Obstetric and gynecologic emergencies:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2007
|
| Series: | Obstetrics and gynecology clinics of North America
34,3 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XXI S., S. 357 - 637 Ill. |
| ISBN: | 1416050981 9781416050988 |
Staff View
MARC
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| 245 | 1 | 0 | |a Obstetric and gynecologic emergencies |c guest ed. Henry L. Galan |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2007 | |
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| 490 | 1 | |a Obstetrics and gynecology clinics of North America |v 34,3 | |
| 650 | 4 | |a Emergencies | |
| 650 | 4 | |a Gynecologic emergencies | |
| 650 | 4 | |a Gynecology | |
| 650 | 4 | |a Obstetric Surgical Procedures | |
| 650 | 4 | |a Obstetrical emergencies | |
| 650 | 4 | |a Obstetrics | |
| 650 | 4 | |a Obstetrics |x ethics | |
| 650 | 4 | |a Pregnancy Complications | |
| 700 | 1 | |a Galan, Henry L. |e Sonstige |4 oth | |
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Record in the Search Index
| _version_ | 1804137230472577024 |
|---|---|
| adam_text | CONTENTS
Foreword xvii
William F. Rayburn
Preface xix
Henry L. Galan
Management of Pregnancy in a Jehovah s Witness 357
Cynthia Gyamfi and Richard L. Berkowitz
In the successful management of a pregnant Jehovah s Witness,
many issues must be addressed beyond those normally required
for routine prenatal care. The clinician who undertakes such care
should be well versed in the potential complications related to
blood refusal, the antepartum management of anemia, and the
intrapartum management of obstetric hemorrhage. Furthermore,
these patients should be delivered in a tertiary care center because
this increases their options for obtaining alternative management
of hemorrhage. A woman who is well informed about her options
can then decide exactly what she wants done in the event of a life
threatening obstetrical hemorrhage.
Intimate Partner Violence 367
Jennifer Gunter
Intimate partner violence (IPV) has a lifetime prevalence of
approximately 60% and is a leading cause of morbidity and
mortality for women of all reproductive ages, especially among
younger women and during pregnancy. Providers should recog¬
nize that every woman who has ever been partnered is at risk for
IPV and should screen appropriately. When a woman screens
positive for IPV, it important to consider the stages of change, to
frame the response appropriately, to perform a risk assessment, to
discuss interventions, and to document in the medical record
accordingly. Screening has yet to translate into reduced rates of
VOLUME 34 ¦ NUMBER 3 • SEPTEMBER 2007 ix
abuse, indicating that IPV is not simply a medical problem, but
involves complex psychological, financial, familial, cultural, and
legal issues.
Approach to the Acute Abdomen in Pregnancy 389
Charlie C. Kilpatrick and Manju Monga
Numerous physiologic changes in pregnancy may affect the
presentation of abdominal pain in pregnancy. A high index of
suspicion must be used when evaluating a pregnant patient with
abdominal pain. General anesthesia is considered safe in preg¬
nancy. Intraoperative monitoring and tocolytics should be indi¬
vidualized. Laparoscopic surgery should be performed in the
second trimester when possible and appears as safe as laparotomy.
If indicated, diagnostic imaging should not be withheld from the
pregnant patient. Appendectomy and cholecystectomy appear to
be safe in pregnancy. The reported incidence of adnexal masses and
fibroids in pregnancy may increase with increasing use of first
trimester ultrasound. Conservative management, with surgical
management postpartum, appears reasonable in most cases.
Current Management of Ectopic Pregnancy 403
Liberato V. Mukul and Stephanie B. Teal
Ectopic pregnancy continues to be one of the most common
gynecologic emergencies and is the leading cause of pregnancy
related first trimester death in the United States. The rate of ectopic
pregnancy continues to rise because of increases in the incidences
of its risk factors. However, improved modalities of early diagnosis
and treatment have reduced both mortality and morbidity of this
condition. In this article, the authors present an evidence based
review of the risk factors and presentation of ectopic pregnancy,
including the utility of various diagnostic techniques, and compare
the appropriateness and effectiveness of different therapeutic
approaches.
