Obstetrics and gynecology
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Obstetrics and gynecology · Sep 1986
Case ReportsSuccessful spontaneous vaginal delivery during mechanical ventilatory support for the adult respiratory distress syndrome.
The adult respiratory distress syndrome is a common cause of acute hypoxemic respiratory failure in the adult that is associated with a high mortality. There is a limited experience with managing this entity in the gravid patient. A case of successful management of mother and fetus through spontaneous delivery is presented, followed by a discussion of the principles of supportive therapy.
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Obstetrics and gynecology · Sep 1986
Palliation of small bowel obstruction by percutaneous gastrostomy in patients with progressive ovarian carcinoma.
Percutaneous gastrostomy is a useful palliative technique for treatment of patients with bowel obstructions in advanced ovarian carcinoma. A description of the technique is presented along with a review of ten cases in which the procedure was used at The University of Texas M. ⋯ In all patients, the procedure was well tolerated and associated with little morbidity. In applicable cases, percutaneous gastrostomy appears to be superior to both nasogastric suction and operative gastrostomy for palliation of small bowel obstruction in terminal ovarian cancer.
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Obstetrics and gynecology · Sep 1986
Case ReportsClostridial myonecrosis arising from an episiotomy.
A case of clostridial episiotomy infection is reported and the literature reviewed. Early recognition of the severity of this disease along with aggressive operative therapy is necessary to improve outcome. Clostridium sordellii is now the most common Clostridia species to be isolated from patients with these serious infections.
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Obstetrics and gynecology · Sep 1986
Uterine contraction pressures with oxytocin induction/augmentation.
Uterine contraction pressures were quantified (in Montetevideo units) in 109 women at term gestation who received oxytocin for induction or augmentation of labor and whose labor resulted in a spontaneous vaginal delivery. Newborn five-minute Apgar scores were greater than or equal to 8 in 108 of the 109 neonates, and no immediate neonatal morbidity was attributable to the oxytocin stimulation of labor. ⋯ During oxytocin induction 91% of women achieved at least 200 to 224 Montevideo Units and 40% at least 300 Montevideo units versus 77 and 7.7%, respectively, during augmentation of labor. With concurrent fetal monitoring these levels of uterine activity should be sought before consideration of a cesarean delivery because of presumed cephalopelvic disproportion or failure to progress.