Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2005
Case ReportsPostcesarean pulmonary embolism, sustained cardiopulmonary resuscitation, embolectomy, and near-death experience.
Survival after surgical embolectomy for massive postcesarean pulmonary embolism causing sustained cardiac arrest is rare. ⋯ Massive pulmonary embolism is a potentially treatable catastrophic event after cesarean delivery, even if continuous cardiopulmonary resuscitation is required until life-saving embolectomy is done.
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Obstetrics and gynecology · Nov 2005
Case ReportsMassive pulmonary embolism in pregnancy treated with tissue plasminogen activator.
Systemic thrombolysis with tissue plasminogen activator (t-PA) in pregnancy is still considered an experimental treatment. Several reports have described the successful use of t-PA in the setting of hemodynamic instability in gravidas with massive pulmonary emboli. ⋯ We describe the successful thrombolysis with t-PA of a massive, life-threatening pulmonary embolism without complications followed by a term delivery.
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Obstetrics and gynecology · Nov 2005
Case ReportsMassive pulmonary embolism in pregnancy treated with catheter fragmentation and local thrombolysis.
Catheter-directed thromboembolus fragmentation and thrombolysis is used with success for treatment of pulmonary embolism with hemodynamic decompensation in nonpregnant patients, but information on its use during pregnancy is limited. We report successful treatment of massive bilateral pulmonary emboli in the third trimester of pregnancy. ⋯ Catheter-directed mechanical fragmentation and local thrombolytic infusion therapy is a treatment option for pulmonary embolism with hemodynamic decompensation in pregnancy. Advantages are rapid clot lysis with consequent return of normal hemodynamics and uterine perfusion and avoidance of systemic thrombolytics and associated risk of bleeding complications.
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Obstetrics and gynecology · Nov 2005
Risk factors for spontaneous abortion in early symptomatic first-trimester pregnancies.
To evaluate the association of an ultimate diagnosis of miscarriage with various clinical symptoms and historical factors in a cohort of women presenting with pain, bleeding, or both in the first trimester of pregnancy. ⋯ II-2.
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Treatment of a major burn injury during pregnancy must incorporate modifications in management resulting from gestational physiologic changes. ⋯ Pregnancy-induced physiologic changes affect key factors in the management of the burned patient, including airway management and hemodynamic support. Multidisciplinary management is essential to achieve the best possible outcome.