Pregnancy and Birth

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Varying risks and benefits are associated with cesarean deliveries as compared to vaginal deliveries, including the impact on the mother’s health and the infant’s health. Ultimately, the goal is to deliver the baby the safest way possible for both mother and baby, but does the mode of delivery significantly impact the health-related quality of life in the immediate postpartum period through the first year after childbirth?

The American College of Obstetricians and Gynecologists recommends that women begin Pap test screening at 21 years, but are there certain circumstances in which Pap tests are warranted at younger ages? Dr Amy M. Johnson of Hartford Hospital in Connecticut and colleagues hypothesized that teenage girls who engage in risky behaviors would benefit from early initiation of cervical screening.

Intrauterine devices (IUDs) represent a safe and effective option for preventing unwanted pregnancies. Yet studies have shown that gynecologists still have concerns over its safety and do not utilize evidence-based criteria to assist in the selection of IUD candidates. In order to overcome this obstacle, it is imperative that current obstetric and gynecology residents are receiving correct information on this treatment modality-but are they?

Despite great advances in maternity care, the number of women who give birth to infants requiring special care is still high. The Centers for Disease Control and Prevention’s National Preconception Health Plan has called for care to ameliorate health problems, support pregnancy spacing, and improve future birth outcomes in those women with a previous adverse pregnancy outcome

A recent study found that women with gestational hypertension are not receiving appropriate follow-up care and prevention. Specifically, the researchers found that women with gestational hypertension were less likely to have their blood pressure checked within the previous 2 years and were less likely to have their blood cholesterol checked within the previous 4 years.

Emergency care in obstetric practice is fraught with medico-legal risk. This is especially true when the practitioner has no established relationship with the parturient and either mother or child sustains serious or permanent injury during the birth process. Although reform efforts have been proposed expanding limits to liability in certain settings where emergency care is provided, currently, obstetricians often must rely on the protection afforded by their respective state’s Good Samaritan statute.

Hypertension affects as many as 8% of all pregnancies. Not only does it pose complications during pregnancy, but even if it resolves after delivery, it places women at increased risk for cardiovascular disease. As such, these women should receive cardiovascular disease counseling and screening, including the monitoring of their blood pressure and cholesterol levels, implementation of lifestyle modifications, and awareness of heart attack symptoms.

Insulin resistance in pregnancy poses risks for the mother, including preeclampsia and many other pregnancy-related complications. In this editor’s choice article-fast-tracked for publication in the American Journal of Obstetrics and Gynecology due to its clinical importance-researchers explored the association between increased maternal midtrimester insulin resistance and subsequent preeclampsia.

Increases in the prevalence of asthma, especially in children, have raised concern in the medical community, resulting in research to find possible causes and to explore potential means of prevention. Recently there has been some evidence linking acetaminophen (known as paracetamol in New Zealand) use in pregnant women and subsequent increased risk for asthma in their offspring.

One in 10 pregnant women experience depression with severe risks, and depression during pregnancy is associated with higher risks for complications as well as postpartum depression. Yet treating depression during pregnancy raises concerns for maternal well-being and fetus well-being alike, requiring clinicians to constantly balance the benefits of psychopharmacological agents for women while minimizing risks to their fetuses.

Incorrectly positioned intrauterine devices (IUDs) make intrauterine pregnancy (IUP) more likely, with more than half of IUDs identified during the first trimester of pregnancy malpositioned, according to a study published online Feb. 24 in the American Journal of Obstetrics & Gynecology.