Obstetrics and gynecology
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Amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult. ⋯ Amniotic fluid embolism is a difficult diagnosis to make, at best. Anticoagulation may be a therapeutic option.
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Obstetrics and gynecology · Sep 2003
Case ReportsAmniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass.
Amniotic fluid embolism is a rare yet often lethal peripartum complication resulting from rapid cardiovascular collapse. Progress toward a better understanding of this entity has failed to identify either the underlying hemodynamic pathophysiology or an effective evidence-based treatment. ⋯ Timely placement of transesophageal echocardiogram revealed catastrophic pulmonary vasoconstriction as the cause of circulatory collapse in a patient with amniotic fluid embolism, supporting the use of cardiopulmonary bypass as an effective intervention.
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Obstetrics and gynecology · Sep 2003
Comparative StudyTracking career satisfaction and perceptions of quality among US obstetricians and gynecologists.
To assess recent trends in professional satisfaction, perceptions of ability to provide high-quality care, and perceptions of ability to obtain needed services for patients in a national sample of obstetricians and gynecologists; to compare obstetrician-gynecologists with physicians in other specialties; and to identify demographic, professional, and practice characteristics associated with high career satisfaction. ⋯ Although most obstetricians and gynecologists are satisfied with their careers, many are experiencing significant professional distress.
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Obstetrics and gynecology · Sep 2003
Comparative StudyA comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies.
To estimate differences between shoulder dystocia-associated transient and permanent brachial plexus palsies. ⋯ Transient and permanent brachial plexus palsies are not associated with significant differences for most antepartum and intrapartum characteristics.
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Obstetrics and gynecology · Sep 2003
Case ReportsAvoiding an incision through the anterior previa at cesarean delivery.
Information is limited regarding the preferred method of delivery when the placenta is underlying the site of the uterine incision. ⋯ This reproducible technique is offered as an alternative to transecting the underlying placenta at cesarean delivery.