Obstetrics and gynecology
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Obstetrics and gynecology · Aug 1988
Management of labor with umbilical cord prolapse: a 5-year study.
Fifty-one cases of cord prolapse, in which delivery was not imminent and the fetus was still alive, were managed by filling the bladder with 500-700 mL of saline and by intravenous ritodrine. Delivery was by cesarean section as soon as possible. ⋯ The mean 5-minute Apgar score was 9.5, and in only three cases was it less than 7. In eight cases, fetal distress continued after treatment, as compared with 33 cases before this type of treatment started (P less than .001); no difference was found in the outcome between neonates weighing less than or greater than 2500 g.
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Obstetrics and gynecology · Jul 1988
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of two antibiotic regimens for treatment of pelvic inflammatory disease.
Sixty-two women were randomized in a double-blind fashion to receive one of two antibiotic regimens for the treatment of clinically diagnosed pelvic inflammatory disease. Thirty of 31 patients (96.8%) receiving a combination of cefoxitin with doxycycline and 28 of 31 (90.3%) receiving a combination of clindamycin with amikacin responded to therapy (P = not significant). ⋯ Of the four patients not responding to therapy, all had inflammatory complexes. Cefoxitin/doxycycline and clindamycin/amikacin are both effective in the treatment of pelvic inflammatory disease.
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Obstetrics and gynecology · Jul 1988
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled analgesia for post-cesarean section pain.
Recent reports have suggested that patient-controlled analgesia is an effective means of narcotic administration in postoperative patients. This prospective investigation was undertaken to determine the efficacy and safety of patient-controlled anesthesia infusion after cesarean section. During a recent ten-month period, 130 patients were assigned randomly to receive meperidine by pump or intramuscular injection. ⋯ The patient-controlled analgesia method provided less sedation and more immediate pain relief without the need for painful injections. The additional cost of renting the infuser device was offset by combined patient and nursing satisfaction. We conclude that patient-controlled infusion of meperidine is safe and effective in satisfying individual patient needs after cesarean section.
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Obstetrics and gynecology · Jun 1988
Epidural anesthesia in pregnant patients with low platelet counts.
A number of patients demonstrate thrombocytopenia in the peripartum period. One hundred four patients with unexplained transient periparturient thrombocytopenia were found over a nine-month period. Sixty-one of them received epidural anesthesia without neurologic sequelae. Epidural anesthesia is safe if the platelet count exceeds 100 x 10(9)/L in otherwise healthy women.
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Obstetrics and gynecology · Apr 1988
Outpatient treatment of pelvic inflammatory disease with cefoxitin and doxycycline.
Sixty-three women with abdominal pain and adnexal tenderness were enrolled in a study of ambulatory treatment of acute pelvic inflammatory disease. Treatment consisted of 2 g of cefoxitin intramuscularly and 1 g of probenecid orally, followed by doxycycline, 100 mg by mouth twice daily for 14 days. Patients were stratified into groups indicating whether pelvic inflammatory disease was probable, possible, or unlikely, based upon endometrial biopsy and clinical criteria. ⋯ Of 22 patients initially infected with C trachomatis and/or N gonorrhoeae, 20 were culture-negative for both organisms after therapy. Both microbiologic failures had been reexposed. This study suggests that the combination of cefoxitin and doxycycline is effective for ambulatory treatment of pelvic inflammatory disease.