ISSN:0029-7828    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This paper discusses the spectrum of pregnancy-induced hypertension and presents a theory for its etiology. Endothelial injury is the purported precursor to pregnancy-induced hypertensive disorders, and this discussion expands on a possible mechanism by which injury could occur as a result of incomplete trophoblastic invasion. We review endothelin physiology and compare and contrast the evidence surrounding endothelin 1 as a putative mediator of PIH. An approach to treatment utilizing antagonists to the endothelin 1 receptor is introduced.

ISSN:0029-7828    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Twin gestations comprise approximately 1 percent of all pregnancies[1], and are associated with increased perinatal morbidity and mortality, mainly due to the increased incidence of prematurity and growth restriction[2].Hazards of twin delivery can be attributed to malpresentation, most often by the second twin. The vertex-nonvertex presentation occurs in approximately 40 percent of all twins[3,4]. Although there is consensus regarding the safety of vaginal delivery for twins when both are vertex[5], controversy exists over intrapartum management when the second twin is nonvertex. Some investigators advocate cesarean delivery, particularly when the second twin is nonvertex[6], or if the expected birth weight is < 2000 gm[6-8]. This review aims to determine whether vaginal delivery of the nonvertex second twin, either by breech extraction or attempted external cephalic version, is associated with increased morbidity or mortality over cesarean delivery.

ISSN:0029-7828    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Arteriovenous malformations (AVM) are rare entities in gynecology, with only 73 cases reported in the literature.Most commonly they present with vaginal hemorrhage, but other presentations such as congestive heart failure, postmenopausal bleeding, and an asymptomatic mass have been described. These lesions may be congenital or acquired. Acquired lesions are believed to follow trauma or may arise after choriocarcinoma or other gynecologic malignancies. Diagnosis can rapidly be made with color flow Doppler ultrasound or angiography. Additionally, they have been detected using hysteroscopy, hysterosalpingogram, and computerized tomography. Acute management consists of hemodynamic stabilization and possibly placement of a Foley bulb in the uterus or methylergonovine injection. Ultimate treatment depends on the patients desire for fertility. Embolization therapy is variably successful and may allow the preservation of reproductive capacity. To date, five pregnancies after embolization have been reported with varying outcomes. If pregnancy is not desired or embolization fails, hysterectomy remains the treatment of choice.

ISSN:0029-7828    

出版商:OVID    

年代:1997

数据来源: OVID