By Ronald S. Gibbs, Beth Y. Karlan, Arthur F. Haney, Ingrid E. Nygaard
A center reference for citizens and practitioners for over forty years, Danforth's Obstetrics and Gynecology is now in its 10th Edition—thoroughly revised and reorganized to supply entire, authoritative insurance of the fashionable medical perform of obstetrics and gynecology. This variation has a brand new co-editor, Ingrid Nygaard, MD, a urogynecologist. a brand new urogynecology part contains chapters on urinary and fecal incontinence and overactive bladder. different new chapters hide stillbirth and mental issues of being pregnant and the postpartum. This version additionally includes a smooth two-color layout, challenge circumstances, boxed pearls and pitfalls, key issues at the start of every bankruptcy, and extra algorithms, tables, and bulleted lists.
A better half web site deals the totally searchable textual content and a picture financial institution which now permits any clinician, both in education or perform, to have in a single position what they should know.
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Additional resources for Danforth's Obstetrics and Gynecology
Fentanyl, remifentanil, and meperidine are the analgesics most commonly employed with this technique. The infusion pump is programmed so that the patient receives an incremental dose when she pushes the button, followed by a lockout interval when additional requests by the patient will not be administered. An hourly maximum may also be programmed. A basal infusion is rarely used in labor because of the risk of respiratory depression between contractions. The actual settings are dictated by the pharmacokinetics of the narcotic chosen.
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.
Additionally, women with active varicella infections, herpes simplex virus infections of the breast, and active hepatitis A and B (until the infant has been passively and actively vaccinated) should refrain from breast-feeding. The list of medications contraindicated in breast-feeding is not extensive. It includes bromocriptine, cocaine, cyclophosphamide, cyclosporine, doxorubicin, ergotamine, lithium, methotrexate, phencyclidine, phenindione, and radioactive iodine and other radiolabeled elements.