Obstetrical & gynecological survey
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Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. ⋯ After completing this activity, the learner should be better able to assist patients and providers in identifying postpartum hypertension; provide a framework for the evaluation of new-onset postpartum hypertension; and provide instructions for the management of acute severe and persistent postpartum hypertension.
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Obstet Gynecol Surv · Aug 2016
ReviewManagement of the Jehovah's Witness in Obstetrics and Gynecology: A Comprehensive Medical, Ethical, and Legal Approach.
Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah's Witness patients in obstetrics and gynecology, most of them are case reports, and a comprehensive review about these patients including ethicolegal perspective is lacking. ⋯ All obstetricians and gynecologists should be familiar with alternatives and "less invasive" options for patients who refuse blood transfusions.
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Obstet Gynecol Surv · Jan 2016
ReviewDelayed Cord Clamping in Preterm Neonates: A Review of Benefits and Risks.
Delayed clamping of the umbilical cord of premature neonates decreases perinatal morbidity. Allowing time for autotransfusion of placental blood before the umbilical cord is clamped represents a simple practice that may have significant impact. In light of many professional societies recommending delayed cord clamping in premature neonates because of its beneficial effects, the topic still holds many unanswered questions. ⋯ Delayed cord clamping in premature neonates is a simple procedure that the current evidence supports to improve neonatal morbidity. The impact on long-term outcomes remains limited. The optimal time to delay cord clamping and potential risks are poorly studied.
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A projected shortage of obstetrician-gynecologists (OB-GYNs) is a result of both the increasing US population and the relatively static number of residency graduates. In addition, generational changes have contributed to increasing subspecialization, more desiring part-time employment, and earlier retirement. This article reviews data regarding changes in the practice of obstetrics and gynecology. ⋯ Compared with other medical specialists, OB-GYNs retire slightly earlier, especially females who will represent the field more. The specialty is moving toward a more comprehensive women's health care practice model that is more patient-centered, efficient, cost controlling, team-based, and adaptable to the needs of a diverse population. Implications from these changes for our practices and improving patient care are currently unclear and await more reported experience.
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Obstet Gynecol Surv · Dec 2015
ReviewEnhanced Recovery Pathways in Gynecology and Gynecologic Oncology.
Enhanced recovery programs (ERPs) are considered standard of care across a variety of surgical disciplines, but ERPs have not been widely adopted in gynecology. ⋯ High-quality evidence exists for improved outcomes among patients in ERPs. Enhanced recovery programs save resources and costs across the health care system. As quality metrics and bundled payments increase in health care, ERPs will have increasing prominence.