Obstetrics and gynecology
-
Obstetrics and gynecology · Apr 2013
ACOG committee opinion no. 559: Cesarean delivery on maternal request.
Cesarean delivery on maternal request is defined as a primary prelabor cesarean delivery on maternal request in the absence of any maternal or fetal indications. Potential risks of cesarean delivery on maternal request include a longer maternal hospital stay, an increased risk of respiratory problems for the infant, and greater complications in subsequent pregnancies, including uterine rupture, placental implantation problems, and the need for hysterectomy. Potential short-term benefits of planned cesarean delivery compared with a planned vaginal delivery (including women who give birth vaginally and those who require cesarean delivery in labor) include a decreased risk of hemorrhage and transfusion, fewer surgical complications, and a decrease in urinary incontinence during the first year after delivery. ⋯ In cases in which cesarean delivery on maternal request is planned, delivery should not be performed before a gestational age of 39 weeks. Cesarean delivery on maternal request should not be motivated by the unavailability of effective pain management. Cesarean delivery on maternal request particularly is not recommended for women desiring several children, given that the risks of placenta previa, placenta accreta, and gravid hysterectomy increase with each cesarean delivery.
-
Obstetrics and gynecology · Apr 2013
Randomized Controlled TrialImproving influenza vaccination rates in pregnancy through text messaging: a randomized controlled trial.
To estimate whether text messages sent to ambulatory pregnant women could improve influenza vaccine uptake. ⋯ : I.
-
Obstetrics and gynecology · Mar 2013
Randomized Controlled Trial Multicenter StudyEffect of validated skills simulation on operating room performance in obstetrics and gynecology residents: a randomized controlled trial.
To estimate whether training on previously validated laparoscopic skill stations translates into improved technical performance in the operating room. ⋯ We found that proficiency-based simulation offers additional benefit to traditional education for all levels of residents. The use of easily accessible, low-fidelity tasks should be incorporated into formal laparoscopic training.
-
Obstetrics and gynecology · Mar 2013
Randomized Controlled TrialPrevention of postlaparoscopic shoulder and upper abdominal pain: a randomized controlled trial.
To estimate the effectiveness of combined intervention with the pulmonary recruitment maneuver and intraperitoneal normal saline infusion to reduce postlaparoscopic shoulder and upper abdominal pain. ⋯ Combined intervention with the pulmonary recruitment maneuver and intraperitoneal normal saline infusion is easy to implement in daily clinical practice to significantly reduce postlaparoscopic shoulder and upper abdominal pain.
-
Obstetrics and gynecology · Mar 2013
Randomized Controlled TrialAntiemetics added to phenylephrine infusion during cesarean delivery: a randomized controlled trial.
To estimate whether the addition of metoclopramide or its combination with ondansetron to a prophylactic phenylephrine infusion provides improved intraoperative nausea and vomiting prophylaxis compared with phenylephrine infusion alone. ⋯ Metoclopramide with ondansetron reduced intraoperative nausea and vomiting and early postoperative nausea and vomiting compared with placebo. Metoclopramide alone also decreased intraoperative but not postoperative nausea and vomiting. Surgical factors contributed to a significant difference in intraoperative nausea and vomiting between the two centers.