Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC
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J Obstet Gynaecol Can · Jul 2014
Correlation of cord blood pH, base excess, and lactate concentration measured with a portable device for identifying fetal acidosis.
To determine the effectiveness of portable lactate analyzers in identifying fetal acidosis by correlating arterial and venous lactate values from umbilical cord blood with lactate, pH, and base excess measurements from central laboratory analyzers. ⋯ Cord blood lactate concentration measured with a portable device is a good predictor of cord blood base excess and pH. Future studies should be designed to correlate scalp blood lactate measurements with clinical outcomes.
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J Obstet Gynaecol Can · Jun 2014
Case ReportsMassive hemorrhage following thrombolysis for postpartum pulmonary embolism with cardiac arrest.
Cardiac arrest following a massive pulmonary embolism in pregnancy or the puerperium is a rare and catastrophic event. ⋯ To our knowledge, this is only the fifth case reported in the literature on thrombolytic therapy in the postpartum period, and of these has the most severe hemorrhagic complication. An effective multidisciplinary approach to such a complex situation can be acquired through simulation-based training.
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J Obstet Gynaecol Can · Apr 2014
Should doxylamine-pyridoxine be used for nausea and vomiting of pregnancy?
Doxylamine-pyridoxine is the first-line agent for the treatment of nausea and vomiting of pregnancy (NVP) according to Canadian guidelines, and this combination is commonly prescribed to pregnant women. There is limited evidence that doxylamine-pyridoxine is more effective than pyridoxine alone. There is stronger support for the safety of pyridoxine monotherapy than for the combination of doxylamine-pyridoxine during pregnancy, and some conflicting evidence links doxylamine-pyridoxine use to pyloric stenosis and childhood malignancies. The role of doxylamine-pyridoxine as the first-line pharmacological treatment for NVP in Canada should be reconsidered.
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J Obstet Gynaecol Can · Feb 2014
ReviewThe fallopian tube as the origin of high grade serous ovarian cancer: review of a paradigm shift.
Research published over the past 10 years has suggested that most "ovarian cancer," and specifically the high-grade serous carcinoma (HGSC) subtype of ovarian cancer, actually originates in the fallopian tube. In this review, we examine the evidence supporting the tubal origin hypothesis for HGSC, and discuss the clinical implications of our improved understanding of the pathogenesis of ovarian cancer. We searched Medline R and Medline in-process and non-indexed citations from inception to December 15, 2012, to identify all English or French language articles discussing the origins of HGSC. ⋯ In both BRCA mutation carriers and women from the general population, pre-invasive changes within the fimbriated end of the fallopian tube appear in association with early HGSC. Molecular and genetic studies, as well as in vitro and animal models, have also supported a tubal origin for HGSC. Whether the removal of fallopian tubes (salpingectomy) at the time of pelvic surgery for other reasons will lead to reductions in mortality from ovarian cancer is currently unknown, but it is an important area for future clinical research.
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J Obstet Gynaecol Can · Feb 2014
Sexual and gender minority peoples' recommendations for assisted human reproduction services.
To determine what recommendations lesbian, gay, bisexual, trans, and queer (LGBTQ) people have for provision of assisted human reproduction (AHR) services to their communities. ⋯ Many of the recommendations made by study participants show how patient-centred models may address inequities in service delivery for LGBTQ people and for other patients who may have particular AHR service needs. Our results suggest that service providers need education to enact these patient-centred practices and to deliver equitable care to LGBTQ patients.