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Ultrasound Clinics: Nuchal translucency assessment: What else can it tell us?Data from the FASTER and BUN trials show that first-trimester NT measurement can reveal a lot more than just trisomy 21. Although not ready for prime time as a screening test for congenital heart disease, we can't ignore the strong association between increased NT and an elevated risk of several cardiac birth defects and to a lesser degree diaphragmatic hernia. But what can we do about it?
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Oxytocin suspect in cases with poor outcomesOxytocin is one of the most frequently used drugs during labor but it can also become a major issue in a malpractice case filed after a labor and delivery if there is an adverse outcome. PLUS: Carolyn Zelop, MD, provides commentary on a lawsuit involving a patient death during pregnancy due to cardiomyopathy.
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Using GnRH Agonists and GnRH Antagonists in Clinical PracticeAn expert in obstetrics and gynecology comments on the utilization of GnRH agonists and GnRH antagonists in COS in IVF treatment.
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Protocols for High-Risk Pregnancies, 7th Edition: Snapshot: Protocol 18 - Peripartum CardiomyopathySnapshot: Protocol 18 - Peripartum Cardiomyopathy
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Is it vulvar vestibulitis?Diagnosing and treating women with vulvar vestibulitis can sometimes seem more art than science. Here an expert reviews the available evidence and describes his approach.
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Protocols for High-Risk Pregnancies, 7th Edition Prenatal testing for chromosomal abnormalitiesProtocol 5 - In this protocol, Norton reviews the pathophysiology of fetal aneuploidy and the wide range of tests for it. Included are perspectives on cell-free DNA testing, first-trimester combined screening, nuchal translucency (NT) sonography, and pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG), as well as quad marker screening in the second trimester in appropriate cases, and combined first- and second-trimester screening.
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Grand Rounds: What's the best approach to spontaneous premature ovarian failure?Learning that she has what used to be called premature menopause can devastate a woman in her 20s or 30s. Diagnose this mysterious condition without delay, deliver the bad news in person, and provide sensitiveanswers to four basic questions.
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Q&A: Controversy: Gender selection via preimplantation genetic diagnosis: ethical pros and cons of the controversyIf choosing gender is okay before fertilization, why shouldn't it be with PGD after fertilization, is the thrust of the "pro" argument. The other side calls PGD gender discrimination.
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Was this uterine perforation properly managed?Complications following IUD removal were the focus of this lawsuit.
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Current choices in cervical cancer screeningIt is essential to expand access to all available, effective cervical cancer screening options for the most vulnerable populations. The targeted use of any particular screening modality in higher-risk populations is not supported by evidence-based guidelines; any effective screening is the priority.
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Sex and the 50-something woman: Strategies for restoring satisfactionFor many women, the 50s are a milestone decade. In addition to other changes, menopause can bring about sexual dysfunction.
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Grand Rounds: Office assessment of urinary incontinenceUrinary incontinence can often be successfully treated without referral, but first ob/gyns need to broach the subject! Two experts tell how to evaluate this widespread condition.
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Oh, by the way. . . what about this mole?How many times has a patient said, "Oh, by the way, doctor..." just as you're leaving the exam room? This column will help you quickly triage those seemingly offhand yet clinically significant encounters.
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Evaluation and management of polyhydramniosThis summary of SMFM Consult Series #46 reviews major considerations in evaluation and management of polyhydramnios.
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Clinician to Clinician: The clinical consequences of loose lipsBe careful what you say in the clinical setting. That truism was brought home to me recently by a patient who burst into tears in a preoperative area.
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Clinician to Clinician: The clinical consequences of loose lipsBe careful what you say in the clinical setting. That truism was brought home to me recently by a patient who burst into tears in a preoperative area.
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Clinician to Clinician: The clinical consequences of loose lipsBe careful what you say in the clinical setting. That truism was brought home to me recently by a patient who burst into tears in a preoperative area.
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What you need to know about laparoscopic surgery for endometrial cancerA laparoscopic procedure is an option for many women with endometrial cancer. Here, two expert gynecologic oncologists tell you what the surgery involves and how to select patients for referral.
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What you need to know about laparoscopic surgery for endometrial cancerA laparoscopic procedure is an option for many women with endometrial cancer. Here, two expert gynecologic oncologists tell you what the surgery involves and how to select patients for referral.
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Grand Rounds: When mom requests a cesareanBefore deciding what to do in this scenario, clinicians must weigh the evidence on length of stay, the risk of postpartum hemorrhage, infection rates, the threat of urinary incontinence, and a host of other complex issues.
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Improving survival in twin-twin transfusion syndromeAlthough serial amnioreduction is still widely used to treat this dangerous condition, a recent randomized trial found that when compared to amnioreduction at 15 to 26 weeks, overall perinatal survival is higher with laser ablation, which tries to reverse the disease process.
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Effective management of antidepressant-induced sexual dysfunctionSmall studies suggest effective strategies, but more trials are needed.
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Maternal death from intracranial hemorrhageDid her family physician meet the standard-of-care?
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Statements from organizations regarding breastfeeding and substance useThese four statements can help provide ob/gyns with guidance about how to counsel patients with substance use disorder about breastfeeding.
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2009 earnings survey: How do you compare?A rough year for the U.S. economy had little negative impact on the income of physicians, according to the results of Medical Economics' 2009 Exclusive Survey.
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Offering breastfeeding mothers advice on contraceptionOb/gyns should ensure that women have the information they need to make an informed decision about breastfeeding. This article addresses the two key concerns that new mothers most express about contraception and breastfeeding.
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Our Generation: Buy-in, buy-out-or bye-bye? One ob/gyn's storyFresh out of residency, I was asked to join a small but successful practice of four ob/gyns in a large, metropolitan area. At first, everything seemed perfect. And then, the buy-in talks began. The "honeymoon" was over.
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Sign Out: When 'show and tell' is serious medicineDo you remember bringing something to school for "show and tell" when you were a child? That's what I did recently, only it wasn't a game. I was teaching basic medicine, obstetrics, and gynecology to medical students, lay midwives, and physicians in Liberia.
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How to survive a depositionBe concise, be cool, be prepared, and don't try to outwit the plaintiff's attorney.
