J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Oct 2004
Review Meta Analysis[Magnesium sulfate in obstetrics: current data].
To review the available evidence regarding history, pharmacology, physiology, maternal/fetal side effects, and efficacy of magnesium sulfate in pregnant women. ⋯ The evidence to date confirms the efficacy of magnesium sulfate therapy for women with eclampsia and preeclampsia. However, magnesium sulfate should not be used in order to treat preterm labor.
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J Gynecol Obst Bio R · May 2009
Review Case Reports[Boerhaave syndrome and pregnancy. A case report and review of the literature].
The syndrome of Boerhaave is a rare affection, corresponding to a spontaneous rupture of the oesophagus, the prognosis of which depends on the precocity of cares. Clinically, it is characterized by a set of three: efforts of vomitings, thoracic pain and subcutaneous emphysema. We report the first case of spontaneous rupture of the oesophagus in a 3-month pregnant woman, further to incoercible vomiting. ⋯ The surgery as a matter of urgency, usually indicated in this pathology, was not realized in this context of pregnancy. The obstetric and neonatal future was favorable. We discuss the diagnostic difficulties, the modalities of cares as well as the prognosis of such a pathology.
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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.
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J Gynecol Obst Bio R · Oct 2009
[Postpartum perineal pain: effectiveness of local ropivacaine infiltration].
To assess efficiency of local ropivacaine infiltration in perineal pain after episiotomy and perineal tear during the first 24 h after vaginal delivery. ⋯ Local ropivacaine infiltration in episiotomy and/or perineal tear reduce post-partum perineal pain within the first 24 h.
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J Gynecol Obst Bio R · May 2009
Multicenter Study[Impact of a new regional management for postpartum hemorrhages by an audit of severe cases: a before and after study (2002-2005)].
Postpartum haemorrhage (PPH) is still the first cause of maternal mortality in France. Most of these cases include inappropriate management. In 2004, regional guidelines were diffused to all the birthplaces in Basse-Normandie. To assess the impact of this regional management, an epidemiological study "before-after" (2002-2005) has been performed. Part of this study was the evaluation of the management of severe PPH. ⋯ The originality from this study is that the modifications of the practices were conducted at a regional level in order to enhance the management of PPH. The assessment which was performed showed that quality of care was improved all over the area but that there is still place to progress.