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Colburn V - - 1999
Of all cases that come to hospital emergency rooms, the traumatized pregnant patient presents one of the most complicated dilemmas because nurses and doctors who commonly treat trauma victims rarely have comparable expertise in the management of pregnancy. Treatment and care of the traumatized pregnant patient are challenging because advanced ...
Howell L J - - 1999
Consensus about complex clinical decisions among specialists with diverse backgrounds will always be a challenge. A specialized center, which focuses on the fetus with an anomaly, provides the most accurate diagnosis and maternal-fetal management recommendations to referring physicians. The essential components of a fetal therapy center facilitate a systematic approach ...
Olutoye O O - - 1999
Myelomeningocele is a common birth defect that is associated with significant lifelong morbidity. Despite improvements in technology and overall patient care, little progress has been made in the postnatal surgical management of the child with spina bifida. Postnatal surgery is aimed at covering the exposed spinal cord and preventing infection. ...
Kalu G - - 1999
Marfan syndrome is an uncommon condition in pregnancy. Few district hospital obstetricians except those who work in areas with Marfan family clusters have experience in managing patients with this condition. Modern medical and surgical treatments have resulted in improved longevity and quality of life for many with this condition. For ...
Daradkeh S - - 1999
BACKGROUND/AIMS: Safety of laparoscopic cholecystectomy (LC) during pregnancy is still controversial, we report our experience in the management of 42 pregnant patients suffering from symptomatic gallbladder stones. METHODOLOGY: Between June 1993 and July 1998, we performed 1700 LC's. During this period we dealt with 42 pregnant patients who had symptoms ...
Iqbal N - - 1999
OBJECTIVE: To report a case of life-threatening hypercalcemia attributable to primary hyperparathyroidism in a pregnant patient and discuss the management of severe hypercalcemia during pregnancy. METHODS: We describe a 28-year-old pregnant woman who had life-threatening hypercalcemia (serum calcium level of 25.8 mg/dL). Primary hyperparathyroidism was diagnosed. The patient's management and ...
- - 1999
Thrombocytopenia in pregnant women is diagnosed frequently by obstetricians because platelet counts are now included with automated complete blood cell counts (CBCs) obtained during routine prenatal screening (1). The condition is common, occurring in 7-8% of pregnancies (2). Thrombocytopenia can result from a variety of physiologic or pathologic conditions, several ...
Ahlawat S K - - 1999
We report on a young woman with pheochromocytoma associated with pregnancy and review 41 other cases reported in the literature from 1988 to 1997. This review reveals that the overall maternal mortality was 4 percent and the fetal loss 11 percent; antenatal diagnosis of pheochromocytoma reduced maternal mortality to 2 ...
Boulanger B R - - 1999
BACKGROUND: Although the routine use of FAST (focused assessment with sonography for trauma) in the evaluation of trauma victims is increasing, to our knowledge, a prospective comparison of contemporary adult trauma victims managed with and without FAST has not been reported in North America. METHODS: Adult victims of blunt trauma ...
Ralph C J - - 1999
A description of antiphospholipid syndrome (APS) and associated maternal and fetal complications is presented along with a review of the management at National Women's Hospital (NWH), Auckland, of 27 pregnancies complicated by APS. Because the obstetric outcome for parturients with APS continues to improve, anaesthetists are more likely to become ...
Tillett J - - 1999
Trauma affects approximately 8% of all pregnancies, and bleeding affects nearly 5% of gestations. These two conditions are potentially life-threatening and require immediate management by the midwife. Trauma in pregnancy is commonly caused by motor vehicle accidents, falls, and assault. Although abruption resulting from trauma is a rare occurrence, injury ...
Marinoff D N - - 1999
Disseminated intravascular coagulopathy is a serious complication of pregnancy. Therapy includes treating the underlying cause, maintenance of blood volume, replacement of depleted clotting factors, and often delivery of the fetus and placenta. We present a case of disseminated intravascular coagulopathy occurring at 19 weeks' gestation that resolved spontaneously with conservative ...
