Obstetrics and gynecology
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Obstetrics and gynecology · Oct 1996
Effect of maternal age and parity on the risk of uteroplacental bleeding disorders in pregnancy.
To examine the risk of placental abruption, placenta previa, and uterine bleeding of unknown etiology in relation to advanced maternal age and parity in a large, population-based study. ⋯ Multiparity is associated with the risk of placenta previa and, to a lesser extent, placental abruption, but not with other uterine bleeding. Increasing maternal age is associated independently with the risk of placenta previa, but not with either of the other two conditions. Finally, the increased risks of uteroplacental bleeding disorders with advanced parity among the younger women (ie, 20-25 years, parity 3+) may reflect effects of close pregnancy spacing, or confounding by unmeasured factors that characterize women who have many pregnancies at a relatively young age. Overall, the findings suggest that the three uteroplacental bleeding disorders do not share a common etiology in relation to maternal age and parity, and that placenta previa is linked to aging of the uterus and the effects of repeated pregnancies.
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Obstetrics and gynecology · Oct 1996
Case ReportsEvaluation of fetal and uterine hemodynamics during maternal cardiopulmonary bypass.
About 4% of pregnant women have concomitant cardiac disease and a few of these do not respond to medical therapy and require surgical correction during pregnancy. We report a unique case describing fetal hemodynamics and uterine blood flow before, during, and after maternal cardiopulmonary bypass, and compare them to normal reference values in the second trimester. ⋯ Despite high peak flow rates, normal mean arterial pressure, and normothermia, fetal outcome was dismal. Nonpulsatile cardiopulmonary bypass under normothermia may not be able to meet the demands of the fetoplacental circulation.
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Obstetrics and gynecology · Oct 1996
Case ReportsSacrospinous colpopexy: management of postoperative pudendal nerve entrapment.
Sacrospinous colpopexy requires the placement of a suture through the sacrospinous ligament, under which lies the pudendal nerve. Entrapment of this nerve may result in perineal or buttock pain. This report analyzes a case of pudendal nerve entrapment and studies the management of the resultant neuropathy. ⋯ Pudendal nerve entrapment should be considered in the differential diagnosis of perineal or buttock pain after sacrospinous colpopexy. Relief of pain can be achieved even 2 years after initial surgery.
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Obstetrics and gynecology · Oct 1996
Case ReportsManagement of intermittent ovarian torsion by laparoscopic oophoropexy.
Ovarian torsion is a serious gynecologic condition that often results in adnexal removal. If recurrent, this can result in castration of young patients. Torsion in the pediatric population is rare, but it presents more management challenges for gynecologists. There are few reports of prophylactic oophoropexy in patients with intermittent torsion. ⋯ We believe that this is the first reported case of laparoscopic triplication of the utero-ovarian ligament to prevent recurrent torsion. In young patients, this treatment may be a reasonable alternative to oophoropexy as prophylaxis for ovarian torsion.