Current opinion in obstetrics & gynecology
-
Curr. Opin. Obstet. Gynecol. · Dec 2011
ReviewThe morbidly adherent placenta: diagnosis and management options.
Randomized controlled trials and large cohort studies regarding the diagnosis and management of placenta accreta are lacking. This review examines the available evidence. ⋯ Women with an antenatal diagnosis of placenta accreta should be managed in a tertiary facility with multidisciplinary input. To determine optimum management strategies, it is imperative that larger studies are carried out in the future. It is essential that the continual monitoring and containment of rising caesarean section rates becomes a priority to prevent a further increase in the incidence of placenta accreta.
-
Curr. Opin. Obstet. Gynecol. · Dec 2011
ReviewA review of current anesthetic concerns and concepts for cesarean hysterectomy.
Peripartum hemorrhage still remains a significant source of maternal morbidity and mortality worldwide. Abnormal placentation is one of the leading causes of peripartum hemorrhage. ⋯ The present article is an update on the state-of-the art multidisciplinary management of parturients undergoing cesarean hysterectomy with special emphasis on anesthetic considerations. It summarizes the prevention, management and treatment of obstetric hemorrhages in parturients with abnormal placentation and highlights recent advances and developments. The obstetrician and the obstetric anesthesiologist must know, on the spot, how to deal with abnormal placentation-related peripartum bleeding. A multidisciplinary approach results in best outcomes.
-
Curr. Opin. Obstet. Gynecol. · Aug 2011
ReviewRobotic versus laparoscopic hysterectomy: a review of recent comparative studies.
To illustrate the current stand on robotic versus conventional laparoscopic hysterectomy regarding operating times, clinical outcome and costs. ⋯ Robotic and conventional laparoscopic hysterectomy are essentially equivalent regarding surgical and clinical outcome. Operating times are slightly higher and costs are significantly higher for the robotic procedure.
-
Curr. Opin. Obstet. Gynecol. · Apr 2011
ReviewNonabortal pregnancy complications of chorionic villous sampling.
First trimester screening for genetic diseases has become the predominant tool for selecting higher risk women in developed countries. As a consequence, chorionic villous sampling (CVS) is considered the most effective method for early diagnosis. The purpose of this review is to report recent updates related to CVS complications. ⋯ Currently CVS is the gold standard method of first trimester prenatal diagnosis. Because it will likely be in higher demand in the next years, knowledge of the associated complications and their frequency is worth noting for both physicians and patients. Recent data have clarified some controversies and speculations but the magnitude of the association between CVS and fetal and obstetrical complications is still unclear.
-
Curr. Opin. Obstet. Gynecol. · Dec 2010
ReviewA review of obstetric anesthesia in the new millennium: where we are and where is it heading?
The present article is an update on the state-of-the-art practice of obstetric anesthesia in the new millennium. It explores a number of important issues in this relatively new and still evolving subspecialty of anesthesiology. ⋯ Changes in maternal-fetal and neonatal medicine and obstetric anesthesia have been developing rapidly during the recent years and will continue to do so in the years to come. Obstetric anesthesia is art and science combined. An obstetric anesthesiologist is concerned simultaneously with the lives of at least two patients - the mother and her child. Exchange of information and communication skills in the ever changing environment of labor and delivery is essential for perfect outcome, which is always expected when providing passage for the mother and her baby from the antepartum to postpartum period.