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Should We Test More Drugs on Pregnant Women?With 64% of pregnant women in the U.S. taking at least one medication during pregnancy, experts are arguing that it’s unethical not to include them in the testing of new drugs.
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The Belle Browne Pain Scale0) No Pain1) Slight Pain, slight ache, pain comes and goes very mild. Able to perform all tasks normally and pain is easily forgotten while attending to something else. No pain medications required.2) Slight pain which lasts a bit longer, still able to perform usual tasks and again, if concentration is shifted away from the pain, the pain is forgotten about. No pain medications required.3) Pain is more noticeable and it comes and goes more frequently. Still able to perform usual tasks but it takes a bit of effort. Mild analgesic usually will help with this type of pain.4) The pain lasts for longer periods, it is much more noticeable and it is starting to bother and interfere with concentration and tasks requiring more effort and concentration. Mild analgesia should alleviate this type of pain, maybe more doses than one single dose may be required. A hot pack or ice pack may also help alleviate the pain.5) The Pain is now very noticeable, it is interfering with everyday tasks and a pain reliever is now required at 4 to 6 hourly intervals. Depending on the patient, someone with acute pain, may still respond well to mild analgesia probably at 4th hourly, maybe with added codeine (if the patient is able to take it) and even heat or ice may help with some relief of this level of pain.6) The Pain level is medium heading towards strong now and it is becoming more constant and it is not easily forgotten about. Pain relief is now required and it may need to be stronger than just mild analgesia, added codeine may help with the level of pain relief, this all depends on whether the pain is acute or chronic and on the patient's actual level of pain tolerance. A chronic pain patient may still have this level of pain even with strong pain relief.7) The pain level is now medium to strong and the pain is continuous. It is not relieved by mild to medium analgesia. Stronger narcotics are now required for pain relief. Chronic pain patients may still be at this level, even with strong narcotic pain relief. Heat may also aid with relief. Its becoming harder to concentrate due to the strength of the pain.8) The pain is becoming unbearable, strong narcotic pain relief is required. The chronic and acute pain patient will be irritable, hot and may be flushed, perspiration may be noticeable. Blood pressure may also be elevated. Patient may start to shake a bit if the pain has been going on for too long.9) The pain now is unbearable, only strong narcotic pain relief for the acute patient will help with the pain. The chronic pain patient will be irritable, the patient may be flushed and their palms are usually sweaty, blood pressure usually raised, pain relief needs to be increased and re-assessed. Nausea or vomiting may be present. The patient may be trembling or shaking due to the amount of pain, moaning and groaning may be present. Whether the pain is acute or chronic, the patient is usually unable to sleep or concentrate on the smallest task.10) The pain level is totally unbearable, the patient maybe vomiting or can even lose consciousness. The patient may also become delirious, moaning and groaning without making any sense. The blood pressure may still be elevated or by now may have dropped and the patient may go into shock. The patient must be treated by his/her symptoms, if cold, then the patient should be kept warm and if hot they should be cooled down. Pain relief is needed urgently. The patient may even become incontinent.
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"Madame, You're going to undergo a hysterectomy"A hysterectomy is the surgical removal of the uterus. One talks of total hysterectomy, if the entire uterus is removed (cervix and corpus) and of subtotal if the cervix is kept in place. During this intervention the ovaries may be removed too.
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FIRST and FASTER Trials for Genetic Markers in First TrimesterOBGYN.net Conference CoverageFrom AIUM 44th Conference held in San Francisco, California - April, 2000
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Prenatal TestingOBGYN.net Conference CoverageINTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY:Zagreb, Croatia
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Olympus Endo OrganizerOBGYN.net Conference CoverageFrom the 31st Annual Meeting of the American Association of Gynecological Laparoscopists (AAGL)
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Procedures that are being moved into the physician's office and the savings that this will bringOBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsLas Vegas, Nevada, November, 1999
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Obstetrics Case Report: Shoulder DystociaObstetric emergencies require quick and decisive action to save the life of the mother and the child. Severe hypertensive disorder, haemorrhage and embolism all threaten the life of the mother. The fetus is directly threatened by umbilical cord accidents, other forms of hypoxia and mechanical delivery problems.
