Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2004
Case ReportsRepair of uterine dehiscence with continuation of pregnancy.
Uterine dehiscence in the past has been treated with delivery of the pregnancy and repair of the uterus or cesarean hysterectomy. Uterine repair and continuation of the pregnancy has not been attempted to our knowledge. ⋯ Repair of a uterine dehiscence in a hemodynamically stable patient and continuation of the pregnancy should be considered in a very premature pregnancy to improve neonatal outcome.
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Obstetrics and gynecology · Nov 2004
Review Case ReportsAbdominal compartment syndrome secondary to ovarian mucinous cystadenoma.
Abdominal compartment syndrome secondary to a very large benign ovarian tumor has been rarely reported in gynecology. With the increase of intraabdominal pressure in abdominal compartment syndrome, all major organ systems are adversely affected, causing a potentially fatal condition. ⋯ Timely aggressive resuscitation, prompt surgical decompression, and intensive perioperative hemodynamic management are required for patients with ovarian mucinous cystadenoma complicated by abdominal compartment syndrome.
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Obstetrics and gynecology · Nov 2004
Randomized Controlled Trial Clinical TrialOxytocin requirements at elective cesarean delivery: a dose-finding study.
Oxytocin is frequently used by intravenous bolus and infusion to minimize blood loss and prevent postpartum hemorrhage at cesarean delivery. Current dosing regimens are arbitrary whereas large doses may pose a serious risk to the mother. The purpose of this study was to estimate the minimum effective intravenous bolus dose of oxytocin (ED90) required for adequate uterine contraction at elective cesarean in nonlaboring women. ⋯ The bolus dose of oxytocin used at elective cesarean deliveries in nonlaboring women can be significantly reduced while maintaining effective uterine contraction. Alteration in practice will likely reduce the potential adverse effects of this drug when given in large bolus doses, but may require modification of the techniques to remove the placenta.
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Obstetrics and gynecology · Nov 2004
Case ReportsA fatal case of Clostridium sordellii septic shock syndrome associated with medical abortion.
Clostridia bacteria are infrequent human pathogens. In the obstetric and gynecologic literature, Clostridium sordellii infections have been very rarely reported. This is a case of infection following medical termination of early pregnancy with mifepristone and misoprostol. ⋯ The frequency of infection following medical abortion is low. The rapid and fatal course of this infection is similar to other obstetric and gynecologic cases reported in the literature. Although providers should remain vigilant to the possibility of infection following medical abortion, the overall proven safety of medical abortion remains the same.
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Obstetrics and gynecology · Nov 2004
Case ReportsHepatic ischemia associated with coarctation of the aorta in pregnancy: key issues in differential diagnosis.
Hepatic ischemia associated with coarctation of the aorta has not previously been reported in an adult; pregnancy increases the pressure gradient across a coarctation. ⋯ This case documents an association between coarctation of the aorta and hepatic ischemia, precipitated by pregnancy and dehydration in combination. It emphasizes the need in the assessment of patients with liver disease in pregnancy to consider not only "traditional" pregnancy-related conditions such as acute fatty liver and the hemolysis, elevated liver enzymes, low platelets syndrome, in which delivery may be necessary as a clinical emergency, but also those in which the circulatory and metabolic demands of pregnancy may precipitate liver injury.