Obstetrics and gynecology
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Obstetrics and gynecology · Sep 2003
Comparative StudyIs the intrapartum biophysical profile useful?
To assess the role of biophysical profile (BPP) during normal labor. The secondary goal was to assess the effect of oxytocics, regional anesthesia, and ruptured membranes on fetal behavior during labor. ⋯ Fetal heart rate monitoring alone did not predict the need for cesarean delivery or neonatal outcome, whereas the BPP did. Biophysical profile could prove to be a clinically useful adjunctive tool in the assessment of fetal well-being in labor.
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Obstetrics and gynecology · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of isosorbide mononitrate and misoprostol cervical ripening before suction evacuation.
To compare the efficacy of a nitric oxide donor (isosorbide mononitrate) and a prostaglandin E1 analogue (misoprostol) for cervical priming before suction termination of pregnancy. ⋯ Intravaginal isosorbide mononitrate was less effective than misoprostol in cervical ripening before suction termination of pregnancy.
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Amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult. ⋯ Amniotic fluid embolism is a difficult diagnosis to make, at best. Anticoagulation may be a therapeutic option.
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Obstetrics and gynecology · Sep 2003
Case ReportsAmniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass.
Amniotic fluid embolism is a rare yet often lethal peripartum complication resulting from rapid cardiovascular collapse. Progress toward a better understanding of this entity has failed to identify either the underlying hemodynamic pathophysiology or an effective evidence-based treatment. ⋯ Timely placement of transesophageal echocardiogram revealed catastrophic pulmonary vasoconstriction as the cause of circulatory collapse in a patient with amniotic fluid embolism, supporting the use of cardiopulmonary bypass as an effective intervention.
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Obstetrics and gynecology · Sep 2003
Comparative StudyTracking career satisfaction and perceptions of quality among US obstetricians and gynecologists.
To assess recent trends in professional satisfaction, perceptions of ability to provide high-quality care, and perceptions of ability to obtain needed services for patients in a national sample of obstetricians and gynecologists; to compare obstetrician-gynecologists with physicians in other specialties; and to identify demographic, professional, and practice characteristics associated with high career satisfaction. ⋯ Although most obstetricians and gynecologists are satisfied with their careers, many are experiencing significant professional distress.