Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC
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J Obstet Gynaecol Can · Feb 2006
Case ReportsHamman's syndrome (spontaneous pneumomediastinum) in a parturient: a case report.
Subcutaneous emphysema and pneumomediastinum in labour and delivery is a rare but potentially serious occurrence that must be identified and managed appropriately to avoid unnecessary investigations and interventions. Published reports indicate that subsequent pregnancies pose no additional risk for recurrence. ⋯ Recognition of spontaneous pneumomediastinum and its potential consequences during labour and delivery requires vigilance. Supportive measures alone may be the only requirement for resolution. Recurrence of the condition is rare, but the appropriate management of subsequent pregnancies is unclear. Expectant management with epidural analgesia to minimize active pushing is suggested in a subsequent spontaneous vaginal delivery.
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J Obstet Gynaecol Can · Jan 2006
Randomized Controlled Trial Comparative StudyOral misoprostol versus oxytocin in the management of the third stage of labour.
To compare the effects of oral misoprostol 800 mug with intramuscular oxytocin 10 IU in routine management of the third stage of labour. ⋯ Routine use of oral misoprostol 800 microg appears to be as effective as 10 IU parenteral oxytocin in minimizing blood loss during the third stage of labour, as determined by change in hemoglobin concentration. Misoprostol appears to be a safe, inexpensive, and effective uterotonic for use in rural and remote areas, where intravenous oxytocin may be unavailable.
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J Obstet Gynaecol Can · Oct 2005
Comparative StudyThe use of an ultrasound bladder scanning device in women undergoing urogynaecologic surgery.
To compare the accuracy of using a bladder scanner to measure post-voiding residual urine volume with measurement by intermittent catheterization in a postoperative urogynaecology population. ⋯ Bladder scanning by staff nurses had limited value in assessing postoperative residual urine volumes. The accuracy of assessment might increase with greater experience with the procedure. The greater discomfort reported by patients with use of the scanner supports continued use of catheterization to assess residual urine volume.
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J Obstet Gynaecol Can · Sep 2005
Intrapartum temperature changes following the intravenous crystalloid bolus for epidural analgesia.
To assess the effect of the intravenous crystalloid bolus given before epidural analgesia on maternal temperature during labour. Multiple studies have demonstrated a hyperthermic trend in parturient women receiving epidural analgesia. This temperature rise may be affected by the pre-epidural intravenous crystalloid bolus. ⋯ Our study indicates that intravenous infusion of a crystalloid bolus at room temperature before induction of epidural analgesia does not significantly decrease parturient temperature.
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J Obstet Gynaecol Can · Sep 2005
Practice GuidelineConsensus guidelines for the management of chronic pelvic pain.
To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies. Because the underlying pathophysiology of this complex condition is poorly understood, these treatments have met with variable success rates. ⋯ 1. The curriculum for professional development should be expanded to include theory and techniques in the management of myofascial dysfunction (A). 2. Research into CPP should be encouraged, particularly in the areas of the impact of CPP on the use of health services, the pathophysiology of myofascial dysfunction, and gene therapy. Because randomized trials for qualitative outcomes are exceedingly difficult, alternative robust models, such as case-controlled or cohort-controlled trials, should be pursued (A). 3. Methods of improving interaction with patients should be explored. They might include formal contractual approaches to managing pain with opiates and efforts to better appreciate the patient's perceived needs (A).