The Simplified Acute Physiologic Score accurately predicts hospital death in critically ill obstetric patients admitted for medical reasons but not for disorders related to pregnancy and delivery.
Pelvic arterial embolization offers women a safe, effective, fertility-preserving alternative to hysterectomy for treatment of intractable postpartum hemorrhage.
Normal, term, nonanomalous breech fetuses delivered vaginally have increased neonatal morbidity and, in nulliparous women, increased mortality compared with breech cesarean delivery.
Plan B and Preven are infrequently available in stock in pharmacies in a moderately sized metropolitan area.
Postmenopausal women with increased plasma low-density lipoprotein cholesterol levels have greater probability of being osteopenic compared with women with normal plasma low-density lipoprotein cholesterol levels.
Bacterial vaginosis occurs commonly in the sexually experienced and inexperienced, is related to concurrent Chlamydia trachomatis, and is inversely related to hormonal contraceptive use.
Chronic pelvic pain after pelvic inflammatory disease is associated with reduced physical and mental health.
Aside from frequency of incontinence, use of protection, and previous treatment for incontinence, there is little association between baseline clinical variables and outcomes of behavioral intervention for urinary incontinence.
Most women residents in obstetrics and gynecology work more than 80 hours per week throughout pregnancy.
Vertical skin incisions are associated with a higher rate of wound complications in severely obese women undergoing cesarean delivery.
One additional dose of a broad-spectrum combination of antibiotics is sufficient postpartum therapy for immune competent women with chorioamnionitis.
Endometritis is common among relatively asymptomatic human immunodeficiency virus–infected women who have a low prevalence of sexually transmitted diseases.
Varicella vaccine virus does not seem to be excreted in breast milk, and postpartum vaccination of susceptible women need not be delayed because of breast-feeding.
Over 27 years, the incidence of choriocarcinoma declined by 49.7% and survival improved, but incidence and mortality rates were higher among blacks.
Maternal serum concentrations of both vascular endothelial growth factor and b-human chorionic gonadotropin were increased in women with preeclampsia, but they did not correlate except in women with placental insufficiency.
A validated Spanish version of the Pelvic Organ Prolapse Incontinence Sexual Questionnaire has been developed.
Childbearing beyond maternal age of 50 years is associated with significant increase in risk of fetal morbidity and mortality.
Women 35 years and older have an increased risk of pregnancy-related death regardless of parity, amount of prenatal care, or education compared with younger women.
Adjusting for confounders, a prepregnancy weight over 200 pounds (91 kg) increases the risks for gestational diabetes, preeclampsia, cesarean delivery, macrosomia, and neonatal intensive care unit treatment.
Although placental chorioangioma is associated with an increased risk for pregnancy complications, perinatal outcome in these cases is generally good.
This study quantifies the appearance and location of urethral and bladder neck structures in healthy, continent, nulliparous women on magnetic resonance images.
Despite the effectiveness of education in increasing folic acid awareness among Michigan mothers, substantial gaps in awareness exist among certain subpopulations.
Among minority women in public clinics, an innovative group prenatal care program resulted in higher birth weight, especially for preterm infants, compared with individual care.
Maternal and neonatal outcomes did not differ by time of delivery within the academic year; hence there appears to be no "July phenomenon" in obstetrics.
An exceedingly rare case of gestational choriocarcinoma arising primarily in an abdominal pregnancy is presented.
Deoxyribonucleic acid microsatellite analysis indicates a gestational ovarian choriocarcinoma with a single maternal allele and two paternal alleles arisen from a partial hydatidiform mole.
A tension-free vaginal tape that had penetrated the urethra is successfully resected by a transurethral technique.
Persistent bleeding during tension-free vaginal tape procedure can be controlled by tamponade with a Foley catheter placed from the vagina into the retropubic space.
Traction suture of the cervix is proposed to possibly reduce chances of inadvertent lacerations of vagina, bladder, and bowel during loop electrosurgical excision procedure.
Loop electrosurgical excision procedure was associated with an increased rate of preterm birth in subsequent pregnancy, even when smoking status was matched.
First-trimester nuchal translucency sonography represents a great advance in the field of Down syndrome screening, although many practical implementation issues remain to be clarified prior to recommending widespread utilization of this technique.
Abstracts: ABSTRACTS Obstet Gynecol 2003 102: 1085-1087. [Full Text] [PDF]
Letters to the Editor: Patient Rotation and Resolution of Unilateral Cornual Obstruction During Hysterosalpingography Hamid H. Sheikh, William W. Hurd, Erich T. Wyckoff, David B. Reynolds, Lawrence S. Amesse, Jack S. Gruber, Gary M. Horowitz Obstet Gynecol 2003 102: 1088-1089. [Full Text] [PDF] A Randomized Controlled Trial of Prophylactic Maneuvers to Reduce Head-to-Body Delivery Time in Patients at Risk for Shoulder Dystocia Leslie Iffy, Joseph Apuzzio, Vijaya Ganesh, Marie H. Beall, Michael G. Ross, Catherine Y. Spong Obstet Gynecol 2003 102: 1089-1090. [Full Text] [PDF]
Iatrogenic endometriosis is a potential risk associated with uterine morcellation at time of laparoscopic supracervical hysterectomy.
