Document Detail


Preoperative evaluation of the gynecologic patient: considerations for improved outcomes.
MedLine Citation:
PMID:  18448753     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The preoperative evaluation serves several purposes for the gynecologist. Patients with previously undiagnosed, or incompletely managed, medical concerns are identified and appropriate treatment initiated. In women with known medical concerns, the surgeon can anticipate problems and plan for appropriate postoperative care. In certain cases, the preoperative evaluation identifies medical conditions that are unstable enough to adversely affect the postoperative outcome, and appropriate referral for medical management can be made. One of the most important aspects of the evaluation is the identification of women at high risk for cardiovascular complications. A stepwise approach is useful to identify those women who may proceed to surgery and those who need further testing. Much of the preoperative evaluation of the woman with pulmonary disease can be done during the history and physical examination without additional testing. Deep venous thrombosis is a significant concern in gynecologic surgery; appropriate identification of the woman at risk is important, with initiation of prophylaxis occurring shortly after the surgery concludes. Many women undergoing gynecologic surgery have diabetes. Careful management of diabetes in the perioperative period has become more germane, with evidence of improved outcomes as tight control is achieved. Much of the preoperative evaluation falls easily into the purview of the gynecologist, with advice presented as to when medical consultation should be considered.
Authors:
Bruce E Johnson; Joann Porter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  111     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-01     Completed Date:  2008-06-12     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1183-94     Citation Subset:  AIM; IM    
Affiliation:
Division of General Internal Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina 27858, USA. johnsonbru@ecu.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Adult
Comorbidity
Coronary Artery Disease / epidemiology
Diabetes Mellitus / drug therapy,  epidemiology
Diagnostic Tests, Routine
Electrocardiography
Female
Genital Diseases, Female / epidemiology*,  surgery*
Humans
Hypoglycemic Agents / administration & dosage
Insulin / administration & dosage
Insulin Infusion Systems
Medical History Taking
Postoperative Complications / prevention & control
Preoperative Care*
Respiratory Function Tests
Risk Assessment
Treatment Outcome
Venous Thrombosis / prevention & control
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Hypoglycemic Agents; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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