Clinical obstetrics and gynecology
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Surgical blood loss of >1000 mL or blood loss that requires a blood transfusion usually defines intraoperative hemorrhage. Intraoperative hemorrhage has been reported in 1% to 2% of hysterectomy studies. ⋯ Preparation, planning, and practicing for a massive hemorrhage is essential for all surgeons and gynecologic operating room teams. Emergency steps should be written and posted in the operating room and rehearsed quarterly.
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This review explores current concepts surrounding breastfeeding complications including nipple pain and trauma, breast engorgement, mastitis, and breast abscess. The review discusses possible etiologies, risk factors, incidence, differential diagnosis, and suggested treatment strategies. The evidence that supports these management options is discussed.
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Intracorporeal electromechanical morcellation has been available for nearly 2 decades, and has allowed hundreds of thousands of women to undergo hysterectomy and myomectomy in a minimally invasive approach. Despite gains in postoperative pain, complications, quality of life, hospital stay, and return to work, it has recently come under attack. The risk of inadvertent morcellation of a uterine malignancy, and subsequent dissemination of occult cancer, must be balanced by the risks of increased numbers of laparotomies. Power morcellation should be available to appropriate surgical candidates.