Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewClinical management of gravid women with peripartum cardiomyopathy.
Peripartum cardiomyopathy is an important cause for idiopathic heart failure associated with pregnancy. Current evidence suggests a potential role for myocarditis in the pathogenesis of this disease. ⋯ Another group of patients with prior history of this disease request information about pregnancy prognosis. This article focuses on current concepts about peripartum cardiomyopathy and presents a reasonable approach to this clinical challenge during pregnancy.
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Any one neurologic emergency is rare during pregnancy. As a group, neurologic disorders are a major cause of maternal mortality. Optimal management requires a multidisciplinary approach and ready access to the collective experience of other clinicians. This article discusses the management of status epilepticus, eclamptic hypertensive encephalopathy, stroke, including subarachnoid hemorrhage, myasthenic crisis, porphyric crisis, acute Guillain-Barré syndrome, autonomic hyperreflexia, malignant hyperthermia, chorea gravidarum, and Wernicke's encephalopathy.
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Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewEvaluation and treatment of the gravida and fetus following trauma during pregnancy.
The management of trauma during pregnancy requires an interdisciplinary team approach involving surgeons, emergency medicine physicians, and obstetricians. Management principles are similar to those utilized in nonpregnant patients, but a number of unique circumstances must be considered, including physiologic changes of pregnancy, diagnosis and management of abruptio placentae and fetomaternal hemorrhage, and the management of traumatic cardiac arrest during pregnancy. The routine use of cardiotocography, Kleihauer-Betke assay, and perimortem cesarean section are discussed as new principles in the management of trauma during pregnancy.
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Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewAdult respiratory distress syndrome in obstetrics.
Despite the advances in medical technologies, ARDS is highly lethal. In the management of patients with ARDS, certain clinical conditions are common predisposing factors to the development of the syndrome. Infection, sepsis syndrome, and conditions requiring massive transfusion are the most common causes in patients initially managed by obstetricians and gynecologist. ⋯ Due to the overall relative youth of our obstetric and gynecologic patients and their lack of other underlying diseases, they should do better than most patients with ARDS. However, at least 50% of all patients succumb to the disease itself or to complications inherent in the care needed. Families and treating physicians should be apprised of this early in the course.
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Obstet. Gynecol. Clin. North Am. · Mar 1991
ReviewEctopic pregnancy: common and some uncommon misdiagnoses.
Several diseases of the peritoneal cavity may present in manners that are difficult to distinguish from ectopic pregnancy. A careful history and a thorough physical examination are paramount to making the correct diagnosis. ⋯ Under such circumstances, other diagnostic modalities, including serial beta-hCG testing and pelvic ultrasound, are extremely useful in distinguishing ectopic pregnancy from other diseases that occur in the abdominal peritoneal cavity. Generous use of the laparoscope facilitates diagnostic exclusion of certain entities, decreases the frequency of misdiagnosis, prevents unnecessary surgical procedures, and reduces morbidity and mortality.