Postpartum Hemorrhage 421
Yinka Oyelese, William E. Scorza, Ricardo Mastrolia,
and John C. Smulian
Postpartum hemorrhage (PPH) is the leading cause of death related
to pregnancy worldwide. Most deaths resulting from PPH are
preventable. Physicians, nurses, midwives, and other birth attend¬
ants should be aware of the risk factors for PPH and be trained
adequately in the preventive measures and management strategies
for this pregnancy complication. Newer, less invasive technologies
such as embolization may improve outcomes with PPH. Reducing
the incidence of PPH and the mortality resulting from the condition
should be a key goal of obstetrics services worldwide. This article
focuses on the etiology, prediction, prevention, and management of
PPH.
X CONTENTS
Blood Component Therapy in Obstetrics 443
Andrea J. Fuller and Brenda Bucklin
Hemorrhage is the leading cause of intensive care unit admission
and one of the leading causes of death in the obstetric population.
This emphasizes the importance of a working knowledge of the
indications for and complications associated with blood product
replacement in obstetric practice. This article provides current
information regarding preparation for and administration of blood
products, discusses alternatives to banked blood in the obstetric
population, and introduces pharmacological strategies for treat¬
ment of hemorrhage.
Early Goal Directed Therapy for Sepsis During Pregnancy 459
Debra A. Guinn, David E. Abel, and Mark W. Tomlinson
Sepsis is a leading cause of death in pregnancy and results in
significant perinatal mortality. These deaths occur despite the
younger age of pregnant patients, the low rate of comorbid
conditions and the potential for effective interventions that should
result in rapid resolution of illness. To date, no evidence based
recommendations are specific to the pregnant patient who is
critically ill or septic. Optimal care for the septic patient requires a
multidisciplinary team with expertise in obstetrics, maternal fetal
medicine, critical care, infectious disease, anesthesia, and phar¬
macy. Coordination of care and good communication amongst
team members is essential. Incorporation of early goal directed
therapy for suspected sepsis into obstetric practice is needed to
optimize maternal and neonatal outcomes.
Thromboembolism in Pregnancy 481
Victor A. Rosenberg and Charles J. Lockwood
Venous thromboembolism in pregnancy is a clinical emergency
that has been associated with significant risk for maternal and fetal
morbidity and mortality. The adaptation of the maternal hemo
static system to pregnancy predisposes women to an increased risk
of thromboembolism. A timely diagnosis of deep venous throm¬
bosis is crucial because up to 24% of patients with untreated deep
venous thrombosis develop a pulmonary embolism. Recent clinical
guidelines identify compression venous ultrasound as the best way
to diagnose deep venous thrombosis in pregnancy and CT
pulmonary angiography as the best way to diagnose pulmonary
embolism in pregnancy. Therapy involves supportive care and
anticoagulation with unfractionated or low molecular weight
heparin, depending on the clinical scenario.
CONTENTS xi
Shoulder Dystocia: An Update 501
Amy G. Gottlieb and Henry L. Galan
Shoulder dystocia has no consensus definition or management
algorithm. Its incidence ranges from 0.2% to 3% and its occurrence
is unpredictable. Risk factors for shoulder dystocia may include
macrosomia, maternal diabetes, operative vaginal delivery, history
of macrosomic infant or shoulder dystocia, labor abnormalities,
post term pregnancy, maternal obesity, advanced maternal age,
fetal anthropometric variations, and male fetal gender. Once
identified, multiple maneuvers can be applied in a stepwise
fashion in an attempt to alleviate the dystocia. While training
clinicians to manage shoulder dystocia is difficult because of its
rare occurrence and lack of standardized management, all
clinicians must be able to manage shoulder dystocia at any time.
Diabetic Ketoacidosis in Pregnancy 533
Jason A. Parker and Deborah L. Conway
Episodes of diabetic ketoacidosis (DKA) can represent a life
threatening emergency for mother and fetus. The cornerstones of
treatment of DKA are aggressive fluid replacement and insulin
administration while ascertaining which precipitating factors
brought about the current episode of DKA, and then treating
accordingly to mitigate those factors. The incidence of DKA and
factors unique to pregnancy are discussed in this article, along with
the effects of the disease process on pregnancy. Clinical presenta¬
tion, diagnosis, and treatment modalities are covered in detail to
offer ideas to improve maternal and fetal outcome.
