Obstetrics and gynecology
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To determine whether opinions and practice patterns have markedly changed over the past decade and whether clinicians are cognizant of the new ACOG definitions for forceps deliveries. ⋯ Although the rate of midforceps use decreased, operative vaginal delivery was still commonly taught in residency programs in North America in 1990.
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Obstetrics and gynecology · Feb 1993
Comparative StudyPulmonary edema associated with pregnancy: echocardiographic insights and implications for treatment.
To evaluate the role of echocardiography in determining the cause of pulmonary edema in pregnancy and the impact this information has on management. ⋯ Because clinical and roentgenographic findings do not accurately differentiate patients with respect to the presence and type of cardiac dysfunction, and because these subgroups differ with respect to treatment and probably prognosis, we recommend echocardiography to evaluate all pregnant women with pulmonary edema.
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Obstetrics and gynecology · Nov 1992
Practice Guideline GuidelineSexual assault: review of a national model protocol for forensic and medical evaluation. New Hampshire Sexual Assault Medical Examination Protocol Project Committee.
A national hospital/community model protocol was developed for the forensic and medical examination of victims of sexual assault. This review is designed to assist states in the development of sexual assault protocols. Controversial issues were addressed, including the collection of hair evidence, the importance of semen, mandatory reporting, pregnancy testing and prophylaxis, and sexually transmitted diseases including human immunodeficiency virus. ⋯ Representatives of the medical, legal, law enforcement, victim advocacy, and forensic science communities contributed to the development of the protocols at the national and state levels. The importance of a collaborative effort is emphasized. The broad protocol goals are to minimize the physical and psychological trauma to the victim while maximizing the probability of collecting and preserving physical evidence for potential use in the legal system.
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To assess the effect of epidural analgesia on fetal temperature in labor, contrasting intrauterine with oral thermometry. ⋯ We estimate that 5% of fetuses reached a core temperature in excess of 40C in this study, all in association with epidural analgesia. We suggest that antipyretic measures be considered after 5 hours of epidural analgesia in ambient temperatures above 24C.
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Obstetrics and gynecology · Oct 1992
Historical ArticleThe introduction of nitrous oxide analgesia into obstetrics.
Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, maternal emotion, and maternal and fetal heart rates, as well as on the frequency, duration, and strength of uterine contractions in 25 parturients. He recognized that, in contrast to chloroform, nitrous oxide did not alter uterine activity. He concluded that the advantages of nitrous oxide administration far outweighed its disadvantages.