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Alejandro Paradas - One of the best experts on this subject based on the ideXlab platform.

  • Paracervical block in incomplete abortion using manual Vacuum Aspiration: randomized clinical trial.
    Obstetrics & Gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    OBJECTIVE: To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion METHODS: A randomized clinical trial was conducted at Nuestra Senora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. RESULTS: Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P

  • paracervical block in incomplete abortion using manual Vacuum Aspiration randomized clinical trial
    Obstetrics & Gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    OBJECTIVE: To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion METHODS: A randomized clinical trial was conducted at Nuestra Senora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. RESULTS: Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P <.001). The manual Vacuum Aspiration technique and the paracervical block were not accompanied by complications. CONCLUSION: The paracervical block technique used in this study along with psychological support was comparable with pain control using psychological support alone; neither pain management regimen provided sufficient pain control. It is recommended that randomized comparative studies be designed to determine the effectiveness of other paracervical block techniques and the efficacy of the use of analgesics in patients suffering from incomplete abortion treated with manual Vacuum Aspiration.

  • Paracervical block in incomplete abortion using manual Vacuum Aspiration: randomized clinical trial.
    Obstetrics and gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion A randomized clinical trial was conducted at Nuestra Señora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P <.001). The manual Vacuum Aspiration technique and the paracervical block were not accompanied by complications. The paracervical block technique used in this study along with psychological support was comparable with pain control using psychological support alone; neither pain management regimen provided sufficient pain control. It is recommended that randomized comparative studies be designed to determine the effectiveness of other paracervical block techniques and the efficacy of the use of analgesics in patients suffering from incomplete abortion treated with manual Vacuum Aspiration.

Michael L Podolsky - One of the best experts on this subject based on the ideXlab platform.

  • Retained viable single intrauterine pregnancy after Vacuum Aspiration for a dichorionic-diamniotic twin pregnancy.
    Obstetrics & Gynecology, 2010
    Co-Authors: Obehi A Asemota, Michael L Podolsky
    Abstract:

    BACKGROUND: Retained viable intrauterine pregnancy is an infrequent complication of Vacuum Aspiration. We report a case of a retained single intrauterine pregnancy after an elective Vacuum Aspiration of a dichorionic-diamniotic twin gestation. CASE: A patient presented to the emergency department reporting vaginal spotting breast engorgement and lower abdominal cramping for the previous 2 weeks. The patient had had an elective abortion 2 months previously. Transvaginal ultrasonography revealed an apparent twin gestational sac within the uterus. The presenting gestational sac contained a mixture of blood clot and tissue with no discernible fetal parts. The second sac contained a live fetus of approximately 15 weeks of gestation. CONCLUSION: An underreported complication of Vacuum Aspiration is a retained viable intrauterine pregnancy. There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.

  • Retained viable single intrauterine pregnancy after Vacuum Aspiration for a dichorionic-diamniotic twin pregnancy.
    Obstetrics and gynecology, 2010
    Co-Authors: Obehi A Asemota, Michael L Podolsky
    Abstract:

    Retained viable intrauterine pregnancy is an infrequent complication of Vacuum Aspiration. We report a case of a retained single intrauterine pregnancy after an elective Vacuum Aspiration of a dichorionic-diamniotic twin gestation. A patient presented to the emergency department reporting vaginal spotting, breast engorgement, and lower abdominal cramping for the previous 2 weeks. The patient had had an elective abortion 2 months previously. Transvaginal ultrasonography revealed an apparent twin gestational sac within the uterus. The presenting gestational sac contained a mixture of blood clot and tissue with no discernible fetal parts. The second sac contained a live fetus of approximately 15 weeks of gestation. An underreported complication of Vacuum Aspiration is a retained viable intrauterine pregnancy. There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.

Pio Iván Gómez - One of the best experts on this subject based on the ideXlab platform.

  • Paracervical block in incomplete abortion using manual Vacuum Aspiration: randomized clinical trial.
    Obstetrics & Gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    OBJECTIVE: To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion METHODS: A randomized clinical trial was conducted at Nuestra Senora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. RESULTS: Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P

  • paracervical block in incomplete abortion using manual Vacuum Aspiration randomized clinical trial
    Obstetrics & Gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    OBJECTIVE: To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion METHODS: A randomized clinical trial was conducted at Nuestra Senora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. RESULTS: Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P <.001). The manual Vacuum Aspiration technique and the paracervical block were not accompanied by complications. CONCLUSION: The paracervical block technique used in this study along with psychological support was comparable with pain control using psychological support alone; neither pain management regimen provided sufficient pain control. It is recommended that randomized comparative studies be designed to determine the effectiveness of other paracervical block techniques and the efficacy of the use of analgesics in patients suffering from incomplete abortion treated with manual Vacuum Aspiration.