Amniotic Fluid Embolism 545
Irene Stafford and Jeanne Sheffield
Amniotic fluid embolism is a catastrophic syndrome occurring
during labor and delivery or immediately postpartum. Although
presenting symptoms may vary, common clinical features include
shortness of breath, altered mental status followed by sudden
cardiovascular collapse, disseminated intravascular coagulation,
and maternal death. It was first recognized as a syndrome in 1941,
when two investigators described fetal mucin and squamous cells
during postmortem examination of the pulmonary vasculature in
women who had unexplained obstetric deaths. Since then, many
studies, case reports, and series have been published in an attempt
to elucidate the etiology, risk factors, and pathogenesis of this
mysterious obstetric complication.
xii CONTENTS
Trauma in Pregnancy 555
Michael V. Muench and Joseph C. Canterino
Trauma is the leading nonobstetric cause of maternal mortality. The
basic tenets of trauma evaluation and resuscitation should be
applied in maternal trauma. Aggressive resuscitation of the mother
is the best management for the fetus. Care must be taken to keep
the patient in the left lateral decubitus position to avoid
compression of the inferior vena cava and resultant hypotension.
Radiographic studies should be used with care. Noninvasive
diagnostics should be used when available. Cardiotocographic
monitoring of a viable gestation should be initiated as soon as
possible in the emergency department to evaluate fetal well being.
Urgent cesarean section should be considered if fetal distress is
present or if the presence of the fetus is contributing to maternal
instability.
Cardiopulmonary Resuscitation in Pregnancy 585
Emad Atta and Michael Gardner
Although pregnancy and delivery in the United States are usually
safe for mother and her newborn child, serious maternal
complications, including cardiac arrest, can occur in the prenatal,
intrapartum and postpartum periods. The clinical obstetrician can
expect to encounter this complication in his or her career. The
obstetrician must be aware of the special circumstances of
resuscitation of the gravid woman to assist emergency medicine
and critical care physicians in reviving the patient. Understanding
the decision process leading to the performance of a perimortem
cesarean and the actual performance of the cesarean delivery
clearly are the responsibility of the obstetrician.
Angiographic and Interventional Options in Obstetric
and Gynecologic Emergencies 599
Filip Banovac, Ralph Lin, Dimple Shah, Amy White,
Jean Pierre Pelage, and James Spies
This article describes the role of angiographic and interventional
techniques in the management of obstetrical and gynecologic
hemorrhage. The complementary role of endovascular therapy is
discussed and a review of management options for both
peripartum hemorrhage and gynecologic hemorrhage is presented.
The article describes special management options involving
angiographic techniques for placentation abnormalities and
arteriovenous malformations, and discusses a limited role for
embolization in the management of ectopic pregnancies. The
authors also present the outcomes of embolotherapy, associated
complications, and implications for future fertility. This article
describes the role of embolotherapy as it has evolved over the last
three decades and clarifies the endovascular management options
available to patients.
CONTENTS xiii
Liability in High Risk Obstetrics 617
James M. Shwayder
This article outlines the major causes of malpractice suits, focusing
on those in obstetrical practice and reviewing the prime areas in
antepartum and intrapartum care. Understanding the basic
elements of medical malpractice allows a provider to better
understand the nature of a suit for medical negligence. While the
threat of a medical malpractice is ever present in obstetrics,
practicing contemporary, evidence based medicine with compas¬
sion and excellent communication is the best way to avoid alleged
negligence.
Index 627
xiv CONTENTS
|
| adam_txt |
CONTENTS
Foreword xvii
William F. Rayburn
Preface xix
Henry L. Galan
Management of Pregnancy in a Jehovah's Witness 357
Cynthia Gyamfi and Richard L. Berkowitz
In the successful management of a pregnant Jehovah's Witness,
many issues must be addressed beyond those normally required
for routine prenatal care. The clinician who undertakes such care
should be well versed in the potential complications related to
blood refusal, the antepartum management of anemia, and the
intrapartum management of obstetric hemorrhage. Furthermore,
these patients should be delivered in a tertiary care center because
this increases their options for obtaining alternative management
of hemorrhage. A woman who is well informed about her options
can then decide exactly what she wants done in the event of a life
threatening obstetrical hemorrhage.
