Obstetrics and gynecology
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Obstetrics and gynecology · Feb 2002
Practice Guideline GuidelineACOG Committee Opinion number 269 February 2002. Analgesia and cesarean delivery rates. American College of Obstetricians and Gynecologists.
Various studies report conflicting data with regard to the level of risk of cesarean delivery for nulliparous women who receive epidural analgesia before 5 cm of cervical dilatation. As a result, some institutions are requiring that laboring women reach 4-5 cm of dilatation before receiving epidural analgesia. The American College of Obstetricians and Gynecologists wishes to reaffirm the opinion published jointly with the American Society of Anesthesiologists that while under a physician's care, in the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor. Decisions regarding analgesia should be coordinated among the obstetrician, the anesthesiologist, the patient, and support personnel.
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Obstetrics and gynecology · Feb 2002
Historical ArticleFurthering the profession: the early years of the American Gynecological Club and its first European tours.
Beginning early in the 20th century, a group of North American leaders in obstetrics and gynecology met annually to promote the furtherance of the specialty. The American Gynecological Club held its meetings at academic medical centers, spending 2 to 4 days viewing the latest diagnostic and operative techniques and hearing presentations by investigators at that institution. On several occasions, club members spent 1 month visiting the foremost medical centers in Great Britain and continental Europe, where they observed surgical procedures, attended clinics, and established friendships that transcended national boundaries. The early years of the American Gynecological Club represent a somewhat idyllic and bygone era in medicine and obstetrics and gynecology.
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Obstetrics and gynecology · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialDose-range effects of propofol for reducing emetic symptoms during cesarean delivery.
To evaluate the efficacy and safety of propofol at subhypnotic doses for reducing emetic symptoms in parturients undergoing cesarean delivery under spinal anesthesia. ⋯ Propofol 1.0 mg/kg per hour is the minimum effective subhypnotic dose for reducing emetic symptoms during cesarean delivery. Increasing the dose to 2.0 mg/kg per hour provides no further benefit.
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Obstetrics and gynecology · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialDexamethasone for the prevention of nausea and vomiting after dilatation and curettage: a randomized controlled trial.
To evaluate the efficacy and safety of dexamethasone administered intravenously at three different doses (4 mg, 8 mg, 16 mg) for the prevention of nausea and vomiting after dilatation and curettage. ⋯ Dexamethasone 8 mg is an effective antiemetic for preventing postoperative nausea and vomiting 0-24 hours after anesthesia in women undergoing propofol-based general anesthesia for termination of pregnancy. Increasing the dose to 16 mg provided no additional benefit.
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To estimate the incidence and factors associated with combined vaginal-cesarean delivery in twin pregnancies. ⋯ There has been a significant increase in combined vaginal-cesarean and elective cesarean deliveries among twin gestations, with a decrease in vaginal births. Vaginal-cesarean delivery is associated with nonvertex second twin and a prolonged interdelivery interval.