Obstetrics and gynecology
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Obstetrics and gynecology · Dec 2010
Multicenter StudyContemporary patterns of spontaneous labor with normal neonatal outcomes.
To use contemporary labor data to examine the labor patterns in a large, modern obstetric population in the United States. ⋯ In a large, contemporary population, the rate of cervical dilation accelerated after 6 cm, and progress from 4 cm to 6 cm was far slower than previously described. Allowing labor to continue for a longer period before 6 cm of cervical dilation may reduce the rate of intrapartum and subsequent repeat cesarean deliveries in the United States.
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Obstetrics and gynecology · Dec 2010
EditorialA simple checklist for preventing major complications associated with cesarean delivery.
I propose a simple, evidence-based, eight-item checklist that, if followed, should reduce the frequency of many of the most serious complications associated with cesarean delivery: endometritis, wound infection, wound disruption, thrombophlebitis, and uterine scar dehiscence in a subsequent pregnancy. The frequency of abdominal wound infections can be reduced significantly by using electric clippers, rather than a razor, to remove the hair at the site of the surgical incision, washing the skin with a chlorhexidine solution, and administering broad-spectrum antibiotic prophylaxis before the start of surgery rather than after the neonate's umbilical cord has been clamped. ⋯ Closure of the deep subcutaneous layer in patients whose subcutaneous tissue is greater than 2 cm in thickness will significantly reduce the risk of seroma, hematoma, and subsequent wound disruption. Institution of appropriate prophylaxis for deep vein thrombosis in intermediate and high-risk patients will reduce the risk of subsequent thromboembolic events.
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Obstetrics and gynecology · Dec 2010
Review Comparative StudyRobotic-assisted hysterectomy for endometrial cancer compared with traditional laparoscopic and laparotomy approaches: a systematic review.
To summarize comparative studies describing clinical outcomes of robotic-assisted surgeries compared with traditional laparoscopic or laparotomy techniques for the treatment of endometrial cancer. ⋯ Perioperative clinical outcomes for robotic and laparoscopic hysterectomy appear similar with the exception of less blood loss for robotic cases and longer operative times for robotic and laparoscopy cases.