The need for an epidural "window of opportunity" in pregnant women with a lumbar tattoo.

Pregnant women with lower back tattoos who wish to have an epidural placed during labour pose a dilemma to anesthesiologists. Clear guidelines have not been established. We reviewed the epidural risks in pregnant women with low back tattoos and have suggested precautionary measures to minimise them.

Dimensions of the fetal facial profile in normal pregnancy.

Objective: To determine sonographic dimensions of the fetal facial profile in normal pregnancy.

Methods: This was a prospective, cross-sectional study of 397 normal healthy fetuses at 14-33 weeks of gestation. After exclusion of the small numbers of patients at the upper GAs, 379 patients between 14.

Early-onset group B Streptococcus sepsis in high risk neonates born after prolonged rupture of membranes.

Background: According to the U.S. Centers for Disease Control guidelines, prolonged rupture of membranes mandates intrapartum antimicrobial prophylaxis for group B Streptococcus whenever maternal GBS status is unknown.

Preoperative analgesia with local lidocaine infiltration for abdominal hysterectomy pain management.

Objective: To evaluate the impact of preemptive local analgesia at the incision site in reducing pain in women undergoing abdominal hysterectomy for a benign myomatous uterus.

Study Design: In this prospective, randomized, double-blinded, placebo-controlled study, 20 mL of 1% lidocaine or 0.9% saline was injected at the abdominal incision site prior to the performance of the hysterectomy.

Pain catastrophizing, response to experimental heat stimuli, and post-cesarean section pain.

Unlabelled: This prospective study assessed the relation between pain catastrophizing, response to experimental pain stimuli, and pain perceived by women after elective cesarean sections. Forty-seven women who were scheduled for elective cesarean section were enrolled in the study. Magnitude estimation to suprathreshold phasic and tonic heat pain stimuli was assessed 1 or 2 days before surgery.

Efficacy of suppository analgesia in postabortion pain reduction.

Purpose: Termination of pregnancy is a painful procedure. Currently, there are no sufficient data regarding the best mode to reduce this pain. The aim of the study was to evaluate postabortion pain levels and to examine the analgesic effect of three different generic types of suppositories provided at the end of the surgical procedure prior to awakening from general anesthesia.

[Episiotomy as a risk factor for early perineal trauma].

Objective: To assess the association between medio-lateral episiotomy and early perineal trauma.

Study Design: A prospective observational cohort study of 667 consecutive vaginal deliveries was conducted over a 10-week period. On the day following delivery, all women were examined for the extent of early perineal trauma (swelling, oedema, haematoma), in addition to the episiotomy or lacerations.

Hypoglycemia during the 100-g oral glucose tolerance test: incidence and perinatal significance.

Objective: To estimate and report the incidence and perinatal significance of hypoglycemia during the 100-g oral glucose tolerance test in pregnant women.

Methods: Over a 3-year period, we analyzed the incidence and perinatal outcome of pregnant women who experienced hypoglycemia, defined as a plasma glucose level of 50 mg/dL or less while undergoing the 100-g oral glucose tolerance test. The study group included women who delivered singletons at term.

Episiotomy: beliefs, practice and the impact of educational intervention.

Objective: To assess the potential effect of educational intervention on episiotomy practice.

Study Design: A survey of the attitude of obstetrical caregivers toward episiotomy was conducted among obstetricians and midwives in the three public hospitals in Haifa. Data regarding episiotomy rates was collected for the years 2001-2003.

Intrapartum prophylaxis of group B streptococcal disease in Israel: guidelines and practice.

Background: The incidence of perinatal, early-onset Group B streptococcal sepsis is very low in Israel and there are no local guidelines for prevention of the disease.

Objectives: To determine to what extent the current Centers for Disease Control guidelines are practiced in Israel, the reasons for their adoption or rejection, and the need for local official guidelines.

Methods: A telephone questionnaire was conducted of all 27 delivery units in Israel.

A 2 hour versus the 3 hour 100 g glucose tolerance test for diagnosing gestational diabetes mellitus.

Aim: To determine how the omission of the third hour glucose measurement of the 100 g oral glucose tolerance test (GTT) affects the diagnosis of gestational diabetes mellitus (GDM).

Methods: Retrospective chart review of 876 women delivered in a tertiary care hospital in Israel during a three-year period, who underwent a 100 g 3 hour oral GTT following an abnormal 50 g glucose screen. GDM was diagnosed according to the "criterion standard" accepted in the Fourth International Workshop Conference on GDM.

Delivery following colon interposition.

Background: Colon interposition carries a significant complication rate due to attenuated arterial blood supply, because the interposed colon segment depends on a single vascular pedicle.

Cases: We report for the first time five vaginal deliveries in two women following the operation, illustrating the dilemmas encountered in choosing the delivery method in these patients.

Conclusion: We suggest that vaginal delivery following colon interposition is feasible.

Perinatal significance of diagnosing glucose intolerance during pregnancy with portable glucose meter.

Objective: To evaluate the effect on perinatal outcome of replacing glucose measurements for the diagnosis of gestational diabetes mellitus in central laboratories with those obtained by portable glucose meter.

Study Design: Simultaneously, venous blood samples were taken at the 100-g glucose tolerance test, and finger capillary blood glucose levels were also measured with a portable glucose meter in 180 pregnant patients. Patient management was according to the venous plasma glucose results.

Over-the-counter oral analgesia for postcesarean pain.

Objective: The purpose of this study was to evaluate patient satisfaction for oral analgesia for postcesarean pain management.

Study Design: A prospective study was conducted on women who underwent cesarean section with regional analgesia. Women were treated with ibuprofen 400 mg in liquid-filled capsules on the first postoperative day by two modes of drug administration: on patient demand (n = 60) and at predetermined regular intervals (n = 54).

Hereditary hemorrhagic telangiectasia with pulmonary arteriovenous malformations.

Background: Most congenital pulmonary arteriovenous malformations are associated with hereditary hemorrhagic telangiectasia. During pregnancy, pulmonary hemorrhage can occur, compromising maternal and fetal health.

Cases: We studied three pregnancies in two women with hemorrhagic telangiectasia complicated by pulmonary arteriovenous malformations.

[Colonic pseudo-obstruction (Ogilvie syndrome) following cesarean section].

Acute colonic pseudo-obstruction, or Ogilvie syndrome can be a major surgical complication. Ogilvie syndrome, unlike adynamic ileus, is usually not self-limiting and may cause ischemic necrosis and colonic perforation, with a mortality rate as high as 50 percent. Ogilvie syndrome represents a diagnostic and therapeutic challenge that deserves a multidisciplinary approach.

Oral analgesia in the treatment of post-cesarean pain.

Objective: Cesarean section is one of the most common operations. The new technologies of postoperative pain treatment such as patient-controlled analgesia, are expensive and may limit women caring for their newborns shortly after delivery. The present study assessed patient satisfaction with oral analgesia following cesarean section.

[Empirical treatment of urinary tract infections in the delivery room--findings and desires].

Urinary tract infection (UTI) is the most common bacterial infection during pregnancy. In prenatal and delivery wards treatment is usually started at once in pregnant women with symptoms suggesting UTI, but there is no uniformity as to treatment. We surveyed such treatment in the delivery rooms throughout Israel, and whether the treatment differed in simple cystitis as opposed to pyelonephritis.