3 results
Contributors
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- By Janine B. Adams, Kirsten B. Barnes, Guy C. Bate, Greg A. Botha, Meyrick B. Bowker, Sarah J. Bownes, Nicola K. Carrasco, Clinton P. Chrystal, Robynne A. Chrystal, Xander Combrink, Allan D. Connell, Digby P. Cyrus, Colleen T. Downs, William N. Ellery, Anthony T. Forbes, Nicolette T. Forbes, Caroline Fox, Nuette Gordon, Michael C. Grenfell, Suzanne E. Grenfell, Sylvi Haldorsen, Marc S. Humphries, Hendrik L. Jerling, Bruce E. Kelbe, C. Fiona MacKay, Christopher M. Maine, Andrew Z. Maro, Andrew A. Mather, Nelson A. F. Miranda, David G. Muir, Holly A. Nel, Sibulele Nondoda, Renzo Perissinotto, Deena Pillay, Naomi Porat, Roger N. Porter, Sean N. Porter, Justin J. Pringle, Ursula M. Scharler, Derek D. Stretch, Ricky H. Taylor, Jane Turpie, Jonathan K. Warner, Alan K. Whitfield
- Edited by Renzo Perissinotto, University of KwaZulu-Natal, South Africa, Derek D. Stretch, University of KwaZulu-Natal, South Africa, Ricky H. Taylor
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- Book:
- Ecology and Conservation of Estuarine Ecosystems
- Published online:
- 05 April 2013
- Print publication:
- 16 May 2013, pp xiii-xvi
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21 - Malignancy and pregnancy
- from Section 5 - Other disorders
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- By Holly A. Muir, Vice Chair, Clinical Operations Department of Anesthesiology, Duke University, Medical Center, Durham, North Carolina, USA; Chief, Division of Women's Anesthesia, Michael Smith, Chief Resident in Anesthesiology, Department of Anaesthesiology, University of Kansas, School of Medicine – Wichita, Wichita, KS, USA, David R. Gambling, Clinical Associate Professor, Department Anesthesiology, University of California, San Diego, CA USA; Staff Anesthesiologist, Sharp Mary Birch Hospital for Women
- Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
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- Book:
- Obstetric Anesthesia and Uncommon Disorders
- Published online:
- 19 October 2009
- Print publication:
- 20 March 2008, pp 371-380
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Summary
Introduction
Malignancy complicates between 0.02% and 0.10% of all pregnancies and in one study cancer diagnosis was associated with 1 in 1000 deliveries. Pregnancy does not affect the frequency of cancers seen in women of childbearing age. Melanoma may be the most frequent malignancy seen during pregnancy (1:350), followed by cervical cancer (1:2250), Hodgkin lymphoma (1:3000), breast cancer (1:7500), ovarian cancer (1:18,000), and leukemia (1:75,000). However, the National Cancer Institute maintains that breast cancer is the most common cancer seen in pregnant and postpartum women at 1:3000 pregnancies (www.cancer.gov/cancertopics/pdq/treatment/breast-cancer-and-pregnancy).
In general, the prognosis for pregnant women with malignant lesions is the same, stage for stage, as for nonpregnant women. However, for many reasons, diagnosis of cancer during pregnancy occurs at more advanced stages of the disease.
Typically, during pregnancy, what benefits the mother also benefits the fetus. However, that is not true in the case of the pregnant woman with cancer as treating the cancer often means compromising the pregnancy. Depending on the type of cancer and gestational age at diagnosis, treatment can sometimes be delayed until the fetus is either viable or mature. In some cases, protection of maternal and fetal health are congruent, but when care of the mother imposes iatrogenic risk to the fetus, the mother may decide to delay or alter her treatment for the good of the fetus, potentially to her own detriment.
Fetal monitoring
Fetal and uterine monitoring during cancer surgery is controversial.
12 - Chronic pain in pregnancy
- from Section 3 - Nervous system disorders
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- By Hector J. Lacassie, Associate Professor, Anesthesiology Departament Pontificia Universidad Católica de Chile; Visiting Associate, Duke Univerity, Medical Center, Durham, NC, USA, Holly A. Muir, Vice Chair, Clinical Operations, Department of Anesthesiology, Chief, Division of Women's Anesthesia, Duke University, Medical Center, Durham, North Carolina, USA
- Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
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- Book:
- Obstetric Anesthesia and Uncommon Disorders
- Published online:
- 19 October 2009
- Print publication:
- 20 March 2008, pp 229-238
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- Chapter
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Summary
Introduction
Pain is defined as a sensory and emotional experience associated with actual tissue damage or described in terms of such damage. This definition has endured through time; however, the classification of the different types of pain is evolving. Original descriptions of pain were based on a temporal evolution, where the distinction between acute and chronic pain was that if it lasted for more than six months it was considered chronic. Another more conservative and innovative view proposed one month as the defining criterion. These early definitions did not account for the mechanisms involved in the development of the pain. The prevailing contemporary view is to classify pain according to the primary pathology involved in the cause of pain, namely: inflammatory (acute) or neuropathic (chronic). The latter can be considered a disease of the nervous system and not merely a symptom of some other condition. Furthermore, poorly treated acute pain can lead to neuropathic chronic pain. The current temporal cutoff value for chronic pain is three months.
During pregnancy, acute inflammatory pain, usually arising from labor and delivery, is the most common type of pain. However, other pain syndromes (chronic neuropathic or acute inflammatory evolving to chronic neuropathic) have been recognized throughout pregnancy. In this chapter we will discuss painful entities encountered during pregnancy, focusing on the chronic pain states and recurrent inflammatory pain that may lead to chronic pain.