Pediatrics

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Therapeutic amenorrhea is not always easy to initiate or to maintain. But anticipating prolonged, heavy bleeding in patients with certain medical problems--and managing it prophylactically--is far better than trying to stop potentially life-threatening bleeding once it's begun.

Rational decision-making and raging adolescent hormones do sound like strange bedfellows. But research reveals some ways ob/gyns can help teens make wiser choices--and grow into healthy sexual adults.

Rational decision-making and raging adolescent hormones do sound like strange bedfellows. But research reveals some ways ob/gyns can help teens make wiser choices--and grow into healthy sexual adults.

Simplex(differentiated) vulvar intraepithelial neoplasia--probably the immediate precursor of most HPV-negative invasive squamous-cell vulvar carcinomas--is easily missed or misdiagnosed. The women who are most at risk are those with vulvar dystrophy or a prior cancer.

A proactive, stepwise approach to management of asthma in pregnancy can help ensure a good perinatal outcome. Focus on preventing acute asthma attacks because they can leave both mother and fetus vulnerable to progressive hypoxia and potentially disastrous consequences.

Although you can't always anticipate a potentially catastrophic obstetric hemorrhage, rapid diagnosis and intervention can make all the difference in the world. The authors review interventions--new and old--and tell clinicians what to have on hand to implement them.

Many adolescents and young adult women experience physical or sexual violence perpetrated by someone close. Knowledge of risk factors and sequelae associated with interpersonal violence and of screening methods to detect it can help the ob/gyn identify potential victims of assault. Careful management and referral of victims is critical and anticipatory guidance also is advised.

In January the March of Dimes launched a 5-year, $75 million national campaign targeting the complex problem of prematurity. Since we don't know what causes approximately half of all spontaneous preterm births, impacting prematurity is a formidable challenge. Obstetrical providers have a pivotal role in meeting this challenge.

Many adolescents and young adult women experience physical or sexual violence perpetrated by someone close. Knowledge of risk factors and sequelae associated with interpersonal violence and of screening methods to detect it can help the ob/gyn identify potential victims of assault. Careful management and referral of victims is critical and anticipatory guidance also is advised.

To promote breastfeeding after a mother returns to work, clinicians need to make knowledgeable recommendations about which breast pump to use and provide guidelines to ensure proper milk storage.

This is the second in a bimonthly series aimed at educating physicians on the pertinent aspects of litigation. Each case study will provide analysis of an actual ob/gyn lawsuit defended by the New York firm of Aaronson, Rappaport, Feinstein & Deutsch, LLP.

Even before Bethesda 2001 terminology recommended substantial changes in how labs should report Pap results--including specimen adequacy--many clinicians were confused about which patients to follow-up with repeat Pap tests. This article explains and clarifies the latest Pap test adequacy guidelines.