Obstetrics and gynecology
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Obstetrics and gynecology · May 1983
Comparative StudyA double-blind comparison of a propionic acid derivative (ibuprofen) and a fenamate (mefenamic acid) in the treatment of dysmenorrhea.
A double-blind three-way crossover design in the treatment of dysmenorrhea comparing a propionic acid derivative (ibuprofen) and a fenamate (mefenamic acid) with a placebo showed that both ibuprofen and mefenamic acid are generally superior to placebo. Statistically significant results were obtained in favor of the study drugs over placebo for the pain relief afforded by the treatments (as graded by patients) and the visual analog pain relief score, which not only ranks but also indicates the degree of pain relief as a percentage of total relief (100%). Pairwise comparisons for the ranks found mefenamic acid significantly superior to placebo (P less than .001) and ibuprofen marginally superior to placebo (P less than .06), while the visual analog pain relief scale demonstrated mefenamic acid and ibuprofen superior to placebo (P less than .001 and P less than .01, respectively). ⋯ These were generally of minor severity or importance and were not statistically different. The need for additional analgesics and the ability to pursue normal daily activity were not different for any treatment group. The findings of this study indicate no clinical difference between a propionic acid derivative such as ibuprofen and a fenamate such as mefenamic acid in the treatment of dysmenorrhea.
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The loss or threatened loss of an infant in the perinatal period is a tragic event. The practitioner often feels helpless in trying to ease the family's grief. ⋯ Suggested interventions for the couple at the time of delivery and a discussion of the needs of other family members are presented. Preparing the family for discharge from the hospital and follow-up are also discussed.
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Obstetrics and gynecology · Mar 1983
Case ReportsAmniotic fluid embolus-like syndrome presenting in the second trimester of pregnancy.
Two cases of sudden cardiopulmonary embarrassment and profound disseminated intravascular coagulation occurring in the second trimester of pregnancy are described and a third from the literature is reviewed. All 3 pregnancies were complicated by persistent uterine bleeding. ⋯ At this time no specific recommendations for prevention or treatment can be made. Vigorous support of the mother appears to offer the best chance for a successful outcome.
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Obstetrics and gynecology · Jan 1983
The relation between fetal heart rate accelerations and fetal movements.
Fetal heart rate (FHR) accelerations associated with fetal movements is considered a sign of fetal well-being. Fetal movements as felt by the pregnant woman and visualized by real-time ultrasonography were correlated to FHR accelerations in 52 normal and high-risk pregnant women. All fetal movements felt by the mother or seen in the real-time ultrasonography were associated with large FHR accelerations (more than 15 beats per minute lasting 15 seconds or more) or small accelerations (fewer than 15 beats per minute). ⋯ The small accelerations were associated with 52.9% of fetal movements felt by the mother and 82.4% of fetal movements seen by ultrasonography. Mothers felt 75.7% of fetal movements seen by real-time ultrasonography. It was concluded that fetal movements could be verified by existence of large accelerations on the FHR tracing.