Obstetrics and gynecology
-
Obstetrics and gynecology · Jun 2006
Professional liability issues and practice patterns of obstetric providers in Washington State.
To describe recent changes in obstetric practice patterns and liability insurance premium costs and their consequences to Washington State obstetric providers (obstetrician-gynecologists, family physicians, certified nurse midwives, licensed midwives). ⋯ III.
-
Obstetrics and gynecology · Jun 2006
Hospitalizations with respiratory illness among pregnant women during influenza season.
To examine hospitalizations with respiratory illness among pregnant women in the United States during periods of influenza activity. ⋯ III.
-
Obstetrics and gynecology · Jun 2006
ACOG committee opinion. No. 339: Analgesia and cesarean delivery rates.
Neuraxial analgesia techniques are the most effective and least depressant treatments for labor pain. The American College of Obstetricians and Gynecologists previously recommended that practitioners delay initiating epidural analgesia in nulliparous women until the cervical dilatation reached 4-5 cm. ⋯ The choice of analgesic technique, agent, and dosage is based on many factors, including patient preference, medical status, and contraindications. The fear of unnecessary cesarean delivery should not influence the method of pain relief that women can choose during labor.
-
Obstetrics and gynecology · May 2006
Improving hospital systems for the care of women with major obstetric hemorrhage.
When 2 maternal deaths due to hemorrhage occurred at New York Hospital Queens in 2000-2001, a multidisciplinary team implemented systemic change. Our objective was to improve outcomes of episodes of major obstetric hemorrhage. ⋯ Despite a significant increase in major obstetric hemorrhage cases, we found improved outcomes and fewer maternal deaths after implementing systemic approaches to improve patient safety. Attention to improving the hospital systems necessary for the care of women at risk for major obstetric hemorrhage is important in the effort to decrease maternal mortality from hemorrhage.
-
Obstetrics and gynecology · Apr 2006
Review Comparative StudyPlacenta previa, placenta accreta, and vasa previa.
Placenta previa, placenta accreta, and vasa previa are important causes of bleeding in the second half of pregnancy and in labor. Risk factors for placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. The diagnostic modality of choice for placenta previa is transvaginal ultrasonography, and women with a complete placenta previa should be delivered by cesarean. ⋯ Vasa previa carries a risk of fetal exsanguination and death when the membranes rupture. The condition can be diagnosed prenatally by ultrasound examination. Good outcomes depend on prenatal diagnosis and cesarean delivery before the membranes rupture.