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obstetrics

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Obstetric Lacerations: Prevention and Repair - American Family Physician Restricted content. Login required.

Jun 15, 2021 - Obstetric lacerations are a common complication of vaginal delivery. Lacerations can lead to chronic pain and urinary and fecal incontinence. Perineal lacerations are defined by the depth of musculature involved, with fourth-degree lacerations disrupting the anal sphincter and the ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0615/p745.html

Shoulder Dystocia: Managing an Obstetric Emergency - American Family Physician Restricted content. Login required.

Jul 15, 2020 - Shoulder dystocia is an obstetric emergency in which normal traction on the fetal head does not lead to delivery of the shoulders. This can cause neonatal brachial plexus injuries, hypoxia, and maternal trauma, including damage to the bladder, anal sphincter, and rectum, and postpartum ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0715/p84.html

Repair of Obstetric Perineal Lacerations - American Family Physician

Oct 15, 2003 - Family physicians who deliver babies must frequently repair perineal lacerations after episiotomy or spontaneous obstetric tears. Effective repair requires a knowledge of perineal anatomy and surgical technique. Perineal lacerations are classified according to their depth. Sequelae of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1015/p1585.html

Postpartum Hemorrhage: Prevention and Treatment - American Family Physician

Apr 1, 2017 - Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p442.html

Family Physicians Practicing High-Volume Obstetric Care Have Recently Dropped by ...

Jun 15, 2017 - Previous research has shown a decline in the percentage of family physicians practicing low- or medium-volume obstetrics. Using 13 years of data through 2016, we found continued declines in low- and medium-volume obstetrics, in addition to a new 50% decrease in family physicians ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2017/0615/p762.html

Obstetric Ultrasound Examination (Position Paper)

Read AAFP's policy on Obstetric Ultrasound Examination (Position Paper)

About AAFP |AAFP Policies and Recommendations

https://www.aafp.org/about/policies/all/obstetric-ultrasound.html

Reducing Obstetric Hemorrhage: Recommendations from the National Partnership for ...

Oct 1, 2015 - A consensus bundle, with recommendations for reducing and managing obstetric hemorrhage and improving overall maternal care, has been published by the National Partnership for Maternal Safety.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/1001/p643.html

Out-of-Hospital Birth - American Family Physician Restricted content. Login required.

Jun 1, 2021 - Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U.S. births (1.64%) occurring out of ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0601/p672.html

Advanced Life Support in Obstetrics (ALSO)

AAFP's Advanced Life Support in Obstetrics (ALSO) is an evidence-based multidisciplinary training program that prepares maternity health care providers to better manage obstetric emergencies.

https://www.aafp.org/cme/programs/also.html

Point-of-Care Guides - American Family Physician

Jun 15, 2021 - This collection features AFP content from the Point-of-Care Guides collection on topics related to anticoagulation, cancer, cardiovascular issues, diabetes, gastrointestinal issues, infectious diseases, mortality risk, musculoskeletal issues, neurologic issues, obstetric issues, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=75

Academy Adds Obstetrics Member Interest Group

A new AAFP member interest group on obstetrics aims to help family physicians integrate comprehensive, evidence-based maternity health care into their practices.

https://www.aafp.org/news/inside-aafp/20190123obmig.html

Basic Life Support in Obstetrics

Learn about the Basic Life Support in Obstetrics (BLSO) program, which prepares participants to manage normal labor and obstetrical emergencies.

https://www.aafp.org/cme/programs/blso.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

Point-of-Care Ultrasonography - American Family Physician Restricted content. Login required.

Mar 1, 2020 - Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0301/p275.html

Intrapartum Fetal Monitoring - American Family Physician

Dec 15, 2009 - Continuous electronic fetal monitoring was developed in the 1960s to assist in the diagnosis of fetal hypoxia during labor. Continuous electronic fetal monitoring has been shown to reduce the incidence of neonatal seizures, but there has been no beneficial effect in decreasing cerebral ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1388.html

Gynecologic Procedures: Colposcopy, Treatments of Cervical Intraepithelial Neoplasia, ...

