The use of estrogens and progestins and the risk of breast cancer in postmenopausal women: Colditz GA, Hankinson SE, Hunter DJ, et al. N Engl J Med 1995: 332(24):1589–1593
✍ Scribed by Betty Chern-Hughes
- Publisher
- Elsevier Science
- Year
- 1996
- Weight
- 234 KB
- Volume
- 41
- Category
- Article
- ISSN
- 0091-2182
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✦ Synopsis
murmce of shoulder dystocla were also reported Eighty women hsd 93 cephalic vaginal dellue~s after Lllri~ wtyirbd ddiw~y wiiii drotier dystocia. GI tim. 38 neonates were heavier, and 55 were Ilghter, than was the mamate wkh shoulder dytocb.
There urns only one case of recurrent shoulder dystocla. which was repotted without perinatal trauma. There were three subsequent pregnar~les with cephalic presentation delivered by cesarean: two for cephalopelvic disproportion and one el&ctive, for oahetcj and macrosomia. All of these infants were larger than infants in the originakoded shoulder dystocia delivery. commentay This sludy provides szzeral useful reminders for nursemidwives. First, the majority of cases of shoulder dystocia occurred without identifiable factors. Therefore, one should always be prepared to manage the unanticipated shoulder dystocia. Second, strong downward tractiorr on the fetal head in an effort tc reelieve shoulder dystocia is more likely to result in perinatal trauma than is use of the McRoberts maneuver or delivery of the posterior arm Third, birth attendants must clearly document their management steps for treatment of shoulder dystocia.
TheuseofeWogensandpmgestinsardtheriskof breast cancer in postmenopausal women. Colditz