  • Paracervical block in incomplete abortion using manual Vacuum Aspiration: randomized clinical trial.
    Obstetrics and gynecology, 2004
    Co-Authors: Pio Iván Gómez, Hernando Gaitán, Casilda Nova, Alejandro Paradas
    Abstract:

    To estimate the effectiveness of paracervical block in controlling pain among women treated with manual Vacuum Aspiration for an incomplete abortion A randomized clinical trial was conducted at Nuestra Señora de Altagracia, a maternal and perinatal referral hospital in the Dominican Republic. The sample size was based on a clinical difference of 1.5 points in the level of pain measured with the visual analog scale using 90% power and a sampling error of 0.04. Women who were at 12 weeks of gestation or less with an incomplete abortion were eligible to participate. They were randomly assigned to receive either the standard treatment of care (manual Vacuum Aspiration for uterine evacuation with psychological support but no paracervical block) or manual Vacuum Aspiration treatment with psychological support and paracervical block using 1.0% lidocaine. Patients with active infections, severe illnesses, psychiatric disorders, or allergies to lidocaine were excluded. Intraoperative pain as reported by the women and as documented by an external observer was measured. Although the paracervical block technique used showed a slight reduction in severe pain, there were no clinically or statistically significant differences in intraoperative pain between the 2 groups (relative risk 0.73; 95% confidence interval 0.43, 1.23) with 50% of all patients registering 7 or higher score on a visual analog pain scale of 0-10. However, statistically significant differences were found in each group when comparing the level of preoperative and intraoperative pain described by the patient (P <.001). The manual Vacuum Aspiration technique and the paracervical block were not accompanied by complications. The paracervical block technique used in this study along with psychological support was comparable with pain control using psychological support alone; neither pain management regimen provided sufficient pain control. It is recommended that randomized comparative studies be designed to determine the effectiveness of other paracervical block techniques and the efficacy of the use of analgesics in patients suffering from incomplete abortion treated with manual Vacuum Aspiration.

Sheryl Thorburn Bird - One of the best experts on this subject based on the ideXlab platform.

  • Similarities in women's perceptions and acceptability of manual Vacuum Aspiration and electric Vacuum Aspiration for first trimester abortion.
    Contraception, 2003
    Co-Authors: Sheryl Thorburn Bird, M. D. Nichols, S. Marie Harvey, Linda J. Beckman, Kathy Rogers, Paul D. Blumenthal
    Abstract:

    This paper examines women's acceptability of and experiences with manual Vacuum Aspiration (MVA) as compared with electric Vacuum Aspiration (EVA) for first trimester abortion. Women requesting pregnancy terminations were randomly assigned to either MVA (n = 64) or EVA (n = 63). Participants completed questionnaires before and after their abortions and approximately 2-4 weeks later. We observed some differences by group in participants' ratings of the importance of method characteristics and in their perceptions of their abortion methods after their abortions. The two groups did not, however, differ in their reports of pain, anxiety or bleeding or in the acceptability of their method.

  • Comparing the acceptability of manual Vacuum Aspiration and electric Vacuum Aspiration as methods of early abortion.
    Journal of the American Medical Women's Association (1972), 2001
    Co-Authors: Sheryl Thorburn Bird, M. D. Nichols, Alison Edelman
    Abstract:

    OBJECTIVE to compare the acceptability of manual Vacuum Aspiration (MVA) and electric Vacuum Aspiration (EVA) as methods of early (< or = 77 days' gestation) abortion. METHODS We interviewed 42 women who had been randomly assigned to either MVA or EVA and compared their perceptions of the two procedures. RESULTS The experiences and perceptions of women in the two groups were similar in many ways. The majority of women in both procedure groups were very satisfied with the method used, and most indicated that they would prefer the same method if they were to have another abortion. CONCLUSION This study found no major differences in the acceptability of MVA and EVA among women undergoing early abortions.

Obehi A Asemota - One of the best experts on this subject based on the ideXlab platform.

  • Retained viable single intrauterine pregnancy after Vacuum Aspiration for a dichorionic-diamniotic twin pregnancy.
    Obstetrics & Gynecology, 2010
    Co-Authors: Obehi A Asemota, Michael L Podolsky
    Abstract:

    BACKGROUND: Retained viable intrauterine pregnancy is an infrequent complication of Vacuum Aspiration. We report a case of a retained single intrauterine pregnancy after an elective Vacuum Aspiration of a dichorionic-diamniotic twin gestation. CASE: A patient presented to the emergency department reporting vaginal spotting breast engorgement and lower abdominal cramping for the previous 2 weeks. The patient had had an elective abortion 2 months previously. Transvaginal ultrasonography revealed an apparent twin gestational sac within the uterus. The presenting gestational sac contained a mixture of blood clot and tissue with no discernible fetal parts. The second sac contained a live fetus of approximately 15 weeks of gestation. CONCLUSION: An underreported complication of Vacuum Aspiration is a retained viable intrauterine pregnancy. There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.

  • Retained viable single intrauterine pregnancy after Vacuum Aspiration for a dichorionic-diamniotic twin pregnancy.
    Obstetrics and gynecology, 2010
    Co-Authors: Obehi A Asemota, Michael L Podolsky
    Abstract:

    Retained viable intrauterine pregnancy is an infrequent complication of Vacuum Aspiration. We report a case of a retained single intrauterine pregnancy after an elective Vacuum Aspiration of a dichorionic-diamniotic twin gestation. A patient presented to the emergency department reporting vaginal spotting, breast engorgement, and lower abdominal cramping for the previous 2 weeks. The patient had had an elective abortion 2 months previously. Transvaginal ultrasonography revealed an apparent twin gestational sac within the uterus. The presenting gestational sac contained a mixture of blood clot and tissue with no discernible fetal parts. The second sac contained a live fetus of approximately 15 weeks of gestation. An underreported complication of Vacuum Aspiration is a retained viable intrauterine pregnancy. There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.