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Can the Difference in Medical Fees for Self and Donor Freeze-thaw Embryo Transfer CycleIn recent years, clinical assisted reproduction techniques (ART) are increasingly being practiced worldwide, which in turn has led to an accumulated surplus of cryopreserved embryos within fertility clinics [1,2].
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First-Trimester Aneuploidy Screening A Combined ApproachPrenatal testing for Down syndrome has gained importance--and urgency--as more women delay pregnancy into their later reproductive years. A first-trimester screening technique that combines use of maternal serum markers with ultrasonographic assessment may offer reliable answers sooner than do other available tests.
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The PAP SmearThe PAP smear is a screening test for detecting cancerous or precancerous changes of the cervix. The test was developed by Dr. George Papanicolaou in the 1940’s.
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Building Safety Nets for Surgery in the Medical OfficeSurgery in the medical office setting can confer benefits for both the physician and the patient, as it can control costs, allow for flexibility in scheduling, and increase overall convenience.
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The Halt Procedure - Radio Frequency Ablation of Uterine FibroidsOBGYN.net Conference Coverage - AAGL 2004
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Windows 2000OBGYN.net Conference CoverageFrom AIUM 44th Conference held in San Francisco, California - April, 2000
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The History of the GnRH Analogue ConferencesOBGYN.net Conference CoverageFrom the 6th GnRH Analogue ConferenceGeneva, Switzerland February 2001
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Current Concepts in the Diagnosis & Therapy of EndometriosisOBGYN.net Conference CoverageFrom 5th International Symposium onGnRH Analogues in Cancer and Human Reproduction inGeneva, Switzerland
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Laparoscopic treatment of endometriosis in patients with failed in vitro fertilization cyclesEndometriosis is one of the most common gynecologic disorders and is significantly more prevalent in the setting of infertility. The prevalence of endometriosis in infertile women ranges from 25% to 50% compared to 5% in fertile women. Successful laparoscopic management of all stages of endometriosis was reported as early as 1986. This has revolutionized the management of endometriosis. The benefits of surgical therapy for infertility associated with endometriosis have been well documented.
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Summary of the IPPS Hartford SymposiumOnce again the International Pelvic Pain Society realized a very successful meeting in Hartford this spring. We were able to pull together interesting and dynamic speakers from many different disciplines with refreshingly new perspectives on the diagnosis, treatment, management and understanding of this complex disease.
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What is Endometriosis?Endometriosis is a condition in which the lining of the uterine cavity (endometrium) grows outside of the uterus. Endometriosis can be found anywhere in the pelvic cavity, including all the reproductive organs as well as on the bladder, small bowel, colon, rectum, appendix, and vagina. However, endometriosis cannot be considered simply as misplaced endometrium, because it differs in hormonal responses and visual appearance.
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Vulvodynia and Vulvar Vestibulitis Syndrome FAQ v2.3Vulvodynia is a medical term that means "painful vulva". The term can cover a wide variety of vulvar pain syndromes, including various infections and skin disorders.
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Endometriosis and Risk of Ovarian Cancer: An updateEmerging information on the link between ovarian cancer and endometriosis gives us an unprecedented opportunity to develop comprehensive screening plans for early detection and prevention of specific types of ovarian cancer.
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Subjective and Objective Outcomes of Botulinum Toxin Type A Treatment in VestibulodyniaBotulinum toxin type A may be effective in reducing coital pain in vestibulodynia with levator ani tenderness, but has little effect on vestibular allodynia.
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Alternatives to hysterectomy for the treatment of uterine fibroidsOBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsSan Francisco, California - November 2001
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Dealing With PMSPremenstrual Syndrome (PMS) refers to uncomfortable physical and mental symptoms that occur before the onset of the woman’s menstrual period. Estimates of affected women range from 40 to 80%.
