Obstetrics and gynecology
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Obstetrics and gynecology · Jul 2003
ReviewDiagnosis and management of gestational hypertension and preeclampsia.
Gestational hypertension and preeclampsia are common disorders during pregnancy, with the majority of cases developing at or near term. The development of mild hypertension or preeclampsia at or near term is associated with minimal maternal and neonatal morbidities. In contrast, the onset of severe gestational hypertension and/or severe preeclampsia before 35 weeks' gestation is associated with significant maternal and perinatal complications. ⋯ Magnesium sulfate should be used during labor and for at least 24 hours postpartum to prevent seizures in all women with severe disease. There is an urgent need to conduct randomized trials to determine the efficacy and safety of antihypertensive drugs in women with mild hypertension-preeclampsia. There is also a need to conduct a randomized trial to determine the benefits and risks of magnesium sulfate during labor and postpartum in women with mild preeclampsia.
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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.
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Obstetrics and gynecology · Jun 2003
Physician cesarean delivery rates and risk-adjusted perinatal outcomes.
To compare perinatal outcomes in obstetric practices with high and low cesarean delivery rates. ⋯ Low cesarean delivery rates reduced the rate of uterine rupture and were not associated with increased perinatal mortality. The data suggest a small increase in intracranial hemorrhages in infants delivered by physicians who perform relatively few cesarean deliveries.
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Obstetrics and gynecology · Jun 2003
Randomized Controlled Trial Clinical TrialRandomized clinical trial of extended spectrum antibiotic prophylaxis with coverage for Ureaplasma urealyticum to reduce post-cesarean delivery endometritis.
To determine if extended spectrum prophylactic antibiotic treatment (with efficacy against Ureaplasma urealyticum) reduces post-cesarean delivery clinical endometritis. ⋯ Extended spectrum prophylactic antibiotic treatment (with presumed efficacy against U urealyticum) given to women undergoing cesarean delivery at term shortens hospital stay and reduces the frequency of post-cesarean delivery endometritis and wound infections.
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Obstetrics and gynecology · Jun 2003
Case ReportsSuccessful treatment of life-threatening postpartum hemorrhage with recombinant activated factor VII.
Postpartum hemorrhage is one of the most common causes of maternal mortality and morbidity worldwide. The aims of treatment are to maintain the circulation and to stop the bleeding. The latter is achieved by either medical or surgical management. In intractable bleeding, emergency hysterectomy is usually required. ⋯ Recombinant factor VIIa may be an alternative hemostatic agent in a patient with life-threatening postpartum hemorrhage unresponsive to conventional therapy.