Obstetrical & gynecological survey
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Parenteral nutrition is required to maintain and restore an anabolic state when oral or enteral routes are not feasible. Despite 16 years of parenteral nutrition availability, reports about parenteral therapy in gynecologic patients or during pregnancy have not been published until relatively recently. Most information is anecdotal but suggests that this mode of therapy is safe, effective, and occasionally life-saving. ⋯ Standardized formulations and fat emulsions are available at pharmacies in many hospitals, making ordering of complex solutions easier, more efficient, and cost effective. Metabolic and septic complications occur infrequently with close monitoring. Few women require intravenous therapy for very long, and home parenteral nutrition is rarely necessary.
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Disseminated intravascular coagulation is a complex syndrome involving inappropriate activation of the coagulation and subsequently fibrinolytic systems. It may occur in conjunction with a variety of disease states. ⋯ Treatment consists of general supportive measures and elimination of the activating source of the coagulopathy. Additional therapy is dictated by individual circumstances.
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Renal disease in pregnancy may be progressive but only rarely. The problems encountered that create maternal and fetal morbidity and mortality relate to the development of superimposed preeclampsia and renal failure. ⋯ The use of medications in renal disease in the presence of hypertension is controversial; however, adequate therapy should be given if indicated. Most cases of renal disease in pregnancy do not require termination; however, counseling concerning pregnancy is needed initially or subsequently.
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Obstet Gynecol Surv · Mar 1984
ReviewGeneral anesthesia in cesarean section: effect on mother and neonate.
Advances in anesthetic techniques during the past several decades have resulted in an excellent outcome in infants delivered by cesarean section under general anesthesia. To understand these results, it is important to be familiar with the physiologic changes which occur during general anesthesia. A review of the literature which focuses on the findings which led to current anesthetic principles is presented.