Obstetrics and gynecology
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Obstetrics and gynecology · Nov 2015
Safety of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis and Influenza Vaccinations in Pregnancy.
To evaluate the safety of coadministering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines during pregnancy by comparing adverse events after concomitant and sequential vaccination. ⋯ II.
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Obstetrics and gynecology · Nov 2015
Case ReportsUse of an Obstetric Balloon for Postabortion Hemorrhage With Disseminated Intravascular Coagulation.
Postabortion hemorrhage occurs in up to 2% of second-trimester pregnancy terminations. Postabortion hemorrhage is the leading cause of postabortion maternal mortality. We report the successful use of an obstetric balloon for second-trimester postabortion hemorrhage complicated by disseminated intravascular coagulation. ⋯ An obstetric balloon should be considered in the management of second-trimester postabortion hemorrhage complicated by disseminated intravascular coagulation while coagulopathy is corrected.
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Obstetrics and gynecology · Nov 2015
Disseminated Intravascular Coagulation Syndromes in Obstetrics.
Disseminated intravascular coagulation (DIC) is a syndrome that can be initiated by a myriad of medical, surgical, and obstetric disorders. Also known as consumptive coagulopathy, DIC is a common contributor to maternal morbidity and mortality and is associated with up to 25% of maternal deaths. The etiopathogenesis of DIC is complex and currently thought to be initiated by tissue factor or thromboplastin, which is released from trophoblastic or fetal tissue, or maternal decidua or endothelium. ⋯ Treatment of DIC is centered on two principles. The first is identification and treatment of the underlying disorder. Because many women with consumptive coagulopathy also have massive hemorrhage, the second tenet of treatment is that obstetric complications such as uterine atony or lacerations must be controlled simultaneously with prompt blood and component replacement for a salutary outcome.
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Obstetrics and gynecology · Nov 2015
Case ReportsTranexamic Acid for Hyperfibrinolytic Hemorrhage During Conservative Management of Placenta Percreta.
Complications of conservative management of abnormal placentation in which the placenta is left in situ for resorption include secondary hemorrhage, infection, and disseminated intravascular coagulation. ⋯ Isolated hyperfibrinolysis is a potential cause of bleeding during conservative management of placenta increta and percreta. Management of this treatment approach should include hemostasis monitoring, because hyperfibrinolysis can be successfully controlled using fibrinolysis inhibitors.