Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2019
EditorialTelemedicine Companies Providing Prescription-Only Medications: Pros, Cons, and Proposed Guidelines.
In the past few years, there has been a significant increase in the number of direct-to-consumer telehealth companies offering prescription medications to women. Leveraging technology, these companies have the potential to improve access to care and ensure that women have access to prescription-only medications in a convenient fashion. However, it is important to ensure that they are doing so in a safe, patient-centered way that observes evidence-based prescribing guidelines. In this article, we discuss the pros and cons of direct-to-consumer telehealth companies offering prescription medicine and suggest several guidelines to ensure that women are being cared for in an appropriate way.
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Obstetrics and gynecology · Nov 2019
Case ReportsExtracorporeal Therapies for Amniotic Fluid Embolism.
Amniotic fluid embolism (AFE) is a catastrophic disease with significant mortality. Because the cardiopulmonary dysfunction associated with AFE is self-limited, the disease could be well suited to the use of extracorporeal therapies. ⋯ Extracorporeal therapies can support severely ill women affected by AFE and could be considered even in the presence of disseminated intravascular coagulation and bleeding.
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Obstetrics and gynecology · Nov 2019
Comparative StudyComparison of Midwifery and Obstetric Care in Low-Risk Hospital Births.
To compare midwife and obstetrician labor practices and birth outcomes in women with low-risk pregnancies delivered in the hospital. ⋯ In low-risk pregnancies, midwifery care in labor was associated with decreased intervention, decreased cesarean and operative vaginal births, and, in multiparous women, an increased risk for shoulder dystocia. Greater integration of midwifery care into maternity services in the United States may reduce intervention in labor and potentially even cesarean delivery, in low-risk pregnancies. Larger research studies are needed to evaluate uncommon but important maternal and newborn outcomes.
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Obstetrics and gynecology · Nov 2019
Decreasing Opioid Use Postpartum: A Quality Improvement Initiative.
To estimate the effects of an inpatient initiative to decrease opioid use among women admitted to labor and delivery. ⋯ A standardized multimodal pain power plan reduced opioid use among a large cohort of women admitted to labor and delivery in Central Texas. Despite meeting functional goals, some women reported increased pain during their hospital stay.