Obstetrics and gynecology
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A continuous rise in the rate of cesarean delivery has been reported in many countries during the past decades. This trend has prompted the emergence of a controversial debate on the risks and benefits associated with cesarean delivery. Our objective was to provide a valid estimate of the risk of postpartum maternal death directly associated with cesarean as compared with vaginal delivery. ⋯ Cesarean delivery is associated with an increased risk of postpartum maternal death. Knowledge of the causes of death associated with this excess risk informs contemporary discussion about cesarean delivery on request and should inform preventive strategies.
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Obstetrics and gynecology · Sep 2006
Determinants of perinatal mortality and serious neonatal morbidity in the second twin.
To identify potential determinants of perinatal mortality and neonatal morbidity among second twins relative to first twins. ⋯ The second twin is at greater risk of adverse perinatal outcome than the first twin, independent of presentation, chorionicity, or infant sex. Planned vaginal delivery, birth weight discordance, and prolonged interdelivery interval increase this infant risk. Elective cesarean delivery at term may improve perinatal outcome for the second twin. However, the number of cesarean births required to prevent one case of composite adverse outcome, assuming causality, was 33.
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The aim of the study was to evaluate pregnancy outcomes by weeks of gestation. A second aim was to assess the outcomes in groups with spontaneous or induced labor. ⋯ Poor pregnancy outcomes vary with gestational age. Postterm pregnancy and induced labor are prognostic factors for poor outcome.
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Obstetrics and gynecology · Sep 2006
Case ReportsArterial embolus during common iliac balloon catheterization at cesarean hysterectomy.
Placenta accreta is associated with significant maternal morbidity. Prophylactic iliac artery balloon placement has been described as a treatment adjunct to minimize maternal risk of excessive blood loss at hysterectomy. ⋯ Prophylactic arterial balloon occlusion may be associated with risks unique to pregnant women.
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Obstetrics and gynecology · Sep 2006
Case ReportsPersistent postpartum headache from a chronic subdural hematoma after peridural anesthesia.
Postpartum headache after peridural anesthesia is usually attributed to accidental perforation of the dura causing postlumbar puncture headache. ⋯ Caution is warranted in patients with peridural anesthesia for labor who present with unusually persistent headache.