Clinics in obstetrics and gynaecology最新文献_第9页

Antiparasitic Agents in Pregnancy 妊娠期抗寄生虫剂

Clinics in obstetrics and gynaecology Pub Date : 1986-06-01 Epub Date: 2021-05-26 DOI: 10.1016/S0306-3356(21)00012-1

Christopher J. Ellis

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Surgical Techniques of Uterine Evacuation in First- and Second-Trimester Abortion 妊娠早期和中期流产的子宫引流手术技术

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01 Epub Date: 2021-06-04 DOI: 10.1016/S0306-3356(21)00153-9

P.G. STUBBLEFIELD

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Index 指数

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01 Epub Date: 2021-06-04 DOI: 10.1016/S0306-3356(21)00162-X

引用次数: 0

Spontaneous abortion. 自然流产。

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01

J J Laferla

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Surgical techniques of uterine evacuation in first- and second-trimester abortion. 头胎和二胎人工流产的清宫手术技术。

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01

P G Stubblefield

{"title":"Surgical techniques of uterine evacuation in first- and second-trimester abortion.","authors":"P G Stubblefield","doi":"","DOIUrl":"","url":null,"abstract":"Induced abortion is an ancient procedure. Vacuum curettage is a recent innovation and is demonstrably superior to other methods for first-trimester abortions. Patient selection, patient preparation and the necessary instruments are described. The only absolute contraindications for local anaesthesia, vacuum curettage abortions are pregnancies too far advanced and allergy to local anaesthestics. The only mandatory laboratory tests are Rh blood group and cervical culture for gonorrhoea. Rh-negative patients must receive anti-D (Rh0) immunoglobulin. Perioperative antibiotics are of proven benefit. The technique of first-trimester vacuum curettage is described in detail here. The technique for very early abortion with the Karman cannula is also described. Fresh examination of tissue is critical after any abortion in order to rule out incomplete or missed abortion and to detect ectopic or molar pregnancy. Management of suspected perforation, haemorrhage, post-abortal syndrome and failed abortion are described. Dilation and evacuation (D&E) is the safest technique for mid-trimester abortion, especially when performed at 13-16 weeks. Some mid-trimester techniques are reviewed and the technique we follow is described in detail. Laminaria tents are left in place overnight, and the procedure is performed under paracervical block with intravenous sedation using low doses of diazepam and fentanyl. Evacuation is by means of large-bore vacuum cannula system and large ovum forceps. General anaesthesia is avoided because it increases the risk of perforation and haemorrhage. Adjuncts to D&E are described: intraoperative real-time ultrasound, intracervical vasopressin, two days' treatment with laminaria tents, and Hern's technique combining laminaria with intra-amniotic infusion of urea prior to D & E.","PeriodicalId":75719,"journal":{"name":"Clinics in obstetrics and gynaecology","volume":"13 1","pages":"53-70"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14217721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychiatric aspects of pregnancy termination. 终止妊娠的精神病学方面。

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01

A Lazarus, R Stern

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Preparation of the cervix: hydrophilic and prostaglandin dilators. 宫颈准备：亲水性和前列腺素扩张剂。

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01

P D Darney

{"title":"Preparation of the cervix: hydrophilic and prostaglandin dilators.","authors":"P D Darney","doi":"","DOIUrl":"","url":null,"abstract":"The use of laminaria has made possible safe uterine evacuation in the second-trimester and has been identified as a protective factor in the prevention of uterine perforation in first-trimester abortion. Two additional approaches to cervical dilation are now available - synthetic hydrophilic dilators and prostaglandin analogues. Neither has been in use long enough to undergo thorough evaluation, but it seems possible that they may confer similar advantages while avoiding the discomfort and inconvenience associated with laminaria. New approaches to the use of laminaria have increased their value as cervical dilators. They may be left in the cervix for 6-48 hours. Multiple sets may be employed to achieve adequate cervical dilation for late second-trimester uterine evacuation. When fetal membranes are intact, prolonged use or multiple insertions of laminaria do not appear to increase rates of post-abortion infection. Lamicel and Dilapan are new synthetic dilators which affect the cervix much more rapidly than laminaria. The former does not apply radial force to the walls of the cervical canal, but the latter does. Significant dilation may be achieved in a few hours. Prostaglandins can also alter the cervix in only a few hours. Meteneprost appears to do so with minimal gastrointestinal side-effects and with a low risk of bleeding or abortion.","PeriodicalId":75719,"journal":{"name":"Clinics in obstetrics and gynaecology","volume":"13 1","pages":"43-51"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14828050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Abortion counselling--a new component of medical care. 堕胎咨询————医疗保健的新组成部分。

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01

U Landy

引用次数: 0

Title Page 标题页

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01 Epub Date: 2021-06-04 DOI: 10.1016/S0306-3356(21)00145-X

引用次数: 0

Preparation of the Cervix: Hydrophilic and Prostaglandin Dilators 宫颈准备:亲水和前列腺素扩张器

Clinics in obstetrics and gynaecology Pub Date : 1986-03-01 Epub Date: 2021-06-04 DOI: 10.1016/S0306-3356(21)00152-7

PHILIP D. DARNEY

{"title":"Preparation of the Cervix: Hydrophilic and Prostaglandin Dilators","authors":"PHILIP D. DARNEY","doi":"10.1016/S0306-3356(21)00152-7","DOIUrl":"https://doi.org/10.1016/S0306-3356(21)00152-7","url":null,"abstract":"<div>The use of laminaria has made possible safe uterine evacuation in the second-trimester and has been identified as a protective factor in the prevention of uterine perforation in first-trimester abortion. Two additional approaches to cervical dilation are now available – synthetic hydrophilic dilators and prostaglandin analogues. Neither has been in use long enough to undergo thorough evaluation, but it seems possible that they may confer similar advantages while avoiding the discomfort and inconvenience associated with laminaria.New approaches to the use of laminaria have increased their value as cervical dilators. They may be left in the cervix for 6–48 hours. Multiple sets may be employed to achieve adequate cervical dilation for late second-trimester uterine evacuation. When fetal membranes are intact, prolonged use or multiple insertions of laminaria do not appear to increase rates of post-abortion infection. Lamicel and Dilapan are new synthetic dilators which affect the cervix much more rapidly than laminaria. The former does not apply radial force to the walls of the cervical canal, but the latter does. Significant dilation may be achieved in a few hours.Prostaglandins can also alter the cervix in only a few hours. Meteneprost appears to do so with minimal gastrointestinal side-effects and with a low risk of bleeding or abortion.</div>","PeriodicalId":75719,"journal":{"name":"Clinics in obstetrics and gynaecology","volume":"13 1","pages":"Pages 43-51"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137287038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0