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Labor, Delivery, and Postpartum Issues - American Family Physician

Nov 1, 2020 - This collection features AFP content on labor, delivery, and postpartum issues and related topics, including breastfeeding, cesarean delivery, episiotomy, labor pain management, postpartum hemorrhage, preterm labor and birth, shoulder dystocia, umbilical cord blood storage, and vaginal ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=16

Antibiotic Prophylaxis for Operative Vaginal Delivery - Medicine by the Numbers - ... Restricted content. Login required.

Oct 1, 2020 - Current guidelines from the World Health Organization do not recommend routine antibiotic prophylaxis for operative vaginal birth because of insufficient evidence of effectiveness.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/1001/od2.html

Placental Alpha Macroglobulin-1 (PartoSure) Immunoassay to Assess the Risk of ... Restricted content. Login required.

Sep 1, 2020 - Placental alpha macroglobulin-1 (PartoSure) is an immunoassay that measures the presence of placental alpha macroglobulin-1 (PAMG-1). PartoSure is used to assess the risk of spontaneous preterm birth and may be a useful adjunct to determine which patients with threatened preterm labor ...

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2020/0901/p269.html

Intrapartum Fetal Monitoring - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Continuous electronic fetal monitoring was developed to screen for signs of hypoxic-ischemic encephalopathy, cerebral palsy, and impending fetal death during labor. Because these events have a low prevalence, continuous electronic fetal monitoring has a false-positive rate of 99%. The ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p158.html

Fetal Fibronectin Testing in Threatened Preterm Labor - Medicine by the Numbers - ... Restricted content. Login required.

Aug 1, 2020 - Fetal fibronectin testing is a common clinical test, performed via cervicovaginal secretion swab after 22 weeks of pregnancy, and is used to identify women at increased risk for preterm delivery. Learn more about the benefits and harms of fetal fibronectin testing in threatened preterm ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0801/p145.html

Ectopic Pregnancy: Diagnosis and Management - American Family Physician Restricted content. Login required.

May 15, 2020 - Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p599.html

Tranexamic Acid for Postpartum Hemorrhage - Medicine by the Numbers - American Family ... Restricted content. Login required.

May 1, 2020 - Postpartum hemorrhage is the most common cause of maternal death worldwide. Tranexamic acid is an antifibrinolytic agent that has shown to decrease bleeding in surgical patients and all-cause death in trauma patients. Does early administration of tranexamic acid reduce the rate of death...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0501/od2.html

Antepartum Omega-3 Fatty Acid Intake and Length of Gestation - Cochrane for Clinicians ... Restricted content. Login required.

Jan 1, 2020 - Omega-3 fatty acids, whether taken as supplements or consumed as part of the diet, reduce the risk of preterm birth (number needed to treat = 68) and early preterm birth (number needed to treat = 55).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p17.html

Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy - ...

Oct 1, 2019 - Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p403.html

Can We Prevent Perinatal Depression in the Primary Care Office? - Editorials - American...

Sep 15, 2019 - Even if we do not provide maternity care, our commitment to the total care of our patients, which includes addressing behavioral medicine needs, allows us to be the ideal physicians to champion interventions to prevent perinatal depression.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0915/p327.html

Treatment of Threatened Miscarriage with Progestogens - Cochrane for Clinicians - ...

Sep 1, 2019 - Progestogens reduce the risk of miscarriage when compared with placebo in patients with threatened miscarriage (number needed to treat [NNT] = 10.) Use of progestogens poses no significant risks to mother or baby.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p279.html

Cognitive Behavior Therapy for Postpartum Depression - FPIN's Help Desk Answers - ...

Aug 15, 2019 - In women with postpartum depression, the addition of CBT reduces depressive symptoms more effectively than usual care alone (medication and other therapies), with a medium effect size at the end of the intervention and a residual small effect size six months later.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0815/p244.html

Skin-to-Skin Contact for Improved Duration of Breastfeeding - FPIN's Help Desk Answers ...

Aug 1, 2019 - Skin-to-skin-contact in the immediate postnatal period should be recommended to all mothers because it is associated with a higher likelihood of exclusive breastfeeding at hospital discharge and for up to six months afterward (number needed to treat [NNT] = 5 to 8).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0801/od2.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

Preventing Spontaneous Abortion with Progestin Therapy - Medicine by the Numbers - ...

