Obstetrics and gynecology
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Obstetrics and gynecology · Feb 2008
Case ReportsLate postpartum hemorrhage due to von Willebrand disease managed with uterine artery embolization.
Von Willebrand disease is the most common inherited bleeding disorder caused by quantitative or qualitative defects of von Willebrand factor, which may lead to postpartum bleeding problems. In such patients, resistant postpartum hemorrhage may be treated effectively by using transcatheter arterial embolization. ⋯ Selective transcatheter uterine artery embolization may be used to control life-threatening pelvic hemorrhage unresponsive to traditional local measures. Such an intervention may also be used successfully in patients with bleeding disorders as the last chance of uterine preservation.
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Tubal sterilization is a common method of contraception used worldwide. The Filshie clip is a device designed to occlude the fallopian tubes. It is common practice to apply the clips across the isthmus using laparoscopy. It is often suggested that failures occur due to problems with the technique used to occlude the fallopian tubes. ⋯ It is important to understand why sterilization clips lead to contraceptive failure and to inform patients of this risk. Contraceptive failure after female sterilization remains a medical issue.
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Obstetrics and gynecology · Jan 2008
Clinical TrialEstimation of birth weight by two-dimensional ultrasonography: a critical appraisal of its accuracy.
To assess the accuracy and characterize two-dimensional ultrasonographic formulas for the estimation of birth weight according to the type of fetal biometric parameters these formulas rely on to make fetal weight predictions. ⋯ III.
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Acknowledgement of the importance of patient autonomy and increased patient access to information has prompted more patient - generated requests for surgical interventions not necessarily recommended by their physicians. Decision making in obstetrics and gynecology should be guided by the ethical principles of respect for patient autonomy, beneficence, nonmaleficence, justice and veracity. Each physician should exercise judgement when determining whether information presented to the patient is adequate. When working with a patient to make decisions about surgery, it is important for obstetricians and gynecologists to take broad view of the consequences of surgical treatment and to acknowledge the lack of firm evidence for the benefit of one approach over another when evidence is limited.
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Obstetrics and gynecology · Jan 2008
Editorial CommentEvidence-based medicine versus liquid-based cytology.