Obstetrics and gynecology
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Obstetrics and gynecology · Jun 2007
Recurrent obstetric management mistakes identified by simulation.
To develop a simulation-based curricular unit for labor and delivery teams involved in obstetric emergencies to detect and address common mistakes. ⋯ A curricular unit based on simulation of obstetric emergencies can identify pitfalls of management in labor and delivery rooms that need to be addressed.
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Obstetrics and gynecology · Jun 2007
Management of human immunodeficiency virus-infected pregnant women at Latin American and Caribbean sites.
To describe the management of a population of human immunodeficiency virus (HIV)-infected pregnant women in Latin America and the Caribbean, and to assess factors associated with maternal viral load of 1,000 copies/mL or more and with infant HIV-1 infection. ⋯ Only a minority of women had a viral load of 1,000 copies/mL or more around delivery, and mother-to-child transmission of HIV occurred rarely (1%).
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Obstetrics and gynecology · Jun 2007
Circulating angiogenic factors in early pregnancy and the risk of preeclampsia, intrauterine growth restriction, spontaneous preterm birth, and stillbirth.
To estimate the relationship between maternal serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in early pregnancy with the risk of subsequent adverse outcome. ⋯ Higher early pregnancy levels of sFlt-1 and PlGF were associated with a decreased risk of adverse perinatal outcome.
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Publication bias is the systematic, preferential publication of studies with statistically significant positive results over indeterminate studies (frequently, researchers inappropriately term these "negative" studies), or studies that show a statistically significant negative outcome. Over time, this practice distorts the medical literature, potentially compromising the validity of systematic reviews. Publication bias primarily stems from investigators, but data suppression can occur by pharmaceutical companies, universities, and regulatory agencies. ⋯ Prior attempts to encourage voluntary trial registration have been largely unsuccessful. Hence, the International Committee of Medical Journal Editors recently adopted a policy of mandatory clinical trial registration before consideration of manuscripts for publication. Trial registration and the development of comprehensive, computerized databases will promote transparency in research and help reduce publication bias.
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Obstetrics and gynecology · Jun 2007
ACOG committee opinion. Number 369. June 2007. Multifetal pregnancy reduction.
Counseling for treatment of infertility should include a discussion of the risks of multifetal pregnancy, multifetal pregnancy reduction should be discussed with patients before the initiations of any treatment that could increase the risk of multifetal pregnancy. In almost all cases, it is preferable to terminate an ovulation induction cycle or limit the number of embryos to be transferred to prevent a situation in which fetal reduction will have to be considered. The best interest of the patient and the future child or children should be at the center of the risk-benefit equation. Although no physicians need to perform fetal reductions if they believe that such procedures are morally unacceptable, all obstetricians and gynecologist should be aware of the medical and ethical issues in these complex situations and be prepared to respond in a professional, ethical manner.