American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2006
Operative vaginal delivery and midline episiotomy: a bad combination for the perineum.
The purpose of this study was to determine the impact of operative vaginal delivery (forceps or vacuum) and midline episiotomy on the risk of severe perineal trauma. ⋯ The use of operative vaginal delivery, particularly in combination with midline episiotomy, was associated with a significant increase in the risk of anal sphincter trauma in both primigravid and multigravid women. Given the reported substantial long-term adverse consequences for anal function, this combination of operative modalities should be avoided if possible.
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Am. J. Obstet. Gynecol. · Aug 2006
Inhibitory effect of leptin on human uterine contractility in vitro.
The purpose of this study was to investigate the effects of leptin on human uterine contractility in vitro. ⋯ This physiologic inhibitory effect of leptin on uterine contractility may play a role in the dysfunctional labor process associated with maternal obesity, and the resultant high cesarean section rates.
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Am. J. Obstet. Gynecol. · Aug 2006
Comparative StudyTiming of scheduled cesarean delivery in patients on a teaching versus private service: adherence to American College of Obstetricians and Gynecologists guidelines and neonatal outcomes.
The purpose of this study was to compare adherence to American College of Obstetricians and Gynecologists guidelines for the timing of scheduled cesarean delivery in patients of a resident teaching service and patients of a private service to determine the neonatal intensive care unit admission rate and the most frequent admission diagnoses after scheduled cesarean delivery and to compare neonatal outcomes between the groups. ⋯ The overall neonatal intensive care unit admission rate after scheduled cesarean delivery in this study is consistent with that reported in the neonatology literature. Patients of a teaching service were a demographically different group than those on the private service, were less likely to get an elective primary cesarean delivery, and were more likely to be delivered in adherence to American College of Obstetricians and Gynecologists guidelines, although this did not significantly affect the rates of admission to the neonatal intensive care unit or neonatal outcome.
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Am. J. Obstet. Gynecol. · Jul 2006
Multicenter StudySTAN in clinical practice--the outcome of 2 years of regular use in the city of Gothenburg.
The purpose of this study was to monitor the introduction of the STAN-methodology (Noventa Medical, Moelndal, Sweden). ⋯ Increasing STAN usage provided consistent improvements in fetal outcome equalling those noted in the Swedish randomized controlled trial (RCT) without increasing operative interventions for fetal distress.
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Am. J. Obstet. Gynecol. · Jul 2006
Case ReportsCharacteristics and treatment of hepatic rupture caused by HELLP syndrome.
The purpose of this study was to review the management of hepatic rupture caused by HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome and to assess maternal and perinatal outcomes of these cases. ⋯ A combination of surgical treatment with hepatic artery ligation and omental patching with supportive measures was effective in decreasing the mortality rate in hepatic rupture caused by HELLP syndrome.