Coagulopathy in surgical management of placenta accreta spectrum.

Background: One of the major complications of the placenta accreta spectrum (PAS) is the development of coagulopathy. The detection, prevention and prompt treatment of coagulopathy may be lifesaving.

Objective: Our objective was to study selected factors associated with coagulopathy in the management of PAS by a well-established multidisciplinary team.

Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review.

Background: Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.

Ultrasonographic surveillance in red blood cell alloimmunization.

Objective: This study was undertaken to audit ultrasonographic measurements of fetal liver length and middle cerebral artery peak velocity in cases of red blood cell alloimmunization between 1986 and 1999.

Study Design: A total of 200 fetuses at risk for anemia because of red blood cell alloimmunization underwent ultrasonographic measurement of the length of the right lobe of the liver, 45 underwent Doppler recording of middle cerebral artery peak velocity, and 119 underwent fetal blood sampling.

Results: The overall survival was 188 of 200 (94%).

Improved patient acceptability with a transdermal drug-in-adhesive oestradiol patch.

The aim of this trial was to assess the relative patient acceptability of two transdermal oestradiol patches used in treatment of oestrogen deficiency in postmenopausal women. Thirty-five hysterectomised postmenopausal women with no previous experience of transdermal oestradiol delivery systems received treatment with either once-weekly drug-in-adhesive (DIA) patches or twice-weekly reservoir patches for 4 weeks, and were then switched to the alternative treatment for a further 4 weeks. At the end of the study, the patients completed a questionnaire to assess their relative preference for a number of characteristics of the 2 transdermal systems and, where possible, their preference for transdermal compared with oral hormone replacement therapy.

D-D dimers: a poor correlate of PPIH and subsequent outcomes.

Objectives: To ascertain the normal range of D-D dimer levels in pregnancy in our population, and whether dimer levels are of value as a correlate of proteinuric pregnancy-induced hypertension (PPIH) or a predictor of adverse outcome.

Methods: Dimer levels were measured in 44 women diagnosed with PPIH after 32 weeks' gestation and 55 controls recruited before 24 weeks' gestation.

Results: Mean dimer levels in the second and third trimester of normal pregnancy were 45 ng/ml (+/- 1 S.