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PubMedDate not supplied

Laparoscopy during pregnancy: a literature review.

OBJECTIVE: To review the literature regarding the role of laparoscopy during pregnancy, particularly adnexal mass and non-obstetric surgery, incorporating the results of a series of 9 cases of laparoscopy during pregnancy at our centers. MATERIALS AND METHODS: A Medline search was performed to review the literature, and the reference lists provided by those articles were further explored for citations regarding laparoscopic adnexal surgery, appendectomy, and cholecystectomy. Our series of 9 patients consisted of pregnant patients with adnexal mass or acute abdomen who would otherwise have undergone exploratory laparotomy. Follow-up data for these 9 cases were collected by office visits, inquiry to the primary referring physicians, and telephone calls to the patient. RESULTS: The literature search yielded 42 additional cases of operative pelvic laparoscopy and 51 cases of abdominal operative laparoscopy (cholecystectomy and appendectomy). The publications, particularly regarding cholecystectomy, were supportive of the laparoscopic approach during pregnancy. All of the patients in our series had favorable outcomes. CONCLUSIONS: Advanced operative laparoscopy has been successfully performed for certain indications during pregnancy.

Adnexal Diseases↗
PubMed1988

Studies of enzymuria and beta 2-microglobulinuria in patients receiving prophylactic cefotaxime in obstetric and gynaecological surgery.

Increased urinary excretion of beta 2-microglobulin and certain enzymes, for example leucine aminopeptidase (LAP) and N-acetyl-beta-D-glucosaminidase (NAG), produces sensitive markers of damage to renal tubular cells. These markers were monitored in patients undergoing obstetric and gynaecological surgery who received cefotaxime for 5 days. Slight increased activity in NAG and beta 2-microglobulin was observed in some patients 3 to 5 days after surgery. However, no changes of significance were found in levels of urinary LAP and NAG. During cefotaxime treatment, urinary beta 2-microglobulin in the group of abdominal hysterectomy increased slightly. In most cases renal side effects are negligible and cannot be detected by these tests. These results indicate that administration of cefotaxime in obstetric and gynaecological surgery does not produce cumulative renal tubular toxicity.

Acetylglucosaminidase↗
PubMed1979

[Postoperative analgesia by constant flow injection of lignocaine in obstetrical and gynecologic surgery].

154 surgical patients were given post-operative analgesia by peridural injection at a constant flow in the post-operative period after obstetric or gynecological surgery. These patients received 536.2 +/- 105.3 mu mol.h-1 (145.2 +/- 28.5 mg.h-1) of lignocaine for 46.97 +/- 15.56 h through a catheter omserted between L1-L2. The drug was given in concentrations which varied between: 27.7 to 18.5 m mol.l-1 (0.75 to 0.50 p. 100) depending on the age; and the volume varied between 17.5 to 30 ml.h-1 depending on the height. Satisfactory analgesia in 87 p. 100 of cases allowed all supplementary analgesia to be stopped. The only significant hemodynamic effect was a slight tachycardia (+ 15 p. 100). Two undesirable side effects were noted: a transitory but well-defined (type 2 or 3) motor paralysis, and an accumulation of plasma lignocaine (40 mu mol.l-1 (1.1 microgram.ml-1) at 48 h).

Analgesia↗
PubMed1993

Training curricula in surgery, anaesthesia and obstetrics for rural GPs.

These three curricula for advanced training practice represent the first significant progress towards the development of specific vocational training for rural general practice. They have been created by rural doctors in consultation with their rural specialist colleagues and with the support of the learned colleges and educationists. Dedicated and enthusiastic project management with a clear understanding of the issues and context of rural general practice was also an essential element for the success of this project. Following implementation and evaluation of the curricula in accredited training posts throughout 1993 and 1994, opportunities will arise to develop further curricula in other medical disciplines and to use the methodology developed for other health fields both in Australia and overseas.

Anesthesiology↗
PubMed1985

[Short-term perioperative prophylaxis with cefotaxim in obstetric and gynecological surgery].

The effectiveness of short-term peri-operative prophylaxis with cefotaxim (Claforan) in gynaecological and obstetric operations was prospectively tested in 764 women (randomized by day of week). The incidence of postoperative infectious complications after vaginal or abdominal hysterectomy was significantly lower in the cefotaxim group than the control group. The rate was also clearly lower after laparotomy without hysterectomy and after abdominal section, but the differences were not statistically significant. In the patients with risk factors, i.e. obesity, cardiopulmonary disease or after laparotomy, which in the control group were correlated with a significantly higher rate of infectious complications, cefotaxim prophylaxis significantly reduced the rate of complications too. There were no side-effects from cefotaxim.

Cefotaxime↗