Obstetrics and gynecology
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A 37-year-old woman, gravida 10, para 1-0-8-1, presented in her second trimester of pregnancy with complaints of frequent sore throats, change in voice quality, and recumbent dyspnea. These symptoms were noted initially during her previous pregnancy, and resolved after delivery. ⋯ The supraglottic hemangioma is a very rare cause of dyspnea in pregnancy. Its growth during pregnancy and regression postpartum is possibly related to the effects of estrogen and progesterone.
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Recent reports of bipolar sterilization failures have questioned the compatibility of bipolar forceps used with different electrogenerators. Four different bipolar forceps were matched and mismatched with five generators and the electrocoagulation effect was studied by two physicians trained in the histologic evaluation of electrical injury. ⋯ Conversely, when mismatched with other generators the coagulation effect of the Kleppinger forceps fell far below that of other bipolar forceps--matched or mismatched. Each bipolar system should be compatible and its electrocoagulation effect studied before it is used for female sterilization.
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Obstetrics and gynecology · Nov 1986
Comparative Study Clinical Trial Controlled Clinical TrialInfluence of crystalloid versus colloid infusion on peripartum colloid osmotic pressure changes.
Plasma colloid osmotic pressure acts to retain fluid in the intravascular space. Intravenous crystalloids have been identified as one of the major factors contributing to the consistent peripartum decline in colloid osmotic pressure. This study was undertaken to compare the effect of two crystalloid infusions (1000 and 2000 mL Plasma-Lyte A) and a colloid infusion (1000 mL 5% albumin) on the peripartum colloid osmotic pressure. ⋯ The lowest mean maternal colloid osmotic pressure (16.6 +/- 1.1 mmHg, P less than .05 compared with baseline) occurred in the 2000-mL crystalloid infusion group eight to 16 hours postpartum. Although the colloid osmotic pressure fell in all groups postpartum, this reduction was significantly (P less than .05) less during the first 24 hours in the colloid infusion group. Minimizing this disruption of the colloid osmotic pressure to pulmonary capillary wedge pressure gradient may be clinically important in selected patients.
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Obstetrics and gynecology · Nov 1986
Effect of anesthesia for primary cesarean section on postoperative infectious morbidity.
It has been stated that general anesthesia is a risk factor for postcesarean infectious morbidity. A retrospective review of 252 women who had undergone primary cesarean section at the University of Iowa Hospital was conducted. Regional anesthesia was successfully administered to 170 patients, and general anesthesia was administered to 82 patients. ⋯ There were no statistically significant differences between the two groups with regard to multiple indexes of postoperative fever or infection, including febrile morbidity, diagnosis of infection, use of therapeutic antibiotics, fever index, and postoperative hospital stay. General anesthesia, as administered to patients in the present series, did not increase the risk of infectious morbidity after primary cesarean section. However, our surgeons apparently were influenced by the choice of anesthetic technique when selecting a skin incision.
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This is the first published recommendation for perimortem cesarean sections in maternal cardiac arrest – from Katz, Dotters and Droegemueller (1986).
It was this recommendation that lead to the ‘4 minute rule’ for deciding to commence a CS in a resuscitation scenario, with the aim of delivering the baby within 5 minutes.
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