Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2004
Case ReportsHepatic ischemia associated with coarctation of the aorta in pregnancy: key issues in differential diagnosis.
Hepatic ischemia associated with coarctation of the aorta has not previously been reported in an adult; pregnancy increases the pressure gradient across a coarctation. ⋯ This case documents an association between coarctation of the aorta and hepatic ischemia, precipitated by pregnancy and dehydration in combination. It emphasizes the need in the assessment of patients with liver disease in pregnancy to consider not only "traditional" pregnancy-related conditions such as acute fatty liver and the hemolysis, elevated liver enzymes, low platelets syndrome, in which delivery may be necessary as a clinical emergency, but also those in which the circulatory and metabolic demands of pregnancy may precipitate liver injury.
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Obstetrics and gynecology · Nov 2004
The appropriateness of red blood cell transfusions in the peripartum patient.
Despite published guidelines, numerous studies have consistently shown that a significant proportion of red blood cell (RBC) transfusions are unnecessary. The purpose of this study was to evaluate the reasons for and the appropriateness of RBC transfusions in the peripartum patient. ⋯ A significant proportion of RBC transfusions given to peripartum women are inappropriate. Educational programs that promote adherence to transfusion guidelines might help reduce exposure to RBC transfusion. Aggressive oral and intravenous iron therapy might have prevented transfusion in 11% of the women in the cohort who were possibly iron deficient.
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Obstetrics and gynecology · Oct 2004
Multicenter StudyQuality of life and sexual function after hysterectomy in women with preoperative pain and depression.
We sought to examine differences in quality of life and sexual function after hysterectomy among women with preoperative pain and depression. ⋯ II-2
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Obstetrics and gynecology · Sep 2004
Case ReportsPrenatal diagnosis of placenta accreta and percreta with ultrasonography, color Doppler, and magnetic resonance imaging.
The risk of placenta previa and accreta is increased in females with previous cesarean deliveries, and there has been an increasing number of these operations. ⋯ Prenatal diagnosis of placenta accreta is of importance because it reduces fetal and maternal morbidity as appropriate preoperative and perioperative procedures are possible.