Obstetrics and gynecology
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The National Hospital Discharge Survey indicates that rates of obstetric and gynecologic operations in the United States plateaued from 1979 to 1984, despite an increase in the number of obstetricians-gynecologists. Thus, the average surgical case-load of the obstetrician-gynecologist has declined. ⋯ As surgical case-loads decrease, obstetricians-gynecologists are likely to direct greater attention toward primary prevention, including prevention of cervical neoplasia, tubal infertility, unplanned pregnancy, and osteoporosis. In the years ahead, social gynecology may emerge as a discipline of equal stature as surgical gynecology in the United States.
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Obstetrics and gynecology · Jun 1986
Obstetric and gynecologic operations in the United States, 1979 to 1984.
An in-depth analysis of numbers of obstetric and gynecologic operations from 1979 to 1984 was performed using data from the National Center for Health Statistics. During the study period, there was a decrease in total numbers of obstetric and gynecologic procedures of 1%. During the same five-year period the numbers of physicians who label themselves as obstetrician-gynecologists increased 22%. ⋯ These figures demonstrate the dynamics of obstetric and gynecologic surgical practice. They show that numbers of obstetric and gynecologic operations have decreased over the last five years, in spite of constantly increasing numbers of obstetrician-gynecologists. If current trends continue, future individual operative workloads, on average, will decrease with possible adverse effects on quality of obstetric-gynecologic surgical care.
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Obstetrics and gynecology · Mar 1986
Comparative StudyBeta-endorphin in maternal and umbilical cord plasma at elective cesarean section and in spontaneous labor.
Concentration of beta-endorphin in relation to the mode of delivery and anesthesia was studied in maternal and umbilical cord plasma in 30 healthy women at term pregnancy. At elective cesarean section under epidural anesthesia, the mean maternal beta-endorphin level rose from 9.8 +/- 2.7 pmol/L (SE) before induction to 15.5 +/- 3.7 pmol/L at the time of delivery (P less than .02). Under general anesthesia the mean beta-endorphin level increased more, from 14.6 +/- 7.2 to 34.4 +/- 7.8 pmol/L (P less than .02), reaching the mean beta-endorphin value of the second stage of normal labor, 39.4 +/- 7.0 pmol/L. ⋯ Thus cesarean section under general anesthesia proved to be more stressful for the mother than that under epidural anesthesia, when beta-endorphin release is used as the measure of stress. The mode of anesthesia did not seem to influence the plasma beta-endorphin level in the newborn infant. Normal delivery by vaginal route increased the release of beta-endorphin both to the maternal and the fetoplacental circulation.
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Obstetrics and gynecology · Nov 1985
Preeclampsia/eclampsia with hemolysis, elevated liver enzymes, and thrombocytopenia.
Data are presented to define a unique group of preeclamptic/eclamptic women with the findings of hemolysis, elevated liver enzymes, and a low platelet count. This syndrome is a variant of severe preeclampsia and may develop either antepartum or postpartum. A nonobstetric diagnosis such as gastrointestinal or hematologic disease is often made. When the patient presents with the hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome, supportive therapy is used and delivery expedited to improve maternal and fetal outcome.
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Obstetrics and gynecology · Sep 1985
Case ReportsPregnancy-associated group B streptococcal endocarditis: a report of two fatal cases.
Group B streptococci commonly colonize parturient women, yet pregnancy-associated endocarditis due to this organism is rare. Most reports of group B streptococcal endocarditis are from the preantibiotic era and occurred in women with rheumatic mitral valve disease. Reported herein are two cases of fatal group B streptococcal endocarditis involving the aortic valve of women with no preexisting heart disease. One had undergone a second-trimester abortion and the other had a normal pregnancy and uncomplicated vaginal delivery.