J Reprod Med
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Multicenter Study
Incidence and determinants of peripartum hysterectomy in the metropolitan area of the District of Columbia.
To review the impact of the changes that have occurred in the standard of care in obstetrics and in the trend of cesarean delivery rates in recent times and factors associated with peripartum hysterectomy procedure. ⋯ Our results suggest that primary and repeat cesarean deliveries, advanced maternal age, obesity, and grand multiparity, uterine atony, placenta previa, and placental accreta, and class III and IV hemorrhage are independently associated with an increased risk for peripartum hysterectomy. These findings may be of concern given the increasing rate of cesarean deliveries in the District.
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Randomized Controlled Trial Multicenter Study
French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study.
A previous open study demonstrated that French maritime pine bark extract (Pycnogenol) may soothe menstrual pain in dysmenorrhea. We thus investigated the effects of Pycnogenol on menstrual pain in a double-blind study. ⋯ The analgesic-sparing effect of Pycnogenol increases with duration of supplementation and benefits persist even after discontinuation.
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Multicenter Study
Uterine contraction frequency before and after successful tocolytic therapy for preterm uterine contractions.
To examine the association between prelabor uterine contraction frequency (UCF) and the success of tocolytic therapy for preterm labor (PTL). ⋯ The mean UCF immediately preceding PTL does not predict tocolytic success or failure.
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Multicenter Study
Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types.
To determine the risk factors for third-degree perineal tears during vaginal delivery and to investigate the relation between different types of episiotomy and the occurrence of such tears. ⋯ We found several risk factors for third-degree perineal tears. The use of midline episiotomy was associated especially with an increased risk of severe anal sphincter tears. To prevent women from long-term sequelae due to third-degree perineal tears, avoidable risk factors should be minimized whenever possible.