Obstetrics and gynecology
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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.
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Obstetrics and gynecology · Jul 1997
Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery.
To determine the prevalence of fetal acidemia associated with regional anesthesia for elective cesarean delivery in healthy paturients with uncomplicated singleton term pregnancies. ⋯ The rate of fetal acidemia is significantly increased after regional anesthesia. This risk must be judged in light of the risks inherent with general anesthesia.
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Obstetrics and gynecology · Jul 1997
The effect of instituting an elective labor epidural program on the operative delivery rate.
To evaluate labor outcome as well as maternal and neonatal morbidity before and after the initiation of elective labor epidural capability. ⋯ Our study demonstrated no increase in the rate of operative deliveries in a population that suddenly received access to on-request labor epidurals. We believe this option should be offered to parturients without making them feel that they must choose between comfort and safety.
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Obstetrics and gynecology · Jun 1997
Randomized Controlled Trial Clinical TrialInduction of labor versus expectant management in macrosomia: a randomized study.
Macrosomia at term is associated with increased maternal and neonatal morbidity, including a higher rate of cesarean delivery and shoulder dystocia. Induction of labor has been suggested as a means to prevent further weight gain and improve outcome. The aim of this study was to determine whether or not induction of labor in these cases improves maternal and neonatal outcome. ⋯ In this prospective, randomized study, induction of labor for suspected macrosomia at term did not decrease the rate of cesarean delivery or reduce neonatal morbidity. Ultrasonic estimation of fetal weight between 4000 and 4500 g should not be considered an indication for induction of labor.
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Obstetrics and gynecology · Jun 1997
Genital herpes during pregnancy: inability to distinguish primary and recurrent infections clinically.
To determine if the signs and symptoms of genital herpes in pregnancy accurately identify primary genital herpes infections using serologic testing for final classification. ⋯ Correct classification of gestational genital herpes infections can be accomplished only when clinical evaluation is correlated with viral isolation and serologic testing using a type-specific assay. Severe first episodes of genital herpes infections among women in the second and third trimesters of pregnancy are not usually primary infections and are not commonly associated with perinatal morbidity.