Pregnancy and Birth

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One of the first uses of ultrasonic energy applied for medical diagnostic purposes was by Dr. George D. Ludwig at the Naval Medical Research Institute, Bethesda, Maryland in 1947-1949, and subsequently at the Massachusetts Institute of Technology. He demonstrated thatgallbladder stones could be detected by an ultrasonic echo method using A mode metal flaw detectors and naval sonar. The documentation of Dr. Ludwig's research came by way of his daughter, Rosemary Ludwig Turner.

Ultrasound-History@OBGYN.net is very fortunate to have papers and communications of Donald W. Baker donated to this polybiography site. Don Baker was a central figure in the invention and production of the first commercial medical Doppler instruments for the noninvasive study of blood flow and motion in the living body. This work constitutes a distinguished career of over 50 years.

My ultrasound training began when I was starting the second year of a neurology residency at the Bowman Gray School of Medicine of Wake Forest University in Winston-Salem, North Carolina. I had just finished a year of general medical internship which was a requirement for neurology residents.

I would like to share with you a few words about the use of a-mode ultrasound (echoencephalography) at Bowman Gray. My training began several years before the ready availability of computed tomography in the emergency center setting. An early application of ultrasound was for rapid screening of trauma and stroke patients for intracranial mass lesions.

This syndrome, which is poorly understood from both diagnostic and treatment perspectives, results in significant perinatal morbidity and mortality. Improved outcomes depend on a better understanding of the etiology of this devastating disease and on the performance of randomized, controlled trials to evaluate treatment protocols.

Welcome to November’s Musings! This month I am going to introduce what I hope will become a regular feature of Midwifery Musings: an interview with a midwife. It is my intent to provide readers with an in-depth look at each midwife’s practice, an overview of the legal and professional aspects of midwifery in their location, and a discussion about the contributions they are making in the provision of maternity care.

This month I had the pleasure of interviewing Simone Valk, a midwife practicing in Rotterdam, Holland. Simone graciously gave of her time to share a bit about herself, the training of midwives in Holland and the general nature of maternity care in Holland. The differences between our systems of healthcare is quite evident, but I found the differences in philosophy most impressive, and sobering.

As a midwife, I am often privileged to witness displays of human emotion that seem to occur exclusively within the context of birth. There are few other transitions of life that elicit the sort of emotion, be it positive or negative, that childbirth does. At every birth I attend there is always a memorable moment, often subtle and intimate, little insights into human nature that I tuck away in my subconscious.

In the United States, nearly one in four births is a cesarean birth. Many of these cesareans are unexpected, so it is a good idea for the expectant mother to become informed and educated about the procedure before her baby arrives.

The possibility of twins or more passes through the minds of every pregnant mother, but nevertheless having the presence of more than one fetus confirmed on ultrasound is a shock. Thankfully the length of the pregnancy allows plenty of time to adapt. Indeed, 'it' rapidly becomes 'they' and one feels a sense of incompleteness for those friends who are expecting just one.

As mothers-to-be, most women imagine a picture perfect pregnancy-- mild or no morning sickness in the first weeks, and within the fourth month, the soft kicking of new life within. Along with the growing, telltale tummy of an expectant mother, comes the choosing of a name decorating a nursery, buying baby clothes, and baby showers in honor of the mommy-to-be and the impending "arrival".

Twins

Multiple gestation is the medical term that refers to a woman who is pregnant with twins, triplets, or other higher-order multiple pregnancies. This will occur in slightly less than 2% of all pregnancies. Within the category of multiple gestation, twin births are by far the most common, accounting for 95% of all multiple pregnancies.

All obstetricians and reproductive endocrinologists know the placenta as the uppermost important organ for normal fetal growth till maturity. This endocrinological organ can be affected by many pathological states like other maternal organs.