Obstetrics and gynecology
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Obstetrics and gynecology · Sep 1989
Concomitant infection with Neisseria gonorrhoeae and Chlamydia trachomatis in pregnancy.
Gonorrhea is an important marker for endocervical chlamydial infections in nonpregnant women. Concomitant infection rates as high as 50% have been reported. There are few data on concomitant infection rates in pregnant patients. ⋯ Patients with gonorrhea were younger, less often married, and more often black than the control population, but these demographic differences did not account for the large difference in the chlamydial prevalence. Erythromycin 500 mg four times daily provided an excellent cure rate without intolerable side effects. Pregnant patients being evaluated or treated for gonorrhea should also be considered at high risk for concomitant cervical chlamydial infection.
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Obstetrics and gynecology · Sep 1989
Does prolonged preterm premature rupture of the membranes predispose to abruptio placentae?
The association between prolonged preterm premature rupture of the membranes and abruptio placentae was investigated in a case-control study. The incidence of abruptio placentae among 143 women with singleton pregnancies at less than 34 weeks' gestation who had ruptured membranes for at least 24 hours was 5.6%, significantly higher than the 1.4% observed among 143 randomly selected controls without preterm rupture of the membranes (P less than .05). Among patients with prolonged preterm premature rupture of the membranes, those who experienced vaginal bleeding before the onset of labor had a significantly higher risk for abruptio placentae than women who did not bleed (24 versus 2.5%; P less than .001). Regardless of the mechanism by which this association is produced, the clinician should be aware of this potential complication, especially in patients who have recurrent bleeding episodes during the period of expectant management.
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Obstetrics and gynecology · Sep 1989
Case ReportsFetal survival following coagulopathy at 17 weeks' gestation.
Placental separation in the third trimester of pregnancy may be associated with coagulopathy, fetal distress, or intrauterine death. We report a case of vaginal bleeding due to placental separation at 17 weeks' gestation associated with disseminated intravascular coagulation. After treatment with blood, fresh frozen plasma, and fibrinogen, the pregnancy progressed uneventfully for another 12 weeks, when delivery by emergency cesarean section was performed.
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Obstetrics and gynecology · Jul 1989
Cesarean delivery and hysterotomy using an absorbable stapling device.
The absorbable stapling device was used in 22 hysterotomies in gravid rhesus monkeys. The efficacy of the device, subsequent fertility and delivery route, fetal effects, and pathohistology were all studied. No statistically significant difference between experimental and control animals was noted.
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Obstetrics and gynecology · Jun 1989
Unrecognized thrombocytopenia and regional anesthesia in parturients: a retrospective review.
Charts from 2929 consecutive parturients were reviewed. Twenty-four had platelet counts less than 100,000/microL in the peripartum period. Seventeen of the 24 had predisposing causes for thrombocytopenia, including preeclampsia (nine), immune thrombocytopenia purpura (two), infection (three), placenta accreta (one), abruption (one), and excessive surgical bleeding (one). ⋯ Fourteen of the 24 thrombocytopenic patients received regional anesthesia, and none had permanent sequelae. Based upon this retrospective review, peripartal thrombocytopenia (15,000-99,000/microL) did not increase the risk of neurologic complications after a regional anesthetic. There have been no reports in the literature of spinal or epidural hematomas in parturients after regional anesthesia, except for one patient with a spinal ependymoma.