Obstetrics and gynecology
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Obstetrics and gynecology · Dec 1997
Randomized Controlled Trial Multicenter Study Clinical TrialVaginal birth after cesarean delivery: an admission scoring system.
To develop a scoring system to predict the likelihood of vaginal birth in patients undergoing a trial of labor after previous cesarean delivery using factors known at the time of hospital admission. ⋯ Increasing scores correlate with increasing probability of vaginal birth after cesarean. The admission vaginal birth after cesarean scoring system may be useful in counseling patients regarding the option of vaginal birth or repeat cesarean delivery. This information could be particularly valuable for the patient who opts for trial of labor but has second thoughts about her mode of birth when labor begins.
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Obstetrics and gynecology · Nov 1997
Analysis of the effectiveness of an endoscopy education program in improving residents' laparoscopic skills.
To evaluate the effectiveness of a gynecologic endoscopy education program in enhancing residents' proficiency in laparoscopic surgery. ⋯ A structured program emphasizing skills enhancement is an effective approach to improve residents' performance in laparoscopic surgery.
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Obstetrics and gynecology · Nov 1997
Randomized Controlled Trial Clinical TrialPostoperative pain relief following laparoscopic tubal sterilization with silastic bands.
To evaluate postoperative pain relief of intramuscular ketorolac, topical bupivacaine, and placebo in patients undergoing laparoscopic tubal sterilization with silastic bands. ⋯ Topical bupivacaine decreases postoperative pain scores significantly compared with placebo in women undergoing laparoscopic tubal sterilization with silastic bands.
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Obstetrics and gynecology · Oct 1997
Case ReportsIntravenous iron therapy for severe pregnancy anemia with high erythropoietin levels.
To demonstrate that intravenous (IV) iron therapy rapidly can secure the physiologic correction of severe nonhemorrhagic anemia more safely than blood component therapy and recombinant erythropoietin treatment. ⋯ Intravenous iron administration rapidly corrected severe nonhemorrhagic anemia in a pregnant patient and may produce an improvement in fetal indices. High erythropoietin levels predict a good response to iron and may obviate the need for blood transfusions and recombinant erythropoietin administration, at least until this therapy is tried.
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Obstetrics and gynecology · Oct 1997
Case ReportsNormovolemic hemodilution before cesarean hysterectomy for placenta percreta.
Placenta percreta can create life-threatening hemorrhage at the time of delivery. The additional challenge of patient refusal of blood transfusion for religious reasons requires the use of comprehensive blood-conserving strategies. ⋯ Acute normovolemic hemodilution can be used safely in the pregnant woman at high risk for excessive intraoperative blood loss and should be considered in obstetric patients who strictly adhere to religious convictions prohibiting the acceptance of blood products.