Obstetrics and gynecology
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Obstetrics and gynecology · Jul 1984
Grieving characteristics after spontaneous abortion: a management approach.
Twenty-two women who experienced a spontaneous abortion were treated during a 15-month period. All patients were seen for counseling sessions immediately after the spontaneous abortion. ⋯ Guilt was the state that appeared to be the most difficult for the women and their spouses to resolve without help. Counseling sessions are considered an essential part of the total obstetric care for patients who experience a pregnancy loss.
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Obstetrics and gynecology · May 1984
Use of intravenous fluids before cesarean section: effects on perinatal glucose, insulin, and sodium homeostasis.
Perinatal glucose, insulin, and sodium homeostases were assessed in relation to antepartum intravenous infusions administered to 59 normal mothers undergoing cesarean section at term without labor under epidural anesthesia. Group A (N = 20) received 1 L of Ringer's lactate without dextrose during one hour; group B (N = 20), 1 L of 5% dextrose in water during one hour; and group C (N = 19), 1 L of 5% dextrose in water during two and one half hours. ⋯ Among group A patients who received sodium, and group B and C patients who did not, fetal hyponatremia (umbilical venous sodium 130 mEq/L or less) correlated with the absence of sodium in the prepartum infusion. The results suggest that the antepartum administration of a balanced electrolyte solution without excess glucose infusion can minimize the incidence of fetal hyperglycemia and hyponatremia and neonatal hypoglycemia.
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The effectiveness and safety of 5 mg of epidurally administered morphine for postoperative analgesia was determined in 276 healthy women undergoing cesarean delivery. Overall pain relief, time to administration of additional analgesic medications, and adverse side effects were evaluated. ⋯ Pruritus, nausea, and vomiting occurred frequently, but were easily treated. Although late respiratory depression did not occur in this group, the authors continue to observe patients closely and monitor respiratory rates for 24 hours.
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Obstetrics and gynecology · Mar 1984
Case ReportsFetal polyuria and hydramnios associated with Bartter's syndrome.
The case of a woman with recurrent hydramnios in three pregnancies, from which the only surviving infant was later found to have Bartter's syndrome, is described. Analysis of electrolytes, renin activity, and aldosterone levels in amniotic fluid from this pregnancy are presented. ⋯ Early onset hydramnios might signify Bartter's syndrome in the offspring in families with an index case. In cases of hydramnios of unknown etiology, appropriate investigations might lead to early diagnosis and treatment of Bartter's syndrome.