeclampsia: a review.
The use of a balloon-tipped, flow-directed pulmonary artery catheter in critically ill and surgical patients has become commonplace in the United States since its introduction into clinical medicine in 1970. The capability of acquiring continuous hemodynamic and, more recently, oxygen transport data, has led to an enhanced understanding of pathophysiologic processes in disease states and to an improved ability to guide therapeutic decision making. The purpose of this paper is to review experience with the pulmonary artery catheter in subsets of women with severe preeclampsia.
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Obstructive sleep apnea is a common medical condition characterized by periodic apneas during sleep that produce hypoxia and sleep disruption. Several cases of obstructive sleep apnea in pregnancy have been reported. ⋯ Pregnancy may be complicated by obstructive sleep apnea with potential adverse effects on the mother and fetus. Prompt diagnosis would allow early treatment and may prevent low birth weight and the development of preeclampsia.
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Osteitis pubis is a painful, noninfectious inflammatory condition that involves the pubic bone, symphysis, and surrounding structures. Initially associated with urologic procedures, osteitis pubis has been described as a complication of various obstetrical and gynecological procedures including vaginal deliveries. An incidence of approximately 2 to 3 percent has been observed after the Marshall-Marchetti-Krantz urethropexy. ⋯ Other more recalcitrant cases require more involved therapy including systemic steroids and rarely surgical resection. The diagnosis of osteitis pubis should be considered when pelvic pain is present in association with potential trauma to the symphysis pubis. Also, with more women participating in sporting activities patients may present to the physician with osteitis pubis related to athletic injury.
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Obstet Gynecol Surv · May 1994
ReviewEpidural analgesia in labor and cesarean delivery for dystocia.
Published studies assessing the effect of epidural analgesia in nulliparous labor on the frequency of cesarean delivery for dystocia are reviewed. There are at least four retrospective studies and two prospective studies that suggest that epidural analgesia may increase the risk of cesarean delivery for dystocia in first labors. ⋯ Epidural is safe and may be a superior labor analgesic when compared with narcotics. However, patients should be informed that epidural analgesia may increase the risk of cesarean birth in first labors.