American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 2007
Randomized Controlled Trial Comparative StudyRandomized trial comparing 3 methods of postoperative analgesia in gynecology patients: patient-controlled intravenous, scheduled intravenous, and scheduled subcutaneous.
The objective of the study was to determine whether any of 3 routes of opioid administration (patient-controlled analgesia [PCA], scheduled intermittent intravenous [i.v.], or scheduled intermittent subcutaneous [s.q.]) provides superior pain relief and satisfaction among patients undergoing abdominal gynecologic surgery. ⋯ Given these findings as well as those in previous literature, no specific method of postoperative analgesia appears to be superior.
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Am. J. Obstet. Gynecol. · Nov 2007
Does a maximum dose of oxytocin affect risk for uterine rupture in candidates for vaginal birth after cesarean delivery?
The purpose of this study was to determine whether the maximum dose of oxytocin impacts the risk of uterine rupture in women who attempt vaginal birth after cesarean delivery (VBAC). ⋯ In VBAC attempts, a dose-response relationship of maximum oxytocin and uterine rupture exists. These results provide evidence for vigilance when higher doses of oxytocin are given to patients who attempt VBAC.
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Am. J. Obstet. Gynecol. · Nov 2007
Case ReportsProphylactic balloon occlusion of the internal iliac arteries to treat abnormal placentation: a cautionary case.
Massive hemorrhage from abnormal placentation is a leading cause of postpartum maternal death and hysterectomy after cesarean section. The endovascular surgeon and radiologist are increasingly asked to assist in the management of these complex patients with the placement of bilateral internal iliac artery balloon catheters. ⋯ A review of the vascular and obstetrical literature reveals divergent recommendations for the use of this technique in patients with abnormal placentation. No guidance from rigorous prospective evidence is available and thus we offer recommendations for the cautious use of this modality.
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Am. J. Obstet. Gynecol. · Oct 2007
Comparative StudyCase-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta.
The objective of the study was to compare outcomes of women with placenta accreta who underwent cesarean hysterectomy with and without prophylactic intravascular balloon catheters. ⋯ Prophylactic intravascular balloon catheters did not benefit women with placenta accreta undergoing cesarean hysterectomy.