Intimate Partner Violence 367
Jennifer Gunter
Intimate partner violence (IPV) has a lifetime prevalence of
approximately 60% and is a leading cause of morbidity and
mortality for women of all reproductive ages, especially among
younger women and during pregnancy. Providers should recog¬
nize that every woman who has ever been partnered is at risk for
IPV and should screen appropriately. When a woman screens
positive for IPV, it important to consider the stages of change, to
frame the response appropriately, to perform a risk assessment, to
discuss interventions, and to document in the medical record
accordingly. Screening has yet to translate into reduced rates of
VOLUME 34 ¦ NUMBER 3 • SEPTEMBER 2007 ix
abuse, indicating that IPV is not simply a medical problem, but
involves complex psychological, financial, familial, cultural, and
legal issues.
Approach to the Acute Abdomen in Pregnancy 389
Charlie C. Kilpatrick and Manju Monga
Numerous physiologic changes in pregnancy may affect the
presentation of abdominal pain in pregnancy. A high index of
suspicion must be used when evaluating a pregnant patient with
abdominal pain. General anesthesia is considered safe in preg¬
nancy. Intraoperative monitoring and tocolytics should be indi¬
vidualized. Laparoscopic surgery should be performed in the
second trimester when possible and appears as safe as laparotomy.
If indicated, diagnostic imaging should not be withheld from the
pregnant patient. Appendectomy and cholecystectomy appear to
be safe in pregnancy. The reported incidence of adnexal masses and
fibroids in pregnancy may increase with increasing use of first
trimester ultrasound. Conservative management, with surgical
management postpartum, appears reasonable in most cases.
Current Management of Ectopic Pregnancy 403
Liberato V. Mukul and Stephanie B. Teal
Ectopic pregnancy continues to be one of the most common
gynecologic emergencies and is the leading cause of pregnancy
related first trimester death in the United States. The rate of ectopic
pregnancy continues to rise because of increases in the incidences
of its risk factors. However, improved modalities of early diagnosis
and treatment have reduced both mortality and morbidity of this
condition. In this article, the authors present an evidence based
review of the risk factors and presentation of ectopic pregnancy,
including the utility of various diagnostic techniques, and compare
the appropriateness and effectiveness of different therapeutic
approaches.
Postpartum Hemorrhage 421
Yinka Oyelese, William E. Scorza, Ricardo Mastrolia,
and John C. Smulian
Postpartum hemorrhage (PPH) is the leading cause of death related
to pregnancy worldwide. Most deaths resulting from PPH are
preventable. Physicians, nurses, midwives, and other birth attend¬
ants should be aware of the risk factors for PPH and be trained
adequately in the preventive measures and management strategies
for this pregnancy complication. Newer, less invasive technologies
such as embolization may improve outcomes with PPH. Reducing
the incidence of PPH and the mortality resulting from the condition
should be a key goal of obstetrics services worldwide. This article
focuses on the etiology, prediction, prevention, and management of
PPH.
X CONTENTS
Blood Component Therapy in Obstetrics 443
Andrea J. Fuller and Brenda Bucklin
Hemorrhage is the leading cause of intensive care unit admission
and one of the leading causes of death in the obstetric population.
This emphasizes the importance of a working knowledge of the
indications for and complications associated with blood product
replacement in obstetric practice. This article provides current
information regarding preparation for and administration of blood
products, discusses alternatives to banked blood in the obstetric
population, and introduces pharmacological strategies for treat¬
ment of hemorrhage.
Early Goal Directed Therapy for Sepsis During Pregnancy 459
Debra A. Guinn, David E. Abel, and Mark W. Tomlinson
Sepsis is a leading cause of death in pregnancy and results in
significant perinatal mortality. These deaths occur despite the
younger age of pregnant patients, the low rate of comorbid
conditions and the potential for effective interventions that should
result in rapid resolution of illness. To date, no "evidence based"
recommendations are specific to the pregnant patient who is
critically ill or septic. Optimal care for the septic patient requires a
multidisciplinary team with expertise in obstetrics, maternal fetal
medicine, critical care, infectious disease, anesthesia, and phar¬
macy. Coordination of care and good communication amongst
team members is essential. Incorporation of early goal directed
therapy for suspected sepsis into obstetric practice is needed to
optimize maternal and neonatal outcomes.
