Pregnancy and Birth

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Physiologic changes during pregnancy affect the body’s hormonal milieu as well as a woman’s sexual desires, responses, and practices. In this review, we discuss knowledge gaps, the physiology of the female sexual response during pregnancy, types of sexual activity during pregnancy, and existing literature on anatomic and physiologic changes by trimester and postpartum.

A new study looks at whether midpelvic operative deliveries have greater trauma than other delivery forms. Plus: A look at the long-term effects of using bisphosphonates. Also, is lithium use in early pregnancy as dangerous as previously thought?

Too many ob/gyns believe that doing something is better than doing nothing, says this reader.

Readers react

Readers write in about their thoughts on the annual labor force survey, the conundrum presented by cesarean delivery and defensive medicine, more information on treating women who have been the victim of sexual assault, and what is adding to the stress of the job.

Can adopting quality measures decrease the cesarean rate? Plus: The Government Accountability Office issues a report on power morcellators and the FDA's system of evaluation. Also, does the volume of one type of heart fat indicate the risk of heart disease?

The plaintiff asserted that during the diagnostic laparoscopy, Dr A and Dr B should have detected the ectopic pregnancy in the right fallopian tube. Her attorneys claimed that based upon the plaintiff’s abdominal pain, vaginal bleeding, and β- hCG levels, and absent evidence of intrauterine pregnancy on ultrasound, the defendants should have presumed ectopic pregnancy and adequately evaluated the fallopian tube before discharging the patient, thus avoiding rupture.

Identifying and Counseling Patients at Risk for Recurrent Preterm Birth. Improving Women’s Understanding of Recurrent Preterm Birth. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline on Reducing the Risk of Preterm Birth and Potential Treatment in Certain At-Risk Women. Strategies for implementing the SMFM clinical guideline for reducing the risk of preterm birth in women with a history of recurrent preterm birth.

Pregnancy-related deaths in the United States have risen from a low of 7.2 per 100,000 live births in 1987 to a high of 17.3 per 100,000 live births in 2013, according to the Centers for Disease Control and Prevention (CDC) Pregnancy Mortality Surveillance System.

Preterm birth (PTB) remains the major cause of neonatal morbidity and mortality. For the vast majority of spontaneous PTBs, the final pathway is opening of the cervix. Pessaries have been proposed since the 1950s as a possible intervention to keep the cervix closed. But are pessaries safe and do they work for prevention of spontaneous PTB?

Preterm birth is a public health concern. Each year in the U.S., nearly one in ten babies are born preterm…meaning less than 37 weeks of pregnancy or more than 3 weeks prior to the expected due date. That’s nearly 400,000 babies every year born too early in this country.