J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Sep 2005
Case Reports[Acute pulmonary edema during nicardipine and salbutamol therapy for preterm labor in twin pregnancy].
We report the case of a 38-year-old parturient at 30 weeks 2 days term of a multiple pregnancy who experienced acute pulmonary edema more than 48 hours after tocolytic treatment with nicardipine and salbutamol. The patient was transferred from a level 1 perinatal center to a level 3 perinatal center by the Grenoble mobile intensive care unit in application of the in utero transfer protocol for preterm labor before 33 weeks with twin pregnancy. This case illustrates the risk of tocolytic treatment and potential adverse effects in the event of preterm labor on twin pregnancy. The question of associating a second tocolytic after failure of the first is also raised.
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J Gynecol Obst Bio R · Jun 2005
Review Case Reports[Endometriosis with massive hemorrhagic ascites: a case report and review of the literature].
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It generally involves the peritoneum, ovaries and rectovaginal septum. Its characteristic symptoms include dysmenorrhea, pelvic pain, deep dyspareunia and infertility. ⋯ The future treatement will consists of GnRH analog for about six months, which will be relayed by a long term progestative therapy. A diagnosis of endometriosis should always be considered in middle-age women who presents with bloody ascites. Long follow-up is advisable for patients who undergo conservative treatment because of thehigh risk of recurrence.
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J Gynecol Obst Bio R · Apr 2005
[Gestational trophoblastic diseases: a retrospective study from 1997 to 2003].
Trophoblastic diseases correspond to a very heterogeneous group of rare pathology in young women which fertility should be preserved. ⋯ Persistent gestational disease should be managed in a highly specialized centre, as developed in the Lyon University Hospital.
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J Gynecol Obst Bio R · Feb 2005
Review[Air or oxygen for neonatal resuscitation in the delivery room?].
Most of the contemporary guidelines on newborn resuscitation are based on experience but lack scientific evidence. The use of 100% oxygen is one of the more evident. Today, these practices are questioned, particularly for the resuscitation of moderately depressed full term or near term newborns. ⋯ On the basis of these data, air can be the initial gas to use for these babies. Large scale trials, including preterm and cause and/or severity of initial asphyxia, must now be undertaken before the publication of new guidelines for these populations. Particularly severely asphyxiated infants might require supplemental oxygen with titration of oxygen delivery and continuous monitoring of oxygen saturation.
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J Gynecol Obst Bio R · Dec 2004
Review Practice Guideline Guideline[Risk factors of postpartum hemorrhage during labor and clinical and pharmacological prevention].
Prevention of postpartum hemorrhage (PPH) is a major concern in regards to its impact on maternal morbidity and mortality. While established risk factors can be identified among risk factors of PPH during labor after multivariate analysis: prolonged labor, oxytocin stimulation of labor, cesarean section, instrumental delivery, genital lacerations and episiotomy, prolonged third stage of labor, retained placenta; other risk factors are still uncertain: induction of labor, hyperthermia or chorioamniotitis, analgesia or anesthesia, macrosomia, various cesarean section techniques. Isolated identified risk factors have a moderate incidence on PPH, but their cumulation in one patient is a potential high risk. ⋯ The alternative use of prophylactic misoprostol in the third stage of labor is less effective than injectable uterotonics in reducing PPH, and is associated with more side effects (severe shivering, pyrexia, diarrhea). None of other described prophylactic methods have proved efficiency: early suckling, umbilical blood drainage, oxytocin umbilical vein injection, among others. A decrease in PPH prevalence should be obtained by particular attention on data from the early postpartum period, active diffusion of effective prophylactic techniques, and an appropriate choice in regards to each delivery unit organization.