Kadir R A - - 1999
The most common inherited bleeding disorders in women are von Willebrand disease (vWD), carriership of hemophilia A and B, and factor XI (FXI) deficiency. Pregnancy and delivery are associated with major concerns and particular risks in women with these disorders. An increased awareness among clinicians of these disorders and their ...
Lippincott L H - - 1999
Pregnancy initiates a unique set of physiologic changes in a woman's body. These changes are commonly manifested as complaints concerning the head and neck. From common findings such as rhinitis, epistaxis, and cutaneous lesions to more rare disorders of the inner ear, physicians should be familiar with these conditions for ...
Odukogbe A A - - 1999
Pregnancy in patients with haemoglobinopathy is associated with increased risk of maternal and perinatal morbidities and mortalities. Multiple pregnancy is potentially more hazardous than singleton pregnancy. There is a dearth of information concerning multiple pregnancies in patients with haemoglobinopathy. Four of such patients seen in the obstetric service of the ...
Paternoster D M - - 1999
The clinical cases of three patients affected respectively by Eisenmerger's syndrome, Marfan syndrome, coarctation of the aorta are described. All patients belonged to NYHA class I or II. During pregnancy contact with cardiologists, anaesthetists, neonatologists was maintained and this allowed accurate management. Both pregnancy and delivery evolved without any complication ...
Sugrue M - - 1999
Injury to the pregnant woman evokes a certain amount of anxiety because of its infrequent occurrence and the complex implications. By definition, it constitutes a multitrauma and, throughout the resuscitation and assessment of the woman, it is important to remember that there are two patients. Of particular importance is that ...
Moore R D - - 1999
OBJECTIVE: To report on 14 cases of adnexal masses in the second trimester of pregnancy that were managed with laparoscopic surgery. STUDY DESIGN: A retrospective study. During the period between January 1994 and January 1998, 14 women presented with adnexal masses in pregnancy and were surgically managed with laparoscopy. A ...
Epstein N E - - 1999
An internist performed percutaneous laser-assisted diskectomies (PLADs) on a patient with a sequestrated disc and stenosis. Subspecialists who perform PLADs should be trained in patient selection and lumbar diskectomy techniques. Chymopapain, percutaneous nucleotome-assisted diskectomy, and PLADs are alternatives to microdiskectomy for the management of lumbar disc herniations. PLADs were performed ...
Alef K - - 1999
Clostridium difficile-associated disease (CDAD), a gastrointestinal infection with a wide range of manifestations whose primary symptom is diarrhea, occurs when antibiotic medications, or rarely other drugs or conditions, disrupt the normal colonic microflora, making it susceptible to the growth of toxigenic C difficile. It is a significant nosocomial infection and ...
Kort K C - - 1999
BACKGROUND: Hyperparathyroidism during pregnancy can carry significant morbidity to both mother and fetus. Surgery is the definitive treatment of choice although medical management is occasionally warranted. This report looks at 6 cases of hyperparathyroidism during pregnancy and reviews the morbidity and mortality of this entity. METHODS: We retrospectively reviewed all ...
Bentley T A - - 1998
This study sought to identify causal factors for slip, trip and fall accidents occurring during the delivery of mail. Analysis of in-house data produced information about accident circumstances for 1734 fall cases. The most common initiating events in delivery falls were slips and trips. Slips most often occurred on snow, ...
Griesshammer M - - 1998
The management of pregnant patients with chronic myeloproliferative disorders (MPD) is a difficult problem. Patients with essential thrombocythaemia (ET), and, less frequently, those with chronic myeloid leukaemia (CML) or polycythaemia vera (PV), present at a childbearing age. Pregnancy itself does not appear to affect adversely the natural course and prognosis ...
Hern S - - 1998
Pemphigus vulgaris is an immunobullous disease affecting the skin and mucous membranes most commonly during the fifth and sixth decades of life. Its occurrence in pregnancy is rare. We now report two severe cases of the disorder presenting during pregnancy and discuss its potential effects on the foetus and its ...
Smith C M - - 1998
Pheochromocytoma, a rare finding in pregnancy, is associated with significant risks for maternal fetal morbidity and mortality when undetected antenatally. The disease is commonly mistaken for hypertensive conditions of pregnancy. The advanced practice nurse may play a crucial role in early diagnosis based on a careful history and physical examination, ...