Jul 1, 2019 - The use of progestin therapy in women with recurrent pregnancy loss appears to reduce the incidence of spontaneous abortion, preterm labor, and stillbirth, and increase the rate of live birth. However, due to issues with the studies the authors were hesitant to give progestin their full...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0701/od1.html

Risks of Elective Labor Induction vs. Expectant Management - FPIN's Help Desk Answers -...

May 1, 2019 - Elective labor induction at 39 weeks’ gestation leads to a mean 145-g (5.1-oz) lower birth weight compared with expectant management, but there is conflicting evidence about the effects on rates of cesarean delivery, perinatal mortality, operative vaginal birth, and admission to the ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0501/p587.html

Maternal Pertussis Vaccination During Pregnancy - FPIN's Help Desk Answers - American ...

Apr 1, 2019 - Women should receive the Tdap vaccine during pregnancy regardless of previous immunization history. Infants whose mothers received prenatal immunization had 50% fewer cases of pertussis compared with those whose mothers received postpartum immunization.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0401/p454.html

Metformin for Improving Maternal and Infant Outcomes in Pregnant Women Who Are Obese - ...

Mar 1, 2019 - This meta-analysis showed no clear benefit for metformin in reducing the risk of large for gestational age infants. Additionally, there was no difference in important secondary outcomes such as gestational diabetes, hypertensive disease in pregnancy, shoulder dystocia, advanced perineal...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0301/od1.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Complementary and Integrative Treatments for Pain Management in Labor - Cochrane for ...

Feb 1, 2019 - There is evidence that all of the studied interventions have some benefit in labor, but the evidence is of low to very low quality. Massage, thermal interventions (warm and cold packs), relaxation techniques, yoga, and music reduce pain during latent labor, but not during active labor.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0201/p154.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.html

The Pregnant Patient: Managing Common Acute Medical Problems - American Family Physician

Nov 1, 2018 - Women often see their primary care physicians for common acute conditions during pregnancy. These conditions may be caused by pregnancy (obstetric problems) or worsened by pregnancy (obstetrically aggravated problems), or they may require special consideration during pregnancy because ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p595.html

Effectiveness of Intrapartum Antibiotics for Meconium-Stained Amniotic Fluid - Medicine...

Nov 1, 2018 - This review concluded that there is insufficient evidence to recommend prophylactic intrapartum antibiotics in laboring women with meconium-stained amniotic fluid because of the lack of difference in rates of neonatal sepsis between the antibiotic and placebo groups.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1101/od1.html

Breastfeeding: Common Questions and Answers - American Family Physician

Sep 15, 2018 - All major health organizations recommend breastfeeding as the optimal source of infant nutrition, with exclusive breastfeeding recommended for the first six months of life. After six months, complementary foods may be introduced. Most organizations recommend breastfeeding for at least ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p368.html

Chewing Gum for Reducing Post-Cesarean Section Ileus - Medicine by the Numbers - ...

Sep 1, 2018 - Although the current body of literature suggests a need for higher-quality, more robust research, the simplicity, frugality, and safety of chewing gum makes it a viable option to offer women undergoing cesarean section.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0901/od2.html

NSAIDs for Postpartum Perineal Pain - FPIN's Help Desk Answers - American Family Physician

Jun 1, 2018 - Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od3.html

Maternal Obesity and Labor Induction - FPIN's Help Desk Answers - American Family ...

May 15, 2018 - Pregnant women who are obese have nearly double the rate of cesarean delivery, and obesity increases the median duration of active labor by up to four hours when labor is induced. The difference in cesarean delivery rate is larger in obese primigravida patients presenting with cervical ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0515/p671.html

Risk of Preterm Birth with Vaginal Progesterone in Twin Pregnancies - FPIN's Help Desk ...

Nov 1, 2017 - Women with twin pregnancies should not routinely receive vaginal progesterone because it does not reduce the risk of preterm birth. Vaginal progesterone should be administered to reduce adverse neonatal outcomes in women with twin pregnancies and a short cervix (25 mm or less).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1101/od3.html

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