Obstetrics and gynecology
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Obstetrics and gynecology · Apr 2015
Committee Opinion No. 629: Clinical guidelines and standardization of practice to improve outcomes.
Protocols and checklists have been shown to reduce patient harm through improved standardization and communication. Implementation of protocols and guidelines often is delayed because of lack of health care provider awareness or difficult clinical algorithms in medical institutions. However, the use of checklists and protocols clearly has been demonstrated to improve outcomes and their use is strongly encouraged. Checklists and protocols should be incorporated into systems as a way to help practitioners provide the best evidence-based care to their patients.
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Obstetrics and gynecology · Apr 2015
Randomized Controlled TrialLow-dose aspirin and preterm birth: a randomized controlled trial.
To evaluate the association between low-dose aspirin initiated before conception and the risk of preterm birth. ⋯ ClinicalTrials.gov, www.clinicaltrials.gov, NCT00467363.
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Obstetrics and gynecology · Apr 2015
Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.
To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. ⋯ Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.
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Obstetrics and gynecology · Apr 2015
Comparative StudyPerinatal outcomes with normal compared with elevated umbilical artery systolic-to-diastolic ratios in fetal growth restriction.
To compare the composite neonatal morbidity of pregnancies with fetal growth restriction (estimated fetal weight less than the 10th percentile) and normal compared with elevated umbilical artery systolic-to-diastolic ratios. ⋯ Composite neonatal morbidity is comparable in fetal growth-restricted pregnancies with elevated compared with normal umbilical artery systolic-to-diastolic ratios when delivered at 37 and 39 weeks of gestation, respectively. Planning delivery of pregnancies with fetal growth restriction and elevated systolic-to-diastolic ratios and without other complications at 37 weeks of gestation results in good outcomes.
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To describe which obstetric patients lose enough blood during postpartum hemorrhage to receive a reinfusion of intraoperative blood salvage. ⋯ Although intraoperative blood salvage was attempted on many patients, on only 21% of the women was a sufficient amount of intraoperative shed blood collected to proceed with reinfusion. Patients who experienced bleeding or who underwent a cesarean hysterectomy were the most likely to receive a reinfusion of intraoperative blood salvage-processed blood.