Ansari A H - - 1998
OBJECTIVE: To comprehensively review causes of recurrent pregnancy loss and the currently applied methodologies for their diagnosis and management. STUDY DESIGN: A review article addressing pertinent issues on the subject of recurrent pregnancy loss, which, by definition, is three consecutive pregnancy losses prior to the 20th week of gestation. RESULTS ...
Buchholz N P - - 1998
Symptomatic urolithiasis in pregnancy is a rare event. We present a series of 13 cases. Although controversial, we think that X-rays should be avoided if possible. Ultrasound may not be the perfect diagnostic tool in every case of stone disease, however in pregnancy it is the imaging of choice and ...
Fazeli-Matin S - - 1998
Retroperitoneal surgery during pregnancy is rarely indicated. Major considerations are the optimal timing of surgery and the consequences of nonoperative management on mother and fetus. We report on the first partial nephrectomy performed during pregnancy and one nephroadrenalectomy. When indicated, the second trimester is the ideal time to perform nonobstetric ...
Vidal M L - - 1998
The authors describe their experience in the follow-up of four patients with chronic renal failure who became pregnant while being treated with chronic hemodialysis. The outcomes were successful and each gave birth to healthy babies. The adequate nutritional condition previous to the pregnancies added more safety to their management. Special ...
Varner M W - - 1998
The puerperium is a time of continued, dramatic pregnancy-associated adaptation. Although much less common than in the early part of the century, maternal death can still occur from common postpartum problems such as infection, hemorrhage, and disease. This article reviews the physiologic and emotional changes as well as the clinical ...
Bradley E - - 1998
For most women, pregnancy is a significant life event and the prospect of losing a baby causes anxiety, stress and grief. Modern treatment of miscarriage should provide rapid sympathetic diagnosis and adequate counselling. Early pregnancy assessment units benefit patients, staff and the NHS. Many clinicians use medical treatment or expectant ...
Wijesinghe P S - - 1998
Spontaneous hepatic rupture in pregnancy is rare and associated with significant maternal morbidity and mortality. It has been reported in association with severe pregnancy-induced hypertension and HELLP (haemolysis elevated liver enzymes low platelets) syndrome. New imaging techniques enable early diagnosis, and in those with subcapsular haematomas, conservative management. Surgical intervention ...
Goldstein A M - - 1998
A case of Herlitz-type epidermolysis bullosa (EB) is reported. The baby was born after a normal, full-term pregnancy with blisters on his extremities. Over the next several months, progressive skin sloughing involving 95% of his body surface area developed, including gastrointestinal, laryngeal, tracheobronchial, and corneal involvement. The diagnosis of junctional ...
Rosenfeld J V - - 1998
A case of tuberculous spinal cord compression causing acute paraparesis in a pregnant woman of 33 weeks gestation is described. Immediate Caesarean section followed by aggressive surgical decompression of the spine via an anterior approach with reconstruction achieved a good outcome for mother and fetus. The management of tuberculous spinal ...
Zakaria F B - - 1998
A case of severe urticaria complicating pregnancy is described. Advice was sought and received from experts in the condition, using the Internet to exchange information. Epsilon-aminocaproic acid (EACA) was used with no apparent adverse effects. This case report highlights some of the problems of management of thi rare condition in ...
Khalil A - - 1998
Bernard-Soulier Syndrome is a rare hereditary thrombocytopathy that manifests clinically by excessive bleeding out of proportion to the degree of thrombocytopenia. Only eight reports of Bernard-Soulier Syndrome in pregnancy have been previously described. In some patients the pregnancy course was smooth while in others post-partum haemorrhage was the most common ...
Saphier C J - - 1998
Hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome is a form of severe preeclampsia that threatens the gravida and her fetus. In this report, the diagnostic criteria and maternal and fetal risks of HELLP are defined. Prompt recognition and treatment in tertiary centers is emphasized, because the prognosis can ...