Jun 15, 2013 - Women who have abnormal Papanicolaou test results may undergo colposcopy to determine the biopsy site for histologic evaluation. Traditional grading systems do not accurately assess lesion severity because colposcopic impression alone is unreliable for diagnosis. The likelihood of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0615/p836.html

Abnormal Uterine Bleeding in Premenopausal Women - American Family Physician

Apr 1, 2019 - Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p435.html

Cervical Treatment Associated with Adverse Obstetric Outcomes - POEMs - American Family...

Dec 1, 2016 - Cervical treatments for dysplasia and early cervical carcinoma are associated with subsequent risk of preterm birth. Excisional treatments carry higher risk than ablative treatments, and multiple treatments carry higher risk than single treatments. The frequency and severity of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p933a.html

Methods for Cervical Ripening and Induction of Labor - American Family Physician

May 15, 2003 - Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0515/p2123.html

Intrauterine Growth Restriction: Identification and Management - American Family Physician

Aug 1, 1998 - Intrauterine growth restriction (IUGR) is a common diagnosis in obstetrics and carries an increased risk of perinatal mortality and morbidity. Identification of IUGR is crucial because proper evaluation and management can result in a favorable outcome. Certain pregnancies are at high ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0801/p453.html

Mobility Assistive Device Use in Older Adults - American Family Physician Restricted content. Login required.

Jun 15, 2021 - Many individuals need a mobility assistive device as they age. These devices include canes, crutches, walkers, and wheelchairs. Clinicians should understand how to select the appropriate device and size for individual patients (or work with a physical therapist) and prescribe the device...

American Family Physician : Article

https://www.aafp.org/afp/2021/0615/p737.html

Bartholin Duct Cyst and Gland Abscess: Office Management - American Family Physician

Jun 15, 2019 - The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p760.html

Prenatal Care - American Family Physician

Apr 15, 2021 - This collection features AFP content on prenatal care and related issues, including preconception care, folic acid, medication safety, nausea and vomiting, pregnancy complications, and prenatal screening. This collection features AFP content on prenatal care and related issues, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=25

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

Dec 15, 2019 - Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p759.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jan 15, 2016 - Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks’ gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks’ gestation), preeclampsia, or preeclampsia superimposed on chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p121.html

Dyspareunia in Women - American Family Physician Restricted content. Login required.

May 15, 2021 - Dyspareunia is recurrent or persistent pain with sexual intercourse that causes distress. It affects approximately 10% to 20% of U.S. women. Dyspareunia may be superficial, causing pain with attempted vaginal insertion, or deep. Women with sexual pain are at increased risk of sexual ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0515/p597.html

Labor, Delivery, and Postpartum Issues - American Family Physician

Jun 1, 2021 - 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

Second Trimester Pregnancy Loss - American Family Physician

Nov 1, 2007 - Second trimester pregnancy loss is uncommon, but it should be regarded as an important event in a woman's obstetric history. Fetal abnormalities, including chromosomal problems, and maternal anatomic factors, immunologic factors, infection, and thrombophilia should be considered; ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1101/p1341.html

In-flight Medical Emergencies - American Family Physician Restricted content. Login required.

May 1, 2021 - In 2018, approximately 2.8 million passengers flew in and out of U.S. airports per day. Twenty-four to 130 in-flight medical emergencies are estimated to occur per 1 million passengers; however, there is no internationally agreed-upon recording or classification system. Up to 70% of ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0501/p547.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

HIV/AIDS - American Family Physician

Jul 15, 2021 - This collection features AFP content on human immunodeficiency virus (HIV) and AIDS and related issues, including antiretroviral therapy, behavioral counseling, HIV testing, sexually transmitted diseases, and infection prevention. This collection features AFP content on human ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=11

Peripheral Nerve Entrapment and Injury in the Upper Extremity - American Family Physician Restricted content. Login required.

