摘要:

The incidence of multifetal pregnancies has been increasing steadily. Fetal complications such as prematurity, discordant growth, intrauterine fetal demise, twin-twin transfusion, and congenital anomalies account for a large share of perinatal morbidity and mortality. Maternal complications from muliple gestations are also significant. Recent trends in antepartum management such as multifetal pregnancy reduction, specialized prenatal care, and well-timed delivery have improved outcomes. Intrapartum management, including the possibility of asynchronous birth and critical assessment of mode of delivery, has also led to better outcomes. This review provides a brief summary of each of these topics, with a particular focus on the recent literature.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Recently published papers on antenatal screening show that a policy of routine cervical examination does not lead to a reduction in preterm birth, perhaps because the results of the cervical examination do not influence the decisions of the obstetricians. A meta-analysis of randomized, controlled trials evaluating umbilical Doppler ultrasonography shows that the systematic use of this method for high-risk pregnant women reduces the odds of perinatal mortality by 38%. Studies on antenatal screening for group B Streptococcus followed by intrapartum treatment show that the antenatal screening can be effective in reducing the rate of infection.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Pregnancy is a time when significant maternal cardiovascular and hemodynamic changes occur. Such alterations may include blood volume, heart rate, stroke volume, cardiac output, and systemic vascular resistance. These physiologic changes are usually well tolerated by the pregnant patient, and they must be recognized and understood by the physician to distinguish them from what is abnormal. Changes begin early in gestation and continue as pregnancy advances, and are totally reversible after delivery. This review summarizes updates on cervical, hemodynamic, cardiovascular, and endocrinologic changes during pregnancy.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The antiphospholipid syndrome in obstetrics represents a striking model of maternofetal pathology related to systemic and intraplacental thrombosis. Two pro-coagulant antibodies are now well known: lupus anticoagulant and anticardiolipin antibody. Therapy is preventive and efficient. It is based on a cautious choice from three drugs: aspirin, heparin, and corticosteroids.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Several mechanical and biochemical methods have been used to induce labor throughout modern obstetrics. We review and compare mechanical and medical methods of labor induction, along with several new uterotonic agents such as mifepristone (RU 486) and misoprostol, which can be conveniently administered orally and managed in the outpatient clinic.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Obstetricians assume a dual role in the provision of health care for both mother and fetus during labor. Not only do they function as consultants for medical and surgical problems peculiar to labor, but they also assume a more broad-based role in the prevention of labor complications to achieve the best possible health maintenance for both patients. This includes the provision of continuous health care throughout pregnancy, delivery, and postpartum management. A summary of the common problems of management of labor and labor complications is provided, including fetal monitoring during labor, augmentation of labor, vaginal delivery after cesarean section, epidural analgesia and its effects on delivery, and fecal incontinence after delivery.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Mothers who have just given birth need support from medical staff and also from their home surroundings. The type of support given to mothers and their new babies varies in different countries and cultures, but should be equally adequate and beneficial. Breast-feeding, as the very best method of early nutrition of the newborn, is the central event of puerperium. Its importance, and other practical approaches during this period are discussed and reviewed.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Most cases of postpartum haemorrhage are caused by uterine atony, maternal soft-tissue trauma, retained placenta or its parts, and obstetric coagulopathy. The factors most significantly associated with haemorrhage include advanced maternal age, prolonged labour, pre-eclampsia, obesity of mother, multiple pregnancy, a birth weight of more than 4000 g, and previous postpartum haemorrhage. It seems that multiparity itself is only a weakly associated factor. The prophylactic use of oxytocic drugs (oxytocin or its combination with ergometrine) at the third stage of labour is always recommended for decreasing the bleeding. Prostaglandins should be used as a second line treatment if uterine atony cannot be abolished by uterine massage and oxytocin infusion. In the surgical management, the role of hypogastric artery ligation is decreasing. The stepwise uterine devascularization may be a reasonable method in the most severe uncontrollable postpartum bleeding. The uterine tamponade with gauze or specific tubes may also be a useful alternative in some cases. Selective arterial embolization is a promising new method that seems to have success in controlling the heavy postpartum bleeding unresponsive to more usual measures. However, the value of this method should be evaluated in bigger series.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID