Journal of midwifery & women's health
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J Midwifery Womens Health · May 2011
ReviewClinicians' guide to the use of oxytocin for labor induction and augmentation.
Oxytocin is commonly used in obstetrics for labor induction and augmentation. Careful assessment of the individual clinical situation based on indications and contraindications is essential to enhancing safe and effective use. Counseling the woman and her partner regarding potential risks and benefits before use is necessary to promote informed consent. ⋯ Although treatment of excessive uterine activity related to oxytocin has not been studied prospectively, several interventions such as maternal repositioning, an intravenous fluid bolus, and discontinuation of the oxytocin infusion are beneficial in returning uterine activity to normal, based on retrospective review of oxytocin-induced tachysystole. Perinatal quality measures from the National Quality Forum and the Joint Commission can be useful in monitoring care related to induction of labor. These include elective births before 39 weeks of pregnancy and cesarean births for low-risk, first-birth mothers.
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J Midwifery Womens Health · May 2011
ReviewHormonal management of the female-to-male transgender patient.
This article focuses on initiating and monitoring testosterone therapy for the female-to-male transgender person. For providers unfamiliar with the evaluation and treatment of the female-to-male transgender patient, this article offers an introduction to the diagnostic criteria for gender identity disorder as well as the eligibility and readiness criteria for hormonal treatment. Also included is information regarding screenings to be done before the initiation of testosterone therapy and during follow-up visits, common side effects of testosterone, and basic testosterone regimens available.
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Adverse drug reactions (ADRs) are drug-related adverse events that occur in individuals using usual or therapeutic doses of medication. Women have a nearly 2-fold greater risk for developing ADRs than men, and they are more likely to be hospitalized secondary to an ADR. This article reviews the physiologic mechanisms of ADRs, common clinical manifestations of ADRs to medications often prescribed in women's health care, documentation and reporting of ADRs, and ADR prevention strategies.
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J Midwifery Womens Health · May 2011
ReviewA review of systemic opioids commonly used for labor pain relief.
Parenteral opioids for pain relief during labor have been the subject of research for many decades. Commonly used systemic opioids provide limited pain relief during labor yet are used extensively for managing labor pain. These opioids share similar pharmacologic profiles but differ in potency, pharmacokinetics, and side effects. This article reviews the pharmacokinetics, pharmacodynamics, and clinical research related to the commonly used systemic labor pain analgesics morphine, meperidine, fentanyl, remifentanil, butorphanol, and nalbuphine.