Mar 1, 2021 - Peripheral nerves in the upper extremities are at risk of injury and entrapment because of their superficial nature and length. Injury can result from trauma, anatomic abnormalities, systemic disease, and entrapment. The extent of the injury can range from mild neurapraxia, in which the...

American Family Physician : Article

https://www.aafp.org/afp/2021/0301/p275.html

Cervical Colposcopy: Indications and Risk Assessment - American Family Physician Restricted content. Login required.

Jul 1, 2020 - The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p39.html

Pain Management in Labor - American Family Physician Restricted content. Login required.

Mar 15, 2021 - A patient’s sense of empowerment and control is most predictive of maternal satisfaction with childbirth. Analgesia during labor greatly affects this experience. Individual patient priorities for labor pain management should be explored as part of routine prenatal care. Continuous labor...

American Family Physician : Article

https://www.aafp.org/afp/2021/0315/p355.html

Maternal/Child Care (Obstetrics/Perinatal Care)

Read the AAFP's policy on maternal and child care, a core discipline of family medicine specialty.

About AAFP |AAFP Policies and Recommendations

https://www.aafp.org/about/policies/all/maternal-child-care.html

Cervical Cancer Screening - American Family Physician

Apr 1, 2018 - Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p441.html

Syphilis: Far from Ancient History - American Family Physician Restricted content. Login required.

Jul 15, 2020 - Rates of primary, secondary, and congenital syphilis are increasing in the United States, and reversing this trend requires renewed vigilance on the part of family physicians to assist public health agencies in the early detection of outbreaks. Prompt diagnosis of syphilis can be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0715/p91.html

Common Benign Chronic Vulvar Disorders - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p550.html

Pregnancy Myths and Practical Tips - American Family Physician Restricted content. Login required.

Oct 1, 2020 - For many patients, pregnancy is a highly anticipated and exciting phase of life, but it can also be anxiety provoking. Family physicians can resolve some of this anxiety and promote maternal and fetal health by making specific recommendations at prenatal visits. A daily prenatal vitamin...

American Family Physician : Article

https://www.aafp.org/afp/2020/1001/p420.html

Thyroid Disease in Pregnancy - American Family Physician

Feb 15, 2014 - Thyroid disease is the second most common endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction. Current guidelines recommend ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0215/p273.html

Preterm Labor: Prevention and Management - American Family Physician

Mar 15, 2017 - In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks’ gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p366.html

Amenorrhea: An Approach to Diagnosis and Management - American Family Physician

Jun 1, 2013 - Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p781.html

Hormone Therapy and Other Treatments for Symptoms of Menopause - American Family Physician

Dec 1, 2016 - The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p884.html

Strategies for Breastfeeding Success - American Family Physician

Jul 15, 2008 - Breastfeeding provides significant health benefits for infants and mothers. However, the United States continues to fall short of the breastfeeding goals set by the Healthy People 2010 initiative. The American Academy of Family Physicians, the American Academy of Pediatrics, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0715/p225.html

Pelvic Organ Prolapse - American Family Physician

Aug 1, 2017 - Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p179.html

Screening for Preeclampsia - Putting Prevention into Practice - American Family Physician

Jan 15, 2018 - A 28-year-old white woman comes to your clinic for prenatal care reporting a new-onset severe headache. She is currently pregnant with twins at an estimated gestational age of 22 weeks. Her obstetric history is significant for one previous term singleton vaginal delivery at 24 years of ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0115/p117.html

Benign Anorectal Conditions: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.html

Inborn Errors of Metabolism: From Preconception to Adulthood - American Family Physician

Jan 1, 2019 - Inborn errors of metabolism (IEM), although individually rare, occur in 1 out of every 1,500 births. The first opportunity to detect IEM occurs during preconception counseling, when pregnant women and couples considering future pregnancies can undergo carrier screening. For individuals ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p25.html

Diagnosis and Treatment of Acute Uncomplicated Cystitis - American Family Physician

Oct 1, 2011 - Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p771.html

HELLP Syndrome: Recognition and Perinatal Management - American Family Physician

Sep 1, 1999 - HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p829.html

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