Therapeutische Umschau. Revue thérapeutique
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Review Comparative Study
[Simulation in obstetrics and gynecology - a new method to improve the management of acute obstetric emergencies].
In medical specialties, such as anaesthesia, the use of simulation has increased over the past 15 years. Medical simulation attempts to reproduce important clinical situations to practise team training or individual skills in a risk free environment. For a long time simulators have only been used by the airline industry and the military. ⋯ In this paper we describe our results about the feedback of doctors and midwives on their personal experiences due to this simulation-based curricular unit. The results indicate that simulation seems to be an accepted method for team training in emergency situations in obstetrics. Whether patient security increases after the regularly use of drill training needs to be investigated in further studies.
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Review Comparative Study
[Gestational diabetes - practical approach in the clinic].
Gestational diabetes is one of the most serious pregnancy associated disorders affecting up to 14% of all pregnant women. The increasing incidence also seen in Switzerland, has been due, among other factors, to the rise of maternal age and maternal body mass index. Due to its high incidence, its major impact on pregnancy outcome and the therpeutic approaches, an universal, instead of a selective screening is preferred. The clinical relevant key points are discussed in this review.
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Pre-eclampsia is a pregnancy-associated disease of the second part of the pregnancy, occurring mainly after 20th weeks gestation. The prevalence of hypertension in pregnancy is between 5 to 11% and affects mainly women under 20 years of age. An inadequate invasion of trophoblasts with consequential placental ischemia as a result of insufficiently dilated uterine spiral arteries is thought to be an initial cause in the pathogenesis of pre-eclampsia. ⋯ Constant maternal hypertension potentially alter vascular integrity of the placenta with further consequences in fetal blood supply leading to growth restriction or zero growth and subsequently resulting in low birth weight or fetal death. The sooner the disease is detected and confirmed, the better the maternal and fetal prognoses are. This is the reason why it is major importance, together with the employment of preventive measures, to identify patients with risk factors with pre-eclampsia though an adequate screening method, thereby detecting the disease earlier and ensuring better pregnancy outcomes for both mother and child.