Pediatrics

Is it possible to be too cautious about prescribing medication to a breastfeeding patient? Absolutely. Two experts in this area provide an informed, balanced perspective.

Thanks to advances in U/S technology, clinicians can now detect ventricular enlargement in its earliest stages. Unfortunately, a few fetuses with borderline ventriculomegaly still have chromosomal or structural malformations.

Using a technique called super crowning, avoiding episiotomy, and reaching for a vacuum device rather than forceps during operative vaginal deliveries are among the strategies that can help reduce the number of third- and fourth-degree lacerations.

We may have seen the first glimmer of light in the otherwise dark tunnel of the professional liability insurance crisis. On July 12, during a speech at the National Press Club, U.S. Senate Majority Leader Bill Frist proposed "an expert medical court system with transparent decisions, limits on punitive damages, and scheduled compensatory damages to provide rapid relief to truly injured patients (instead of trial lawyers)" while holding negligent doctors accountable.

An expert in the field provides a balanced approach to protecting patients from this potentially lethal infection.

An expert in the field provides a balanced approach to protecting patients from this potentially lethal infection.

In the 2 years since I completed my ob/gyn training, I've had four jobs in three different practice settings in three different cities. I'm now headed back where I started geographically, combining the practice of obstetrics and gynecology with raising a rambunctious 7-year-old boy and a 9-year-old Hllary Duff-wannabe as a single parent.

Nearly twice as many women as men suffer from clinical depression, and up to 50% of ob/gyn patients have the disorder or its symptoms. Since you may be the only clinician many of these women see, you're uniquely positioned to detect its presence and steer patients toward appropriate treatment.

Delay in aggressively treating out-of-control, unremitting vomiting in pregnancy can dehydrate, deplete, and nearly starve a woman and her fetus. This expert's approach tells you how to quickly distinguish developing hyperemesis gravidarum from something more benign.

Once a common cause of perinatal death, Rh disease is now quite rare in pregnant women, thanks in large part to advances in U/S and DNA technology. But the fact that roughly 7 out of every 1,000 liveborn infants are delivered by Rh-sensitized women emphasizes the need for more vigorous preventive efforts and up-to-date management skills.

There are several biological mechanisms behind the age-related drop in female fertility--and a number of tests to assess this decline.

Depression does occur in pregnant women and not just in those with preexisting mood symptoms. Knowing how to detect the disorder and when to refer is important because you may be the only physician these patients see during the perinatal period.

Studies leave little doubt that this nonsteroidal anti-inflammatory agent can stop preterm labor. But the drug also needs to be administered wisely, and with several fetal complications in mind.

While insulin-sensitizing agents like metformin have proven useful in managing this disorder, mounting evidence indicates that rosiglitazone can also help induce ovulation and improve the metabolic profile in these patients.

Your patient has CIN, a precursor to cervical cancer. How do you manage her pregnancy? An expert pathologist provides algorithms and a step-by-step guide for safely biopsying a pregnant cervix-when appropriate.

Women need thorough and accurate information about the entire array of contraceptive options--new and old--so they can find their ideal method. Adherence--not efficacy--is the problem, and the hope is that greater choice will translate into fewer unintended pregnancies.

Antibiotics can prove invaluable in the treatment of mastitis, but before you prescribe them, it's important to distinguish breast engorgement from infectious mastitis.

Analgesics are everywhere, but that doesn't mean they're without risk. This timely review offers a balanced assessment of which ones pose the greatest threat.

With new research showing that aromatase inhibitors can dramatically cut the risk of recurring breast cancer, patients will probably have many questions about drugs like anastrozole and letrozole. Two experts review the scientific evidence on these valuable agents.