By Ronald S. Gibbs, Beth Y. Karlan, Arthur F. Haney, Ingrid E. Nygaard
Obstetricia y ginecología de Danforth ha sido durante forty años una obra de referencia primary para residentes y médicos de estas especialidades. En esta 10.ª edición se han revisado y reorganizado por completo los contenidos a fin de proporcionar una guía completa y fiable de l. a. práctica clínica moderna en obstetricia y ginecología. Se ha añadido un apartado sobre uroginecología y nuevos capítulos sobre mortinalidad y trastornos psicológicos durante el embarazo y el puerperio.
- Incluye casos clínicos
- Resúmenes de conceptos básicos al principio de cada capítulo
- Más algoritmos y tablas
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1). 1. Examples of orders after routine vaginal delivery: immediately postpartum When regional anesthesia is used, care must be taken to avoid problems with urinary retention and bladder overdistention. Women should be encouraged to void every 2 to 3 hours, even if they are not aware of any sensation of bladder fullness, as rapid diuresis may occur following delivery, especially when oxytocin is discontinued. Prior to discharge, a hemoglobin or hematocrit should be checked if there is any concern that a woman has experienced heavier than normal postpartum bleeding, or if she entered labor significantly anemic.
Breast-feeding Breast-feeding has undergone somewhat of a renaissance in the United States over the past 30 years: in 1971 only one-fourth of mothers breast-fed at hospital discharge, versus almost two thirds in 1998. 3). 3. Research on established and potential protective effects of human milk and breast-feeding on infants Breast-feeding mothers benefit as well. Suckling-triggered oxytocin release promotes uterine contractions and leads to diminished blood loss. Oxytocin and prolactin levels are elevated in breast-feeding mothers, enhancing feelings of attachment and relaxation.
Sedation and dysphoric reactions may also occur. Reversal of other opioid effects may precipitate withdrawal in a susceptible patient. A possible transient depressive effect of nalbuphine on the fetal CNS has been identified. Butorphanol Butorphanol (Stadol) is another synthetic narcotic with agonist–antagonist properties. It is five times more potent than morphine and 40 times more potent than meperidine. It has achieved moderate popularity in the United States in the management of the pain of the first stage of labor.