Always be vigilant for placenta accreta
See related article, page 177 Perhaps there is no greater obstetrical surgical challenge than that of managing a delivery complicated by placenta accreta. Placenta accreta results from a defect of…
GYNECOLOGY
Quality in obstetrics: the search continues
See related article, page 147 As an active clinician, administrator, and researcher in health care quality, I am often amusingly reminded of Robert Pirsig’s Zen and the Art of Motorcycle…
The complicated Allen-Masters syndrome: small bowel herniation through a broad ligament defect
Small bowel obstruction through a broad ligament defect is a very rare condition. We present 2 cases, one without any associated abdominal trauma. Rapid diagnosis and treatment of this rare…
Misperception of estrogen activity in patients treated with an estrogen receptor antagonist
Measurement of estradiol is an important marker of ovarian function. At low levels, accurate measurement has been difficult because of unique characteristics of immunoassay kits. We present this case to…
The PORTO study and the gestational age perspective of Doppler interrogation of IUGR fetuses
The Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) study challenges the idea that Doppler interrogation of intrauterine growth-restricted (IUGR) fetuses might be useful to describe a sequence…
Preeclampsia: 2 placental phenotypes, 1 etiology?
In 1914, James Young set out a detailed account of the placental findings in preeclampsia that included the incidence of infarction and villous over-crowding. His placental ischemia theory displaced the…
Decision-to-delivery interval (DDI) for emergency cesarean section (ECS) for nonreassuring fetal heart rate (NRFHR)
On one hand, the well-conducted prospective study by Weiner et al could be considered a very good-quality evidence for a 30 minute decision-to-delivery interval (DDI) standard, especially because randomized controlled trials…
