Abstract:
:The drug abusing patient can provide a management dilemma for health care providers including nurses, obstetrician, anesthesiologist, and pediatrician. Certain illicit drugs may mimic other diseases of pregnancy and result in inappropriate treatment for the mother and child. Pain management may be challenging in such patients because of increasing drug tolerance and increased sensitivity to pain. This article highlights the clinical presentation in a pregnant patient who may have recently used some of the more commonly abused drugs. The ability to identify such a patient is crucial so that the appropriate screening and treatment can occur.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Geary FH Jr,Turnquest Wells MAdoi
10.1097/GRF.0b013e318282738bsubject
Has Abstractpub_date
2013-03-01 00:00:00pages
166-72issue
1eissn
0009-9201issn
1532-5520pii
00003081-201303000-00023journal_volume
56pub_type
杂志文章,评审abstract::Direct electronic urethrocystometry simultaneously records pressures in the bladder, proximal urethra, and abdomen in a patient at rest and under stress while the bladder fills with urine. It documents the presence or absence of detrusor contractions and is an essential part of the evaluation of patients with detrusor...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-197809000-00008
更新日期:1978-09-01 00:00:00
abstract::Despite advances in estimating prognosis and predicting response to adjuvant systemic therapy, the status of the axillary lymph nodes remains a critical component in initial surgical planning and in determining therapeutic strategies for patients with breast cancer. Buoyed by evidence from multi-institutional randomiz...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000232
更新日期:2016-12-01 00:00:00
abstract::Magnetic resonance imaging has a complementary role in obstetrical imaging to ultrasound (US). Although US has advantages as an initial imaging technique, there are significant numbers of patients who cannot be adequately evaluated for a variety of reasons including calvarial calcification, oligoanhydramnios, or simpl...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182487d04
更新日期:2012-03-01 00:00:00
abstract::The modern role of reproductive surgery has changed because of improved capabilities of endoscopic surgery resulting from innovation, instrumentation and experience, the development and increasing applicability of assisted reproductive technologies, and improved knowledge of the optimal application of these and other ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182353d86
更新日期:2011-12-01 00:00:00
abstract::This review provides an evidence-based approach to the management of fetal growth restriction (FGR). The management consists of the following components: appropriate fetal surveillance, timely intervention, and selective etiological management. Umbilical arterial (UA) Doppler sonography is the primary test. Supplement...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200606000-00013
更新日期:2006-06-01 00:00:00
abstract::Unlike urinary incontinence (UI) in younger women, UI in older women is usually multifactoral in etiology and involves factors beyond the more common types of lower urinary tract (LUT) pathophysiology associated with UI in younger women. The evaluation and management of UI in older women, therefore, must itself be mul...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3180d0a4e7
更新日期:2007-09-01 00:00:00
abstract::Many otherwise healthy women will experience a significant disruption in lifestyle from abnormal uterine bleeding. Most of those seeking medical attention will not be at risk for developing anemia. In each case, a thorough search for underlying systemic, hormonal, and organic causes should be instituted. The use of bl...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199506000-00017
更新日期:1995-06-01 00:00:00
abstract::Removal of the fallopian tubes and ovaries at the time of vaginal hysterectomy is a skill that must be acquired if one is to be a competent vaginal surgeon. Various techniques have been described and will be reviewed in this chapter. A single technique or series of steps often must be modified depending on the descent...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181ce87fc
更新日期:2010-03-01 00:00:00
abstract::The recent clinical trials indicate that EA is feasible. The use of ancillary tools, such as ultrasound, requires only a slight modification of the previously established techniques for MA. The amniotic fluid can be obtained and cultured. Combining the reported populations sampled, the procedural and cytogenetic failu...
journal_title:Clinical obstetrics and gynecology
pub_type: 临床试验,杂志文章,评审
doi:10.1097/00003081-198806000-00011
更新日期:1988-06-01 00:00:00
abstract::American College of Obstetricians and Gynecologists' guidelines on vaginal birth after cesarean had both intended and unintended consequences for anesthesiologists. Epidural analgesia continues to play an important role in patient acceptance of a trial of labor after prior cesarean delivery. It does not impact the suc...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3182618937
更新日期:2012-12-01 00:00:00
abstract::The present status of oral contraceptive steroids and the IUD, the 2 most effective and increasingly popular contraceptive methods (used by 41.6% of all U.S. married couples practicing contraception in 1970), is presented. Oral steroid contraceptives with varying quantity and activity of estrogen (ethinyl estradiol o...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-197403000-00007
更新日期:1974-03-01 00:00:00
abstract::Hyperthyroidism is relatively uncommon during pregnancy. However, those caring for pregnant patients should be versed in the evaluation and management of hyperthyroidism, as there are potential maternal and fetal implications that are related to the disease and to treatment. The differential diagnosis of hyperthyroidi...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000435
更新日期:2019-06-01 00:00:00
abstract::Medical methods for pregnancy termination in early gestation offer women an alternative to surgical evacuation and have the potential to improve access globally to safe abortion. Several drug regimens are used with varying efficacy including mifepristone plus misoprostol, misoprostol alone, and methotrexate plus misop...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181a2b026
更新日期:2009-06-01 00:00:00
abstract::The purpose of this review was to assist obstetricians and gynecologists in considering the most appropriate conservative treatment option to manage women with placenta accreta spectrum according to their individual need and local expertise of the heath care team. The issue is challenging, as the quality of evidence w...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000395
