European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Mar 2007
ReviewNon-obstetrical acute abdomen during pregnancy.
Acute abdomen in pregnancy remains one of the most challenging diagnostic and therapeutic dilemmas today. The incidence of acute abdomen during pregnancy is 1 in 500-635 pregnancies. Despite advancements in medical technology, preoperative diagnosis of acute abdominal conditions is still inaccurate. ⋯ Surgical treatment is indicated in most cases, as in nonpregnant women. Laparoscopic procedures in the treatment of acute abdomen in pregnancy proved safe and accurate, and in selected groups of patients are becoming the procedures of choice with a perspective for the widening of such indications with more frequent use and subsequent optimal results. Despite these advances, laparotomy still remains the procedure of choice in complicated and uncertain cases.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2006
ReviewInterventions for leg edema and varicosities in pregnancy. What evidence?
Leg oedema from venous insufficiency is not dangerous but it can cause women symptoms such as pain, feelings of heaviness, night cramps and paraesthesiae. Leg oedema can be a sign of pre-eclampsia when associated with raised blood pressure or proteinuria. The objective of this review was to assess the effects of treatment to relieve the symptoms associated with varicosity in pregnancy and to reduce leg oedema. ⋯ In conclusions, rutosides appear to relieve symptoms of venous insufficiency in late pregnancy. However, it is not known if the drug is safe in pregnancy. External pneumatic compression appears to reduce ankle swelling and compression stockings reduce leg symptoms but not varicose veins.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2006
ReviewIsobaric (gasless) laparoscopic uterine myomectomy. An overview.
The aim of this review has been to assess the usefulness and effectiveness of isobaric (gasless) laparoscopic myomectomy using a subcutaneous abdominal wall lifting system, and to evaluate the advantages and disadvantages of this technique in comparison with the conventional laparoscopic myomectomy using pneumoperitoneum. Laparoscopy using CO2 is more frequently employed for small or medium-sized myomas. Furthermore, multiple myomectomies (>or=3 myomas per patient) are performed rarely. ⋯ Laparoscopic myomectomy using CO2 remains the preferred minimally invasive approach for small and medium-sized myomas and when the total number of myomas removed does not exceed 2 or 3. Gasless laparoscopic myomectomy could be mainly indicated for removal of large intramural myomas (>or=8 cm) and/or for multiple myomectomies (>or=3 myomas per patient). Anyhow, further controlled studies are needed to evaluate entirely their respective indications.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 2005
Review Historical ArticleA historical perspective on pregnancy-related low back and/or pelvic girdle pain.
The growing interest in pregnancy-related low back and/or pelvic girdle pain has invoked research projects to this subject. Although it seems a modern syndrome, historical articles show that pregnancy-related pelvic girdle pain (PPGP) was already known centuries ago. ⋯ These differences can be explained by the use of different definitions and descriptions of pregnancy-related pelvic girdle pain between studies. In conclusion, it is necessary to search for an evidence-based overall definition of pregnancy-related pelvic girdle pain in order to provide more knowledge about incidence rates, etiologic factors and other related subjects.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2004
Review Comparative StudyIs it possible to improve diagnostic and prognostic criteria of preterm labour?
Preterm labour is a frequent cause of admission to hospital during pregnancy. However, in most cases, preterm labour is diagnosed with reference to clinical criteria only. Since the clinical assessment of uterine contractions and of cervical changes is highly subjective, few of the patients admitted to the hospital with suspected preterm labour will ultimately deliver preterm. ⋯ In the future, the assessment of cervical status may be based not only on anatomical changes, but also on functional criteria. New techniques are being developed for evaluation of the mechanical properties of the cervix (cervical distensibility), noninvasive measurement of its collagen content (light-induced fluorescence of cervical collagen), or even direct assessment of the changes in cervical water content (magnetic resonance imaging). Correlations have been found between these measurements and the risk of preterm birth, but clinical studies are still needed to allow better assessment of the predictive value of these new methods in clinical practice.