European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 1995
ReviewThe nature and consequences of childbirth pain.
For most women, childbirth is associated with very severe pain often exceeding all expectations. Some childbirth education groups and popular texts on the subject, however, seem disposed to encourage unrealistic expectations: claiming that labour is other than painful and that pharmacological analgesia is both unnecessary and harmful. All too often, those who promote such views witness women in labour only occasionally and are rarely responsible for patient care. ⋯ As described in this review, it is now well established that uterine contraction pain evokes a generalised neuroendocrinal stress response producing widespread physiological effects during the first stage of labour. They include increased oxygen consumption, hyperventilation and respiratory alkalosis; increased cardiac output, systemic peripheral resistance and blood pressure; delayed gastric emptying; impaired uterine contractility and diminished uterine perfusion; and metabolic acidaemia. While other factors (such as anxiety, starvation and physical exertion) are also partly responsible for inducing some of these effects, pain appears to be the most potent source because they are all obtunded by effective epidural analgesia.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 1995
Retinal detachment in association with preeclampsia and abruptio placentae.
Retinal detachment is a rare complication of preeclampsia, eclampsia and abruptio placentae. We report a case of bilateral retinal detachment in association with severe preeclampsia complicated with abruptio placentae, intrauterine fetal death and disseminated intravascular coagulation. In obstetric complications, placental thromboplastin may release into maternal circulation and activate the extrinsic coagulation system with resultant disseminated intravascular coagulation. This may be responsible for choroidal ischemia and consequent serous retinal detachment.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Feb 1995
Case ReportsEndometriosis of the sciatic nerve: case report demonstrating the value of MR imaging.
Among the many causes of sciatica, endometriosis, a rare aetiology, should be considered in menstruating women in view of the diagnostic strategy and ensuing therapeutic implications. We report a case of sciatic nerve involvement with endometriosis in contact with the nerve in the left sciatic notch. Exploration by MRI was invaluable for the diagnosis, revealing a signal on the stem of the nerve suggestive of a lesion with haemorrhagic content.