ABSTRACT
Preeclampsia is a common complication of pregnancy and often manifests in severe cases with neurological symptoms. We present the first documented case of preeclampsia associated with third nerve palsy. A 19-year-old primigravida presented at 31 2/7 weeks' gestation with preeclampsia. In addition to classic preeclampsia symptoms, the patient had atypical visual disturbances. Exhaustive neurological and ophthalmological examinations revealed a third nerve palsy with no etiology other than preeclampsia. Deteriorating renal function necessitated preterm delivery. She ultimately underwent a cesarean section. Two months postpartum, the patient has shown complete spontaneous resolution of third nerve palsy. In this case of severe preeclampsia manifested by third nerve palsy, we hypothesize that the mechanism is attributed to vasospasm of the vessels supplying the oculomotor nerve.
Subject(s)
Oculomotor Nerve Diseases/etiology , Pre-Eclampsia/diagnosis , Adult , Diagnosis, Differential , Female , Gravidity , Humans , Infant, Newborn , Male , Pre-Eclampsia/complications , Pre-Eclampsia/pathology , Pregnancy , Pregnancy Trimester, Third , Severity of Illness IndexABSTRACT
OBJECTIVE: The study was undertaken to determine factors influencing a medical student's decision to choose obstetrics and gynecology (OB/GYN) versus another specialty. STUDY DESIGN: Medical school graduates from 1991 to 2001 were surveyed about factors influencing their specialty choice. Data were analyzed with chi(2), logistic regression, and odds ratio where appropriate. RESULTS: Of 1128 surveys, 562 (50%) were returned; 37% of respondents were women and 63% were men; and 73 (13%) chose OB/GYN. Statistically significant positive influences included student sex, second-year rotations, OB/GYN staff, continuity of patient care, primary care opportunities, surgical opportunities, healthy patient population, female patients, lifestyle, and financial opportunities. CONCLUSION: Perceived lifestyle, primary care opportunities, and malpractice concerns did not influence the choice to enter the field of OB/GYN. Also, the perception of patient's desire for female physicians had no apparent influence, either positive or negative, in the decision process.