Thromboembolism in Pregnancy 481
Victor A. Rosenberg and Charles J. Lockwood
Venous thromboembolism in pregnancy is a clinical emergency
that has been associated with significant risk for maternal and fetal
morbidity and mortality. The adaptation of the maternal hemo
static system to pregnancy predisposes women to an increased risk
of thromboembolism. A timely diagnosis of deep venous throm¬
bosis is crucial because up to 24% of patients with untreated deep
venous thrombosis develop a pulmonary embolism. Recent clinical
guidelines identify compression venous ultrasound as the best way
to diagnose deep venous thrombosis in pregnancy and CT
pulmonary angiography as the best way to diagnose pulmonary
embolism in pregnancy. Therapy involves supportive care and
anticoagulation with unfractionated or low molecular weight
heparin, depending on the clinical scenario.
CONTENTS xi
Shoulder Dystocia: An Update 501
Amy G. Gottlieb and Henry L. Galan
Shoulder dystocia has no consensus definition or management
algorithm. Its incidence ranges from 0.2% to 3% and its occurrence
is unpredictable. Risk factors for shoulder dystocia may include
macrosomia, maternal diabetes, operative vaginal delivery, history
of macrosomic infant or shoulder dystocia, labor abnormalities,
post term pregnancy, maternal obesity, advanced maternal age,
fetal anthropometric variations, and male fetal gender. Once
identified, multiple maneuvers can be applied in a stepwise
fashion in an attempt to alleviate the dystocia. While training
clinicians to manage shoulder dystocia is difficult because of its
rare occurrence and lack of standardized management, all
clinicians must be able to manage shoulder dystocia at any time.
Diabetic Ketoacidosis in Pregnancy 533
Jason A. Parker and Deborah L. Conway
Episodes of diabetic ketoacidosis (DKA) can represent a life
threatening emergency for mother and fetus. The cornerstones of
treatment of DKA are aggressive fluid replacement and insulin
administration while ascertaining which precipitating factors
brought about the current episode of DKA, and then treating
accordingly to mitigate those factors. The incidence of DKA and
factors unique to pregnancy are discussed in this article, along with
the effects of the disease process on pregnancy. Clinical presenta¬
tion, diagnosis, and treatment modalities are covered in detail to
offer ideas to improve maternal and fetal outcome.
Amniotic Fluid Embolism 545
Irene Stafford and Jeanne Sheffield
Amniotic fluid embolism is a catastrophic syndrome occurring
during labor and delivery or immediately postpartum. Although
presenting symptoms may vary, common clinical features include
shortness of breath, altered mental status followed by sudden
cardiovascular collapse, disseminated intravascular coagulation,
and maternal death. It was first recognized as a syndrome in 1941,
when two investigators described fetal mucin and squamous cells
during postmortem examination of the pulmonary vasculature in
women who had unexplained obstetric deaths. Since then, many
studies, case reports, and series have been published in an attempt
to elucidate the etiology, risk factors, and pathogenesis of this
mysterious obstetric complication.
xii CONTENTS
Trauma in Pregnancy 555
Michael V. Muench and Joseph C. Canterino
Trauma is the leading nonobstetric cause of maternal mortality. The
basic tenets of trauma evaluation and resuscitation should be
applied in maternal trauma. Aggressive resuscitation of the mother
is the best management for the fetus. Care must be taken to keep
the patient in the left lateral decubitus position to avoid
compression of the inferior vena cava and resultant hypotension.
Radiographic studies should be used with care. Noninvasive
diagnostics should be used when available. Cardiotocographic
monitoring of a viable gestation should be initiated as soon as
possible in the emergency department to evaluate fetal well being.
Urgent cesarean section should be considered if fetal distress is
present or if the presence of the fetus is contributing to maternal
instability.
Cardiopulmonary Resuscitation in Pregnancy 585
Emad Atta and Michael Gardner
Although pregnancy and delivery in the United States are usually
safe for mother and her newborn child, serious maternal
complications, including cardiac arrest, can occur in the prenatal,
intrapartum and postpartum periods. The clinical obstetrician can
expect to encounter this complication in his or her career. The
obstetrician must be aware of the special circumstances of
resuscitation of the gravid woman to assist emergency medicine
and critical care physicians in reviving the patient. Understanding
the decision process leading to the performance of a perimortem
cesarean and the actual performance of the cesarean delivery
clearly are the responsibility of the obstetrician.