Gynecologists should be aware of the possible exacerbation of multiple polypoid endometriosis in breast cancer patients undergoing long-term tamoxifen treatment.
A procedure involving transillumination of uterine vessels and simultaneous transvaginal ultrasonography simplifies suture placement at the isthmus during abdominal cerclage and reduces the amount of dissection and bleeding.
Magnetic resonance imaging is a valuable diagnostic tool for the detection of an incarcerated uterus in pregnancy.
Accumulation of menstrual blood in a dehiscent cesarean scar can cause irregular bleeding and should be considered in the differential diagnosis.
With close monitoring, expectant management of uterine dehiscence diagnosed in the second trimester is possible.
We report a case of severe hemolytic disease caused by anti-D in a child whose mother had a partial D antigen (DVI).
The management of Rh isoimmunization caused by Rh partial null (D- -) can be enhanced by measuring middle cerebral artery peak systolic velocity.
Peritonitis can presumptively occur after hysteroscopy when sorbitol is used as a distending medium.
Abnormal vaginal bleeding in a patient with known breast carcinoma can be the first sign of endometrial metastasis.
Thorough assessment of the endometrium is an important consideration in patients with hereditary nonpolyposis colon cancer undergoing prophylactic hysterectomy because they are at risk for having occult endometrial cancer.
Estrogen and progesterone receptor–positive intraabdominal fibromatosis, induced during hormone replacement therapy, resolved during aromatase inhibitor therapy.
The innovative surgical management of an unusually presenting retroperitoneal cellular schwannoma in the abdominoinguinal area is described, along with the histopathology.
Vulvar tubulovillous adenoma is a rare cloacogenic benign tumor that can be associated with a rectal villous adenoma.
The vacuum-assisted closure device was successfully used in a challenging wound after resection of recurrent Paget's disease of the vulva.
Disorientation and agitation in conjunction with excessive urination, hypernatremia, and low urine osmolality after cesarean delivery led to a diagnosis of transient diabetes insipidus of pregnancy.
Pica of clay (geophagia) during pregnancy can cause hypokalemic myopathy.
Radiofrequency catheter ablation is an effective treatment for maternal supraventricular tachycardias refractory to pharmacological therapy in advanced pregnancy.
The prenatal ultrasound diagnosis and natural history of a right atrial myxoma are described.
Acrania, associated with amniotic band syndrome and diagnosed prenatally, is presented.
Anterior urethral diverticulum can be a difficult but treatable diagnosis to make in a patient with severe urge incontinence and pelvic pain.
Laparoscopic ureteral reimplantation is successfully performed on a patient who experienced accidental ureteral transection during a laparoscopic extended hysterectomy.
Maternal serum alpha-fetoprotein, fetal hemoglobin in maternal circulation, and elevated middle cerebral artery peak velocity can be helpful in managing patients with large chorioangiomas.
Ultrasound-guided interstitial laser is a novel modality for treating placental chorioangiomas requiring prenatal therapy.
Cesarean delivery under general anesthesia might be used successfully in a woman with an Arnold-Chiari malformation.
A case of vaginal delivery after antenatal repair of maternal congenital diaphragmatic hernia is reported.
Central neurologic system involvement of disseminated herpes simplex virus type 2 in utero could result in fetal brain death.
Paclitaxel and carboplatin chemotherapy given during pregnancy to a patient diagnosed with advanced epithelial ovarian cancer produced no recognized untoward effects.
A pregnant woman presenting with acute cardiopulmonary failure was found to have an underlying pheochromocytoma as part of multiple endocrine neoplasia type IIa.
Hormonal replacement therapy resulted in a successful pregnancy in a woman with hypopituitarism from a suprasellar germinoma.
Splenic rupture should be included in the differential diagnosis of severe abdominal pain and distention with or without vaginal bleeding in postpartum women.
Severe hyperglycemia and insulin resistance were noted in a human immunodeficiency virus–positive patient in preterm labor treated with protease inhibitors and corticosteroids.
Diagnosis of a urea cycle disorder should be considered in any patient with unexplained neuropsychologic reactions accompanied by hyperammonemia in the immediate postpartum period.
Anticonvulsant hypersensitivity reactions must be considered in the differential diagnosis of a pregnant patient undergoing anticonvulsant therapy with hyperthermia, pancytopenia, and a rash.
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