Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2003
Obstetric admissions to the intensive care unit: outcomes and severity of illness.
To determine whether mortality prediction based on a current model of outcome prediction is accurate in obstetric patients. ⋯ The Simplified Acute Physiologic Score accurately predicts hospital mortality in obstetric patients admitted to the intensive care unit for medical reasons but not for indications related to pregnancy and delivery. An alternate model that predicts outcomes in obstetric patients admitted for obstetric indications should be developed.
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Obstetrics and gynecology · Nov 2003
Practice Guideline GuidelineACOG Committee Opinion. Primary and preventive care: periodic assessments.
Periodic assessments provide an excellent opportunity for obstetricians and gynecologists to provide preventive screening, evaluation, and counseling. This Committee Opinion provides the recommendations of the American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice for routine assessments in primary and preventive care for women based on age and risk factors.
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The Arnold-Chiari malformation type I is characterized by the prolapse of the cerebellar tonsils below the foramen magnum. There is a lack of literature on the management of a pregnancy in a woman affected by an Arnold-Chiari malformation. ⋯ Careful selection of anesthetic technique for the delivery of a woman with an Arnold-Chiari malformation is of paramount importance.
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Obstetrics and gynecology · Nov 2003
Case ReportsSevere hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy.
Transient diabetes insipidus is an uncommon complication of pregnancy, usually manifesting with polydipsia and polyuria. This condition is considered to result from excess placental vasopressinase activity and is managed with deamino D arginine vasopressin. ⋯ Transient diabetes insipidus of pregnancy should be considered in the differential diagnosis of severe hypernatremia in obstetric patients with restricted oral intake after operative delivery.
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Obstetrics and gynecology · Nov 2003
Case ReportsAcute postpartum mental status change and coma caused by previously undiagnosed ornithine transcarbamylase deficiency.
Acute postpartum mental status change usually represents postpartum blues or depression. Psychosis and coma are rare. This is a case report of a patient with previously undiagnosed ornithine transcarbamylase deficiency presenting as postpartum acute mental status change and coma. ⋯ Ornithine transcarbamylase deficiency should be included in the differential diagnosis of acute postpartum coma. Hyperammonemia, hyperglutaminemia, and orotic aciduria are diagnostic, facilitate early treatment, and mitigate the risk of permanent neurologic impairment or death.