Pediatrics

In June 2000, I arrived a few minutes late to the American College of Obstetricians and Gynecologists' headquarters for a meeting of the Committee on Obstetric Practice. As Chair, I was used to dealing with political hot potatoes, but that day, I was handed a real sizzler. Earlier that morning, then ACOG president, Benjamin Harer, MD, speaking for himself and not the College, had seemingly endorsed "elective" cesarean deliveries (CD) in an interview with Diane Sawyer on "Good Morning America." After watching an excerpt of the interview in which Dr. Harer debated a non-physician advocate of home VBACs attended by midwives, I was struck by the logic of his arguments and his grace under fire. Yet it fell to my committee to restate ACOG's official position against such surgeries, which we did in a press release

Your patient has a twin gestation at almost 29 weeks and one of the fetuses has IUGR. How should you proceed?

It's imperative to identify more HIV-infected women earlier in pregnancy through HIV testing and to reduce mother-to-child transmission of the virus that causes AIDS.

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.

Ob/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.

Ob/gyns with even a little gray hair have witnessed an extraordinary evolution in our collective thinking about cesarean delivery (CD) over the past three decades. I believe that a variety of factors are behind high CD rates in the United States, and that continued increases are inevitable.

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.