American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · May 2002
ReviewNonpharmacologic relief of pain during labor: systematic reviews of five methods.
Nonpharmacologic measures to reduce labor pain have been used throughout history. Despite reports that some of these methods reduce pain, increase maternal satisfaction, and improve other obstetric outcomes, they have received limited attention in the medical literature and are not commonly available to women in North America. The controlled studies of nonpharmacologic methods are limited in number and sometimes provide conflicting results. ⋯ An extensive search of electronic databases and other sources identified studies for consideration. Critical evaluation of controlled studies of these 5 methods suggests that all 5 may be effective in reducing labor pain and improving other obstetric outcomes, and they are safe when used appropriately. Additional well-designed studies are warranted to further clarify their effect and to evaluate their cost effectiveness.
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Am. J. Obstet. Gynecol. · May 2002
ReviewNitrous oxide for relief of labor pain: a systematic review.
A systematic review was conducted to determine the efficacy and safety of nitrous oxide for labor analgesia. Eleven randomized controlled trials with adequate control groups and outcome assessment by parturients during or shortly after the intervention were used to determine efficacy. ⋯ Nitrous oxide is not a potent labor analgesic, but it is safe for parturient women, their newborns, and health care workers in attendance during its administration. It appears to provide adequately effective analgesia for many women.
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Am. J. Obstet. Gynecol. · May 2002
Selection of obstetrics and gynecology residents on the basis of medical school performance.
The purpose of this study was to determine whether United States Medical Licensing Examination scores during medical school predict resident-in-training examination scores and whether other criteria of medical student performance correlate with the faculty's subjective evaluation of resident performance. ⋯ Standardized tests of medical student cognitive function predict the resident's performance on standardized tests. Selection criteria that are based on other medical school achievements do not necessarily correlate with overall performance as residents in obstetrics and gynecology.
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Am. J. Obstet. Gynecol. · May 2002
Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache.
The experience of women was sought about nausea and vomiting, its relation to olfaction, its occurrence among pregnant women with anosmia, and the potential association of hyperemesis gravidarum and migraine headache. ⋯ The frequency of nausea and vomiting, caused most often by nonpregnancy-related triggers, is high among women. In a small sample of women with congenital anosmia, nausea and vomiting of pregnancy occurred in only 1 pregnancy, suggesting that olfaction is a highly selected trigger for nausea and vomiting of pregnancy. The shared nausea and vomiting experience of hyperemesis gravidarum and migraine headache among women suggests a common mechanism, possibly based on allelic variations within the DRD2 (dopaminergic receptor) gene. Because olfactory receptors, odor types, and MHC antigens are closely integrated, and because olfactory stimuli often incite episodes of pregnancy, nausea, and vomiting, hyperemesis gravidarum, and migraine headache, these genes and their products invite further scrutiny. The pregnancy-conserving effect of PNV and the MHC antigen overlap in couples with recurrent abortion are important clues possibly relating olfaction, MHC antigens, and reproductive success or failure.
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Am. J. Obstet. Gynecol. · May 2002
Randomized Controlled Trial Multicenter Study Clinical TrialEffectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial.
Pelvic inflammatory disease (PID) is a common and morbid intraperitoneal infection. Although most women with pelvic inflammatory disease are treated as outpatients, the effectiveness of this strategy remains unproven. ⋯ Among women with mild-to-moderate pelvic inflammatory disease, there was no difference in reproductive outcomes between women randomized to inpatient treatment and those randomized to outpatient treatment.