European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2004
ReviewEthical dilemmas in extreme prematurity: recent answers; more questions.
Advances in perinatal care allow survival of more extremely premature infants, but the implementation and continuation of intensive care may itself constitute an ethical dilemma, given the limited chances of intact survival among the patients most at risk. This paper discusses several key issues raised by the options that are under general consideration with reference to births of infants at the threshold of viability, in particular: the implications of making a distinction between extreme prematurity and other general medical situations that may involve decisions on ending support; the concrete nature of the restrictions on therapy in such patients interactions and the need for feedback between parents, medical staff and society.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2004
ReviewThe obstetrician and depression during pregnancy.
The objective of this article is to review the literature as to the presence of depression during and after pregnancy and some of its clinical implications; and to present a simple statistical aide for screening purposes. Clinical depression affects at least one in five women of childbearing age. During pregnancy, this figure does not diminish and not only signals problems for the pregnant woman but also for the child, measurably so into adolescence. ⋯ The obstetrician should regularly test for depression from the very first moments of planning for a child, and use the test results for a "pregnancy mood profile". This profile requires only a few minutes and is very simple to complex. It could serve for early control of depression during pregnancy as well as determine the risk for postpartum depression and thus serve as a pre-alert for postpartum suicide.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2003
ReviewCurrent status of intrapartum fetal monitoring: cardiotocography versus cardiotocography + ST analysis of the fetal ECG.
Two randomized controlled trials (RCT) on intrapartum fetal monitoring with cardiotocography (CTG) only versus CTG combined with automatic ST segment waveform analysis of the fetal ECG have been performed. In altogether 6826 randomized cases, the odds ratio for operative delivery for fetal distress (ODFD) was 0.65 (95% confidence interval 0.53-0.78) and for metabolic acidosis at birth 0.39 (0.21-0.72), in favor of the CTG+ST method. CTG combined with ST analysis increases the ability of obstetricians to identify fetal hypoxia and to intervene more appropriately, resulting in an improved perinatal outcome.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Aug 2002
ReviewMyasthenia gravis in pregnancy: report on 69 cases.
To review our experience with pregnancies in women with myasthenia gravis (MG). ⋯ MG patients can have normal pregnancy and delivery but the course is unpredictable. Shorter disease history and infection predispose to puerperal exacerbation. Maternal thymectomy lessens the likelihood of neonatal myasthenia. An interdisciplinary approach is required for managing the pregnant women with MG.