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  1. Article: A Case of Outpatient Hysterectomy in the Setting of Gitelman Syndrome.

    Siripala, Duminda S / Bagiardi, Leah / Mikhail, Emad

    Cureus

    2020  Volume 12, Issue 12, Page(s) e12129

    Abstract: Gitelman syndrome is a rare autosomal recessive disorder involving a defect in the sodium-chloride cotransporter, which is expressed in the apical membrane of the distal convoluted tubule. Electrolyte abnormalities commonly occur in patients with ... ...

    Abstract Gitelman syndrome is a rare autosomal recessive disorder involving a defect in the sodium-chloride cotransporter, which is expressed in the apical membrane of the distal convoluted tubule. Electrolyte abnormalities commonly occur in patients with Gitelman syndrome as a result, including hypokalaemia, hypomagnesemia, and metabolic alkalosis. As a result, the disorder may present with various clinical manifestations, including fatigue, weakness, muscle tetany, facial paresthesias, and a predisposition to the development of various ventricular arrhythmias. As a result, the perioperative management of patients with this disorder presents unique challenges with regard to fluid and electrolyte management and the prevention and management of potential arrhythmias. In addition, the pharmacology of various anesthetics may present additional complexity with regard to perioperative management in this particular patient population. The following case presentation of a 42-year-old female with Gitelman syndrome undergoing elective outpatient hysterectomy for suspected endometriosis serves to illustrate the challenges that arise with regard to perioperative management in this particular patient population and demonstrates how they may be addressed.
    Language English
    Publishing date 2020-12-17
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.12129
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Risk factors for Cesarean delivery in pregnancy with small-for-gestational-age fetus undergoing induction of labor.

    Nwabuobi, C / Gowda, N / Schmitz, J / Wood, N / Pargas, A / Bagiardi, L / Odibo, L / Camisasca-Lopina, H / Kuznicki, M / Sinkey, R / Odibo, A

    Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology

    2020  Volume 55, Issue 6, Page(s) 799–805

    Abstract: Objectives: To identify risk factors for Cesarean delivery and non-reassuring fetal heart tracing (NRFHT) in pregnancies with a small-for-gestational-age (SGA) fetus undergoing induction of labor and to design and validate a prediction model, combining ... ...

    Abstract Objectives: To identify risk factors for Cesarean delivery and non-reassuring fetal heart tracing (NRFHT) in pregnancies with a small-for-gestational-age (SGA) fetus undergoing induction of labor and to design and validate a prediction model, combining antenatal and intrapartum variables known at the time of labor induction, to identify pregnancies at increased risk of Cesarean delivery.
    Methods: This was a retrospective cohort study of non-anomalous, singleton gestations with a SGA fetus that underwent induction of labor, delivered in a single tertiary referral center between January 2011 and December 2016. SGA was defined as estimated fetal weight (EFW) < 10
    Results: A total of 594 pregnancies were included. Cesarean delivery was performed in 243 (40.9%) pregnancies. Significant risk factors associated with Cesarean delivery, and included in the final model, were maternal age, gestational age at delivery and initial method of labor induction. The bootstrap estimate of the AUC of the final prediction model for Cesarean delivery was 0.82 (95% CI, 0.78-0.86). The model had sensitivity of 64.2%, specificity of 86.9%, positive likelihood ratio (LR) of 4.9 and negative LR of 0.41. The model had good fit (P = 0.617). NRFHT complicated 117 (19.7%) pregnancies. Significant risk factors for NRFHT included EFW < 5
    Conclusion: We identified several significant risk factors for Cesarean delivery and NRFHT among SGA pregnancies undergoing induction of labor. Clinicians may use these risk factors to guide patient counseling and to help anticipate the potential need for operative delivery. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
    MeSH term(s) Adult ; Area Under Curve ; Cesarean Section/statistics & numerical data ; Clinical Decision Rules ; Female ; Fetal Diseases/diagnosis ; Fetal Heart ; Fetal Weight ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Labor, Induced/statistics & numerical data ; Maternal Age ; Obstetric Labor Complications/diagnosis ; Obstetric Labor Complications/surgery ; Predictive Value of Tests ; Pregnancy ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity
    Language English
    Publishing date 2020-05-15
    Publishing country England
    Document type Journal Article ; Validation Study
    ZDB-ID 1073183-0
    ISSN 1469-0705 ; 0960-7692
    ISSN (online) 1469-0705
    ISSN 0960-7692
    DOI 10.1002/uog.20850
    Database MEDical Literature Analysis and Retrieval System OnLINE

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