Obstetrics and gynecology
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Obstetrics and gynecology · May 2010
First-trimester vaginal bleeding and complications later in pregnancy.
To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy. ⋯ Women with first-trimester bleeding in the first pregnancy have an increased risk of complications later in the first pregnancy and of recurrence of first-trimester bleeding and other complications in the second pregnancy.
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Obstetrics and gynecology · May 2010
ReviewMultidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review.
To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. ⋯ Introduction of multidisciplinary teamwork training with integrated acute obstetric training interventions in a simulation setting is potentially effective in the prevention of errors, thus improving patient safety in acute obstetric emergencies. Studies on its effectiveness and cost-effectiveness are needed before team training can be implemented on broad scale.
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Obstetrics and gynecology · May 2010
Randomized Controlled Trial Comparative StudyPromethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial.
To compare the effects of promethazine with those of metoclopramide for hyperemesis gravidarum. ⋯ Promethazine and metoclopramide have similar therapeutic effects in patients who are hospitalized for hyperemesis gravidarum. The adverse effects profile was better with metoclopramide.
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Obstetrics and gynecology · May 2010
Evaluating risk-adjusted cesarean delivery rate as a measure of obstetric quality.
To validate the risk-adjusted cesarean delivery rate as a measure of obstetric quality through its association with maternal and neonatal outcomes for all pregnancies (model 1) and in primiparous patients with singleton pregnancies (model 2). ⋯ Lower-than-expected risk-adjusted cesarean delivery rates in all patients or when restricted to a more homogeneous group of primiparous patients with term singleton pregnancies are associated with higher-than-expected adverse maternal or neonatal outcomes. Higher-than-expected risk-adjusted cesarean delivery rates do not result in improved outcomes.
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To estimate the incidence of amniotic-fluid embolism and to describe risk factors, management, and outcomes. ⋯ High-quality supportive care can result in good maternal outcomes after amniotic-fluid embolism. Clinicians should consider both the risks and benefits of induction and cesarean delivery because more restricted use may result in a decrease in the number of women suffering a potentially fatal amniotic-fluid embolism. The observed increased risk of fatality in ethnic-minority women may be associated with differences in underlying medical conditions or access to care, and clinicians should that ensure appropriate services are provided to minimize this risk.