更新日期:2018-12-01 00:00:00
abstract::Methods of analyzing errors and proactively preventing errors are discussed. A framework for using these concepts is presented. ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3181899a5a
更新日期:2008-12-01 00:00:00
abstract::Causative factors in cerebral palsy (CP) vary to some degree according to gestational age group and clinical CP subtype. Such catastrophes of birth as placental abruption, cord prolapse, and uterine rupture sharply heighten risk of CP. These conditions are fortunately uncommon, and are sometimes not survived; individu...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318187087c
更新日期:2008-12-01 00:00:00
abstract::In gestational diabetes (GDM), achieving euglycemia through treatment decreases the risk of adverse outcomes associated with hyperglycemia. Treatment starts with diet and nutritional counseling; however, up to 50% of women will require pharmacologic therapy to meet glucose goals. Although insulin remains the only Fede...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182a8e0a5
更新日期:2013-12-01 00:00:00
abstract::Physicians caring for women with diseases of the breast are well aware of the time lost before many patients consult their physicians. Nowhere is this more apparent than when a breast mass is associated with gestation or lactation. Enlargement of the breast tends to obscure parenchymal masses. Those that are found are...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-198312000-00010
更新日期:1983-12-01 00:00:00
abstract::Diagnosis of the cause of pruritus in a pregnant patient should be approached systematically, beginning with a detailed history (especially drug exposure) and physical examination. Systemic diseases must be excluded. Liver function tests and hepatitis screen are in order if symptoms suggest liver dysfunction. Stool ex...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199012000-00007
更新日期:1990-12-01 00:00:00
abstract::Recurrent pregnancy loss affects up to 5% of couples trying to establish a family. Evaluation classically begins after 3 consecutive miscarriages of less than 10 weeks of gestation but may be warranted earlier if a prior miscarriage was found to be euploid, or if there is concomitant infertility and/or advancing mater...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31802f1c28
更新日期:2007-03-01 00:00:00
abstract::Most operative office surgery can be done easily. If, midway through a procedure in the office, the operator finds that a myoma is too large or deep to resect safely in the office, the procedure can be terminated and rescheduled for the operating room. Polyps, retained products, and the lost intrauterine device all ca...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Human papillomavirus (HPV) infection has been implicated in the intraepithelial cervical changes that cause most abnormal Papanicolaou smears. To date, 14 types of HPVs have been identified. All are small, nondeveloped, icosahedral DNA viruses that share a common internal antigen. In cases of cervical HPV infection...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00003081-198312000-00019
更新日期:1983-12-01 00:00:00
abstract::Venous thromboembolism is a leading cause for maternal mortality. Because of the increase risk for thromboembolism in pregnancy and the postpartum period, the clinician must be on high alert for the signs and symptoms and use appropriate diagnostics in a timely manner so that prompt anticoagulation therapy can be init...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3181deb27e
更新日期:2010-06-01 00:00:00
abstract::In summary, ultrasound plays an important role in the evaluation of the postterm pregnancy, and its use should be considered in the following situations: 1) estimation of fetal weight in the potentially macrosomic infant before vaginal delivery is attempted; 2) frequent evaluation for oligohydramnios using the amnioti...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198906000-00008
更新日期:1989-06-01 00:00:00
abstract::The provision of hormone therapy, both estrogens and antiandrogens, to adult transgender females is well within the scope of practice of the obstetrician gynecologist. The goal is to induce feminizing changes and suppress previously developed masculinization. Estrogens in sufficient doses will usually achieve both goa...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000396
更新日期:2018-12-01 00:00:00
abstract::A brief review of cervical intraepithelial neoplasia has been presented. Attempts have been made to identify the high-risk patient, and etiologic considerations have been detailed. The conservative management of cervical intraepithelial neoplasia is available and applicable to many patients. Regardless of the definiti...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198003000-00021
更新日期:1980-03-01 00:00:00
abstract::Abdominal myomectomy and hysterectomy remain the traditional treatment of large symptomatic uterine myomas. The preoperative indications for abdominal myomectomy or hysterectomy must be clearly evaluated and delineated avoid unnecessary intervention. There appears to be an increasing trend toward expectant management ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-200106000-00024
更新日期:2001-06-01 00:00:00
abstract::Preterm premature rupture of the membranes remains difficult to predict accurately. The majority of those suffering preterm premature rupture of the membrane lack risk factors that might lead to preventative treatments. Its management is centered on an evaluation of the risks and benefits of attempted pregnancy prolon...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e318217d4d3
更新日期:2011-06-01 00:00:00
abstract::Fetal glucocorticoid overexposure is a key potential mechanism underlying the link between low birthweight and later life diseases. The fetus is protected from high maternal glucocorticoid levels by the placental enzyme 11β-hydroxysteroid dehydrogenase type 2. Antenatal glucocorticoid administration to women at threat...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31829939f7
更新日期:2013-09-01 00:00:00
abstract::The UK Confidential Enquiry into Maternal Deaths has been in operation for more than 60 years, during which time maternal mortality rates have fallen 10-fold. The program includes two aspects, surveillance and confidential case review, providing different information to aid quality improvement in maternity care. The e...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000352
更新日期:2018-06-01 00:00:00