Obstetrics and gynecology
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Obstetrics and gynecology · Aug 1985
Comparative StudyEffect of anesthesia for repeat cesarean section on postoperative infectious morbidity.
It has been suggested that general anesthesia is a risk factor for postcesarean infectious morbidity. A retrospective review of 206 women who underwent repeat cesarean delivery at Duke University Medical Center was conducted. ⋯ 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, does not increase the risk of infectious morbidity after repeat cesarean delivery.
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Toxic reactions to bupivacaine and 2-chloroprocaine recently have been reported in parturients receiving epidural analgesia. Neurotoxicity has occurred after the accidental subarachnoid injection of large doses of 2-chloroprocaine. Cardiac arrest and death have occurred after the accidental intravascular injection of bupivacaine. Obstetricians should be aware of these hazards and how to avoid them by the use of proper technique.
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Obstetrics and gynecology · Mar 1985
Case ReportsSelf-inflicted gunshot wound to the pregnant uterus: report of two cases.
Attempts to terminate a pregnancy by self-inflicted gunshot-wounds is a new mechanism whereby women sustain gunshot wounds of the pregnant uterus. Two patients with self-inflicted gunshot wounds of the gravid uterus in an attempt to induce abortion are presented. The conservative management of such wounds is discussed.
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Obstetrics and gynecology · Mar 1985
Clinical Trial Controlled Clinical TrialNaproxen sodium in dysmenorrhea secondary to endometriosis.
Twenty patients with moderate to very severe painful menstrual periods secondary to endometriosis were treated in a double-blind, four-period, crossover clinical trial with naproxen sodium and placebo. Complete or substantial pain relief was obtained in 83% of the cases of painful menstruation with naproxen sodium and in 41% with placebo (P = .008). ⋯ No significant side effects occurred with either treatment. These results indicated that naproxen sodium is efficacious and safe for the treatment of menstrual distress in patients with endometriosis.
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Obstetrics and gynecology · Mar 1985
Case ReportsPneumatosis intestinalis associated with enteral feeding by catheter jejunostomy.
Pneumatosis intestinalis is an unusual, but potentially serious, postoperative complication. The differential diagnosis includes life-threatening conditions, such as intestinal necrosis, that may require immediate surgical intervention. ⋯ The cause of pneumatosis intestinalis was attributed to enteral feeding by catheter jejunostomy, and a successful outcome is reported after conservative management. As the use of enteral feeding through catheter jejunostomies will likely increase, this cause of pneumatosis intestinalis must be recognized.