Katz P O - - 1998
Pregnant patients with symptomatic GERD should be managed aggressively with lifestyle modification and dietary changes. Antacids and antacids/alginic acids combination or sucralfate should be considered first-line medical therapy. If symptoms are not adequately relieved or complications develop, treatment with cimetidine or ranitidine should be considered; these H2 receptor antagonists are ...
Firstenberg M S - - 1998
Gastrointestinal surgical problems often mimic symptoms and signs of nonsurgical conditions that occur during pregnancy. This mimicry presents a particular challenge to diagnosis because avoiding a delay in treatment is critical to successful management. Some of these conditions, such as acute appendicitis and biliary colic, are common in younger women; ...
Polko L E - - 1998
Pregnancy complicated by a thermal injury must be aggressively managed to provide a favorable outcome for the mother and her developing fetus. The MEDLINE database was used to search for English-language papers published after 1980 to evaluate the classification, complications, and treatment of thermal injuries in pregnancy. Additional sources were ...
Kaplan C - - 1998
The optimal antenatal therapy for fetal thrombocytopenia has not been determined. We analysed 37 cases managed by maternal therapy and observed a successful outcome of maternal treatment in 26% of IvIgG cases and in 10% of steroid-treated cases. The significance of a plateau of the fetal platelet counts during pregnancy, ...
Hou S - - 1998
In this report, the outcome, diagnosis, management, and complications of pregnancy in dialysis patients are discussed. The advantages and disadvantages to the use of peritoneal dialysis and hemodialysis and the changes in dialysis regimen used in pregnant women are addressed. Maternal complications, particularly hypertension and anemia, are reviewed. This report ...
Viguera A C - - 1998
Although the postpartum period has typically been considered a period of risk for relapse of bipolar disorder, systematic data regarding the course of bipolar disorder during pregnancy is essentially unknown. The management of bipolar women who plan to conceive or who are pregnant poses significant challenges for clinicians who care ...
Ghumman E - - 1997
BACKGROUND: Biliary disease during pregnancy is rare and the management of cholecystitis during pregnancy is controversial. Cholecystectomy in the pregnant patient has generally been avoided because of the reported high incidence of associated fetal loss. Recent developments relating to diagnostic and anaesthetic management have altered the overall approach to symptomatic ...
Bell C M - - 1997
OBJECTIVE: To assess the safety and efficacy of topical 5-aminosalicylic acid preparations for therapy of distal colitis during pregnancy. METHODS: Nineteen pregnancies in sixteen consecutive patients with proven distal colitis were identified prospectively at a tertiary care center. All patients were given trials of weaning off medication and all failed. ...
To W K - - 1997
Pregnant women can present with a wide variety of neurological conditions. Patient data from 1 January 1985 through 31 December 1994 for all deliveries at the Tsan Yuk and Queen Mary hospitals were reviewed to determine the local frequency of various neurological conditions during pregnancy. Conditions including epilepsy, eclampsia, facial ...
Luppi C J - - 1997
Although cardiopulmonary arrest rarely occurs in the pregnant woman, it is important that the health care team know the appropriate actions to take in such an event, to promote positive outcomes for both mother and fetus. Specific techniques, personnel, and equipment are required to manage this grave situation. The principles ...
O'Shaughnessy M J - - 1997
BACKGROUND: Gunshot wounds to the abdomen during pregnancy are becoming increasingly common. When the gravid uterus is injured but repairable and the fetus is either previable or dead, conservative management is an option, even if laparotomy is required for management of other injuries. CASE: A pregnant woman sustained a gunshot ...
Gabrielse L - - 1997
There is current evidence that maternal surgery, ie, surgery performed during pregnancy (for any reason) and requiring an anesthetic, is associated with increased perinatal morbidity and mortality rates. The "Obstetrical Patient Management Protocol" details the behaviors and actions required by the postanesthesia nurse in providing quality care for the pregnant ...
O'Day M P - - 1997
Significant physiological adaptations during pregnancy contribute to its successful outcome. These occur early in the pregnancy and continue throughout gestation, with complete reversal after delivery. Many changes that are normal during pregnancy are pathological should they occur in the nonpregnant woman. Adequate understanding of these normal changes is essential in ...
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