Angiographic and Interventional Options in Obstetric
and Gynecologic Emergencies 599
Filip Banovac, Ralph Lin, Dimple Shah, Amy White,
Jean Pierre Pelage, and James Spies
This article describes the role of angiographic and interventional
techniques in the management of obstetrical and gynecologic
hemorrhage. The complementary role of endovascular therapy is
discussed and a review of management options for both
peripartum hemorrhage and gynecologic hemorrhage is presented.
The article describes special management options involving
angiographic techniques for placentation abnormalities and
arteriovenous malformations, and discusses a limited role for
embolization in the management of ectopic pregnancies. The
authors also present the outcomes of embolotherapy, associated
complications, and implications for future fertility. This article
describes the role of embolotherapy as it has evolved over the last
three decades and clarifies the endovascular management options
available to patients.
CONTENTS xiii
Liability in High Risk Obstetrics 617
James M. Shwayder
This article outlines the major causes of malpractice suits, focusing
on those in obstetrical practice and reviewing the prime areas in
antepartum and intrapartum care. Understanding the basic
elements of medical malpractice allows a provider to better
understand the nature of a suit for medical negligence. While the
threat of a medical malpractice is ever present in obstetrics,
practicing contemporary, evidence based medicine with compas¬
sion and excellent communication is the best way to avoid alleged
negligence.
Index 627
xiv CONTENTS |
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| id | DE-604.BV023014373 |
| illustrated | Illustrated |
| index_date | 2024-07-02T19:10:40Z |
| indexdate | 2024-07-09T21:08:59Z |
| institution | BVB |
| isbn | 1416050981 9781416050988 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016218556 |
| oclc_num | 180769856 |
| open_access_boolean | |
| owner | DE-19 DE-BY-UBM |
| owner_facet | DE-19 DE-BY-UBM |
| physical | XXI S., S. 357 - 637 Ill. |
| publishDate | 2007 |
| publishDateSearch | 2007 |
| publishDateSort | 2007 |
| publisher | Saunders |
| record_format | marc |
| series | Obstetrics and gynecology clinics of North America |
| series2 | Obstetrics and gynecology clinics of North America |
| spelling | Obstetric and gynecologic emergencies guest ed. Henry L. Galan Philadelphia [u.a.] Saunders 2007 XXI S., S. 357 - 637 Ill. txt rdacontent n rdamedia nc rdacarrier Obstetrics and gynecology clinics of North America 34,3 Emergencies Gynecologic emergencies Gynecology Obstetric Surgical Procedures Obstetrical emergencies Obstetrics Obstetrics ethics Pregnancy Complications Galan, Henry L. Sonstige oth Obstetrics and gynecology clinics of North America 34,3 (DE-604)BV000617486 34,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016218556&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Obstetric and gynecologic emergencies Obstetrics and gynecology clinics of North America Emergencies Gynecologic emergencies Gynecology Obstetric Surgical Procedures Obstetrical emergencies Obstetrics Obstetrics ethics Pregnancy Complications |
| title | Obstetric and gynecologic emergencies |
| title_auth | Obstetric and gynecologic emergencies |
| title_exact_search | Obstetric and gynecologic emergencies |
| title_exact_search_txtP | Obstetric and gynecologic emergencies |
| title_full | Obstetric and gynecologic emergencies guest ed. Henry L. Galan |
| title_fullStr | Obstetric and gynecologic emergencies guest ed. Henry L. Galan |
| title_full_unstemmed | Obstetric and gynecologic emergencies guest ed. Henry L. Galan |
| title_short | Obstetric and gynecologic emergencies |
| title_sort | obstetric and gynecologic emergencies |
| topic | Emergencies Gynecologic emergencies Gynecology Obstetric Surgical Procedures Obstetrical emergencies Obstetrics Obstetrics ethics Pregnancy Complications |
| topic_facet | Emergencies Gynecologic emergencies Gynecology Obstetric Surgical Procedures Obstetrical emergencies Obstetrics Obstetrics ethics Pregnancy Complications |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016218556&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000617486 |
| work_keys_str_mv | AT galanhenryl obstetricandgynecologicemergencies |