Obstetrics and gynecology
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Intestinal obstruction during pregnancy is rare, with volvulus being responsible for about 25% of cases. ⋯ Volvulus in pregnancy carries a high mortality rate, often because diagnosis is delayed due to avoidance of radiography and because of similarity of symptoms to other clinical entities. A high index of suspicion for volvulus must be maintained when a pregnant patient presents with obstructive symptoms. Abdominal radiographs may be justified in aiding the diagnosis, and diagnostic laparoscopy is a viable alternative when the patient has an acute abdomen.
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Obstetrics and gynecology · Aug 2009
Case ReportsListeriosis in pregnancy complicated by postpartum heart block.
Listeria monocytogenes is a food-borne pathogen that primarily affects pregnant women. Cardiac involvement is an uncommon complication of infection. We present a case of a gravida with Listeria bacteremia at 36 weeks of gestation. ⋯ Heart block is a rarely reported and possibly overlooked complication of listeriosis. Mothers with listerial infection should be screened for cardiac complications to avoid unexpected decompensation.
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Obstetrics and gynecology · Aug 2009
Historical Article GuidelineACOG Committee Opinion No. 439: Informed consent.
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Obstetrics and gynecology · Jul 2009
Comparative StudyDiagnosing pulmonary embolism in pregnancy using computed-tomographic angiography or ventilation-perfusion.
To estimate the rate of nondiagnosis for patients who initially undergo computed-tomographic angiography compared with those who undergo ventilation-perfusion imaging to diagnose pulmonary embolism in pregnancy. ⋯ II.
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Acute traumatic injury during pregnancy is a significant contributor to maternal and fetal morbidity and mortality in the United States. Motor vehicle accidents are the leading cause of injury-related maternal death, followed by violence and assault. Lack of seat belts or other restraints increases the risks of both maternal and fetal morbidity and mortality. ⋯ Perimortem cesarean delivery should be considered early in the resuscitation of a pregnant trauma victim, especially when fetal viability is a concern. Once the mother is stabilized in the emergency setting, she should be transported for appropriate maternal and fetal observation until both mother and fetus are clear of danger. It is essential that the clinician and staff maintain thorough and accurate documentation and recording of the chronology of events, the maternal and fetal assessment, and the management and outcome of the pregnancy.