Obstetrics and gynecology
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Obstetrics and gynecology · Sep 2003
Lymphovascular and perineural invasion in the parametria: a prognostic factor for early-stage cervical cancer.
To estimate the impact of parametrial lymphovascular and perineural involvement on nodal metastasis and failure pattern of women with early-stage, surgically treated cervical cancer. ⋯ Presence of parametrial lymphovascular space invasion correlates significantly with the risk of nodal metastasis in women with early-stage cervical cancer. Parametrial perineural invasion is an independent poor prognostic factor. Histopathologic findings within the parametria are a valuable independent predictor of recurrence and thus may influence the selection of patients for adjuvant treatment.
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Obstetrics and gynecology · Aug 2003
Simulation laboratories for training in obstetrics and gynecology.
Simulations have been used by the military, airline industry, and our colleagues in other medical specialties to educate, evaluate, and prepare for rare but life-threatening scenarios. Work hour limits for residents in obstetrics and gynecology and decreased patient availability for teaching of students and residents require us to think creatively and practically on how to optimize their education. Medical simulations may address scenarios in clinical practice that are considered important to know or understand. ⋯ We briefly describe an example of how simulation may be incorporated into obstetric and gynecologic residency training. It is our contention that educators in obstetrics and gynecology should be aware of the potential for simulation in education. We hope this commentary will stimulate interest in the field, lead to validation studies, and improve training in and the practice of obstetrics and gynecology.
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Obstetrics and gynecology · Aug 2003
Practice Guideline Guideline Retracted PublicationACOG Committee Opinion Number 284, August 2003: Nonobstetric surgery in pregnancy.
Although there are no data to support specific recommendations regarding nonobstetric surgery and anesthesia in pregnancy, it is important for nonobstetric physicians to obtain obstetric consultation before performing nonobstetric surgery. The decision to use fetal monitoring should be individualized, and each case warrants a team approach for the optimal safety of the woman and her baby.
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Obstetrics and gynecology · Jul 2003
ReviewEthical and medicolegal considerations in the obstetric care of a Jehovah's Witness.
Jehovah's Witnesses comprise a unique obstetric population. Their refusal of blood stems from an interpretation of a literal translation of the Bible, and it is this belief that puts them at an increased risk of morbidity and mortality if hemorrhage occurs. Many Jehovah's Witnesses feel that accepting a blood transfusion will lead them to eternal damnation. ⋯ This brings a new twist to the physician's obligation to "do no harm." When one undertakes the care of one of these patients, it is important to understand the ethical and medicolegal ramifications. The decision to be the primary caregivers can only be made once the physicians have decided they can let the patient die when all other options have been exhausted. This commentary discusses the ethical concerns and reviews the alternatives available to a Jehovah's Witness.
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Obstetrics and gynecology · Jul 2003
Comparative StudyThe influence of interpregnancy interval on the subsequent risk of stillbirth and early neonatal death.
To study whether interpregnancy interval is associated with increased risks of stillbirth and early neonatal death and whether this possible association is confounded by maternal characteristics and previous reproductive history. ⋯ Short interpregnancy intervals appear not to be causally associated with increased risk of stillbirth and early neonatal death, whereas long interpregnancy intervals were associated with increased risk of stillbirth and possibly early neonatal death.