Clinical obstetrics and gynecology
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Clin Obstet Gynecol · Jun 2013
ReviewIndications, contraindications, and complications of mesh in surgical treatment of pelvic organ prolapse.
Women are seeking care for pelvic organ prolapse in increasing numbers and a significant proportion of them will undergo a second repair for recurrence. This has initiated interest by both surgeons and industry to utilize and design prosthetic mesh materials to help augment longevity of prolapse repairs. Unfortunately, the introduction of transvaginal synthetic mesh kits for use in women was done without the benefit of level 1 data to determine its utility compared with native tissue repair. This report summarizes the potential benefit/risks of transvaginal synthetic mesh use for pelvic organ prolapse and recommendations regarding its continued use.
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Myasthenia gravis is an autoimmune disease of the neuromuscular junction characterized by painless fluctuating skeletal muscle weakness. Disease exacerbations are more likely to occur in the first trimester or puerperium. ⋯ Mainstay treatments involve acetylcholine esterase inhibitors, corticosteroids and other immunosuppressants, and adequate rest. Newborns may suffer in utero or neonatal consequences, usually transient, of transplacental antibody exposure.
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Clin Obstet Gynecol · Mar 2013
ReviewPharmacologic management of neonatal abstinence syndrome in a community hospital.
Neonatal abstinence syndrome has become a growing concern in infants born to substance-abusing mothers in the State of Florida. At Sarasota Memorial Hospital in Sarasota, FL, methadone and morphine treatment strategies have been formulated to manage symptomatic neonates after birth. We report our findings over a 5-year period utilizing each of these protocols in a community hospital setting.
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Clin Obstet Gynecol · Dec 2012
Early recognition of serious infections in obstetrics and gynecology.
Pelvic infections commonly occur in pregnant and postoperative women. Most of these infections are readily diagnosed because of their typical clinical manifestations and prompt antimicrobial therapy that leads to the resolution of disease. However, uncommon cases may escape detection and the severity of the process may also go unrecognized without a careful assessment of clues available through physical examination and laboratory testing. In some cases a particularly virulent pathogen can lead to severe infection, septic shock and its consequences, even death, despite clinicians acting appropriately.