1/7. Holy consent--a dilemma for medical staff when maternal consent is withheld for emergency caesarean section.A parturient (grand multipara) developed arrested labour complicated by severe fetal heart rate decelerations. Senior physicians explained the need for a caesarean section, but she chose to deliver vaginally since rabbinical blessing could not be obtained. Forcing the mother to have a cesarean section without consent is considered "civil battery." The dilemma faced by medical staff and the implications of her refusal for the treating medical staff are described.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. marfan syndrome in the parturient.Early recognition of the marfan syndrome and knowledge of its potentially lethal complications facilitates successful treatment of these individuals. It is through a joint effort by many specialist physicians such as the obstetrician, cardiologist, and anesthesiologist that these patients can be managed safely through pregnancy, labor, and delivery.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Ultrasound for the primary care physician. Applications in family-centered obstetrics.Ultrasound imaging is a noninvasive diagnostic tool that enhances the patient's and physician's understanding of prenatal care. According to a multisite study, use of ultrasound by primary care physicians appears to improve prenatal patient education and support early formation of the family unit. Other potential benefits include early detection of fetal abnormalities, savings in time and cost, and enhanced continuity of care. However, consultation with and referral to specialists, when appropriate, remain essential ingredients for state-of-the-art healthcare. Further studies defining the role and boundaries of ultrasound in primary care are needed.- - - - - - - - - - ranking = 6keywords = physician (Clic here for more details about this article) |
4/7. pain during childbirth leads to $2.4-million lawsuit.A woman from Hamilton, Ont., is suing a local hospital an three physicians, alleging that she suffered excessive pain while giving birth. The first-time mother alleges that she experienced excessive pain during delivery despite her repeated requests for pain relief.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Symphysis pubis separation during childbirth.A severe case of separation of the symphysis pubis during labor and delivery is reported, which included severe pain and unusual complications of urinary outflow incontinence and fecal incontinence that gradually resolved with conservative treatment. The incidence of symphysis pubis separation is reported to be between 1:600 and 1:3400 obstetric patients. Treatment should generally be conservative and symptomatic. prognosis for recovery is excellent. Recurrent separation of the symphysis pubis could occur during subsequent deliveries but generally is no worse than the first occurrence. This case report illustrates the unusual complications that can occur with severe diastasis of the symphysis pubis during pregnancy. family physicians, obstetricians, and orthopedic surgeons could encounter this complication of childbirth in their own practices. Although the symptoms are dramatically severe in presentation, a conservative management approach is effective.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Peripartum complications. hemorrhage, embolism, hypertension, and infection.Maternal peripartum complications continue to be a significant problem in the united states, even among previously healthy women. The problems include peripartum bleeding, infection, hypertension, and thromboembolic disease. Primary care physicians are often called upon to treat these conditions. An awareness of the approach to diagnosis and management helps to ensure optimal outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Observatory clues to aid in the diagnosing of diastasis symphysis pubis: an underreported complication of parturition.diagnosis of diastasis symphysis pubis in the postpartum period need not depend on radiographic findings. This diagnosis can be made with simple observation techniques. Entertaining a high index of suspicion and observation of the patient are the most important contributions the physician can make. Parameters triggering a tentative diagnosis would include, but not be limited to, a large infant, a small pelvis, a rapid second stage of delivery, or application of forces to abduct the thighs. The diagnosis of diastasis symphysis pubis should be ruled out if the following conditions are present postpartum: the flattened abdomen (the postpartum "pooch" is absent); the patient is incontinent of urine when changing position from supine/prone to upright; the patient has pain in the hips or sacral region when walking; or the patient waddles when walking. The change in gait, or the pain on walking may not be noticed until 24 hours or more after delivery. However, the change in abdominal contour and incontinence is noticed immediately. Using these observational clues, the physician can institute treatment sooner, thereby expediting recovery.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |