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Pregnancy Myths and Practical Tips - American Family Physician

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

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

Uterine Fibroids: Diagnosis and Treatment - American Family Physician

Jan 15, 2017 - Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p100.html

Over-the-Counter Medications in Pregnancy - American Family Physician

Oct 15, 2014 - Many pregnant women take over-the-counter (OTC) medications despite the absence of randomized controlled trials to guide their use during pregnancy. Most data come from case-control and cohort studies. In 1979, the U.S. Food and Drug Administration began reviewing all prescription and ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1015/p548.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

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.html

Shoulder Dystocia: Managing an Obstetric Emergency - American Family Physician

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

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

Urinary Incontinence in Women: Evaluation and Management - American Family Physician

Sep 15, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p339.html

Fetal Aneuploidy: Screening and Diagnostic Testing - American Family Physician

Apr 15, 2020 - Aneuploidy is the presence of one or more extra chromosomes or the absence of one or more chromosomes. The risk of fetal aneuploidy rises with increasing maternal age. Because fetal aneuploidy can affect any pregnancy, all pregnant women should be offered screening. First-trimester ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p481.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

Intrapartum Fetal Monitoring - American Family Physician

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

Ectopic Pregnancy: Diagnosis and Management - American Family Physician

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

Screening, Diagnosis, and Management of Gestational Diabetes Mellitus - American Family...

Apr 1, 2015 - Gestational diabetes mellitus (GDM) affects approximately 6% of pregnancies in the United States, and it is increasing in prevalence. Pregnant women without known diabetes mellitus should be screened for GDM after 24 weeks of gestation. Treatment of GDM results in a statistically ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p460.html

Endometrial Biopsy: Tips and Pitfalls - American Family Physician

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.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

Newborn Circumcision Techniques - American Family Physician

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.html

Postpartum Care: An Approach to the Fourth Trimester - American Family Physician

Oct 15, 2019 - The postpartum period, defined as the 12 weeks after delivery, is an important time for a new mother and her family and can be considered a fourth trimester. Outpatient postpartum care should be initiated within three weeks after delivery in person or by phone, and may require multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p485.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

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

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.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

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

Common Questions About Recurrent Urinary Tract Infections in Women - American Family ...

Apr 1, 2016 - Recurrent urinary tract infections (UTIs) are common in women, including healthy women with normal genitourinary anatomy. Recurrent UTI is typically defined as three or more UTIs within 12 months, or two or more occurrences within six months. The same species that caused previous ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p560.html

Trauma in Pregnancy: Assessment, Management, and Prevention - American Family Physician

Nov 15, 2014 - Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1115/p717.html

Cervical Cancer: Evaluation and Management - American Family Physician

Apr 1, 2018 - Human papillomavirus infection is the precursor for the development of cervical cancer and is detectable in 99.7% of squamous cell carcinoma and adenocarcinoma cases. Early detection of precancerous lesions with Papanicolaou testing remains the primary mechanism for cancer prevention. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p449.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Identification and Management of Peripartum Depression - American Family Physician

May 15, 2016 - Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p852.html

Diagnosis and Management of Endometrial Cancer - American Family Physician

Mar 15, 2016 - Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p468.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.html

Update on Prenatal Care - American Family Physician

Feb 1, 2014 - Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor....

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p199.html

Hirsutism in Women - American Family Physician

Feb 15, 2012 - Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0215/p373.html

Common Questions About the Evaluation of Acute Pelvic Pain - American Family Physician

Jan 1, 2016 - Acute pelvic pain is defined as lower abdominal or pelvic pain of less than three months’ duration. It is a common presentation in primary care. Evaluation can be challenging because of a broad differential diagnosis and because many associated signs and symptoms are nonspecific. The ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p41.html

Nausea and Vomiting of Pregnancy - American Family Physician

Jun 15, 2014 - Nausea and vomiting of pregnancy affects nearly 75% of pregnant women. The exact cause is unknown. In most cases, it is a mild, self-limited condition that can be controlled with conservative measures and has no adverse fetal sequelae. About 1% of women develop hyperemesis gravidarum, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p965.html

Diagnosis and Management of Ectopic Pregnancy - American Family Physician

Jul 1, 2014 - Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p34.html

Dyspareunia in Women - American Family Physician

Oct 1, 2014 - Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. Dyspareunia can have a significant impact on a woman’s mental and physical health, body image, relationships with ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1001/p465.html

Sexual Dysfunction in Women: A Practical Approach - American Family Physician

Aug 15, 2015 - Sexual dysfunction in women is a common and often distressing problem that has a negative impact on quality of life and medication compliance. The problem is often multifactorial, necessitating a multidisciplinary evaluation and treatment approach that addresses biological, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p281.html

Management of Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2015 - Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p202.html

Health Maintenance in Women - American Family Physician

Jan 1, 2013 - The health maintenance examination is an opportunity to focus on disease prevention and health promotion. The patient history should include screening for tobacco use, alcohol misuse, intimate partner violence, and depression. Premenopausal women should receive preconception counseling ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p30.html

Options for Women with Unintended Pregnancy - American Family Physician

Apr 15, 2015 - Unintended pregnancy refers to unwanted, unplanned, or mistimed pregnancies. One-half of all pregnancies in the United States are unintended, and family physicians are often asked to provide counseling, support, and resources for women with unintended pregnancies. Options include ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p544.html

Cesarean Delivery: Counseling Issues and Complication Management - American Family ...

Feb 1, 2015 - Nearly one-third of all deliveries in the United States are cesarean deliveries. Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Interventions that decrease the chance of a cesarean delivery ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0201/p178.html

Prevention and Management of Postpartum Hemorrhage - American Family Physician

Mar 15, 2007 - Postpartum hemorrhage, the loss of more than 500 mL of blood after delivery, occurs in up to 18 percent of births and is the most common maternal morbidity in developed countries. Although risk factors and preventive strategies are dearly documented, not all cases are expected or ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0315/p875.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

Recommendations for Preconception Counseling and Care - American Family Physician

Oct 15, 2013 - Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1015/p499.html

Evaluation and Treatment of Endometriosis - American Family Physician

Jan 15, 2013 - Endometriosis, which affects up to 10 percent of reproductive-aged women, is the presence of endometrial tissue outside of the uterine cavity. It is more common in women with pelvic pain or infertility (25 to 40 percent and 70 to 90 percent, respectively). Some women with endometriosis ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0115/p107.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

Clinical Management of Urinary Incontinence in Women - American Family Physician

May 1, 2013 - Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. A stepped-care approach that advances from least invasive (behavioral modification) to more invasive (surgery) interventions is recommended. Bladder retraining and pelvic floor ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0501/p634.html

Common Skin Conditions During Pregnancy - American Family Physician

Jan 15, 2007 - Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0115/p211.html

Breast Cancer Screening Update - American Family Physician

Feb 15, 2013 - Breast cancer is the most common non–skin cancer and the second leading cause of cancer death in North American women. Mammography is the only screening test shown to reduce breast cancer–related mortality. There is general agreement that screening should be offered at least biennially ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p274.html

Labor Analgesia - American Family Physician

Mar 1, 2012 - Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0301/p447.html

Office Management of Early Pregnancy Loss - American Family Physician

Jul 1, 2011 - The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p75.html

Preterm Premature Rupture of Membranes: Diagnosis and Management - American Family ...

Feb 15, 2006 - Preterm premature rupture of membranes is the rupture of membranes during pregnancy before 37 weeks' gestation. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p659.html

Health Effects of Prenatal Radiation Exposure - American Family Physician

Sep 1, 2010 - Pregnant women are at risk of exposure to nonionizing and ionizing radiation resulting from necessary medical procedures, workplace exposure, and diagnostic or therapeutic interventions before the pregnancy is known. Nonionizing radiation includes microwave, ultrasound, radio frequency,...

American Family Physician : Article

https://www.aafp.org/afp/2010/0901/p488.html

Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline - American...

Jul 1, 2012 - Group B streptococcus is the leading cause of early-onset neonatal sepsis in the United States. Universal screening is recommended for pregnant women at 35 to 37 weeks’ gestation. The Centers for Disease Control and Prevention recently updated its guideline for the prevention of ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p59.html

Postpartum Major Depression - American Family Physician

Oct 15, 2010 - Postpartum major depression is a disorder that is often unrecognized and must be distinguished from baby blues. Antenatal depressive symptoms, a history of major depressive disorder, or previous postpartum major depression significantly increase the risk of postpartum major depression. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p926.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

Treatment of Breast Cancer - American Family Physician

Jun 1, 2010 - Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment. This article reviews typical treatments based on stage, histology, and biomarkers. Lobular carcinoma in situ does not require treatment. Ductal carcinoma ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0601/p1339.html

Managing Adverse Birth Outcomes: Helping Parents and Families Cope - American Family ...

May 1, 2012 - Unexpected adverse fetal and neonatal outcomes (e.g., stillbirth, birth trauma, congenital anomalies) present a crisis for the family and the medical care team. In cases of stillbirth, the family physician should be flexible in supporting the parents’ choices, validate the loss, and ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0501/p900.html

Over-the-Counter Medications in Pregnancy - American Family Physician

Jun 15, 2003 - Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0615/p2517.html

Diagnosis and Management of Preeclampsia - American Family Physician

Dec 15, 2004 - Preeclampsia is a pregnancy-specific multisystem disorder of unknown etiology. The disorder affects approximately 5 to 7 percent of pregnancies and is a significant cause of maternal and fetal morbidity and mortality. Preeclampsia is defined by the new onset of elevated blood pressure ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1215/p2317.html

Fetal Alcohol Spectrum Disorders - American Family Physician

Jul 15, 2005 - To complement the 2005 Annual Clinical Focus on medical genomics, AFP will be publishing a series of short reviews on genetic syndromes. This series was designed to increase awareness of these diseases so that family physicians can recognize and diagnose children with these disorders ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0715/p279.html

Nausea and Vomiting in Pregnancy - American Family Physician

Jul 1, 2003 - Nausea and vomiting of pregnancy, commonly known as 'morning sickness,' affects approximately 80 percent of pregnant women. Although several theories have been proposed, the exact cause remains unclear. Recent research has implicated Helicobacter pylori as one possible cause. Nausea and...

American Family Physician : Article

https://www.aafp.org/afp/2003/0701/p121.html

Management of Spontaneous Abortion - American Family Physician

Oct 1, 2005 - Spontaneous abortion, which is the loss of a pregnancy without outside intervention before 20 weeks' gestation, affects up to 20 percent of recognized pregnancies. Spontaneous abortion can be subdivided into threatened abortion, inevitable abortion, incomplete abortion, missed abortion,...

American Family Physician : Article

https://www.aafp.org/afp/2005/1001/p1243.html

Shoulder Dystocia - American Family Physician

Apr 1, 2004 - Shoulder dystocia can be one of the most frightening emergencies in the delivery room. Although many factors have been associated with shoulder dystocia, most cases occur with no warning. Calm and effective management of this emergency is possible with recognition of the impaction and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1707.html

Urinary Tract Infections During Pregnancy - American Family Physician

Feb 1, 2000 - Urinary tract infections are common during pregnancy, and the most common causative organism is Escherichia coli. Asymptomatic bacteriuria can lead to the development of cystitis or pyelonephritis. All pregnant women should be screened for bacteriuria and subsequently treated with ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0201/p713.html

Venous Thromboembolism During Pregnancy - American Family Physician

Jun 15, 2008 - Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1709.html

Late Pregnancy Bleeding - American Family Physician

Apr 15, 2007 - Effective management of vaginal bleeding in late pregnancy requires recognition of potentially serious conditions, including placenta previa, placental abruption, and vasa previa. Placenta previa is commonly diagnosed on routine ultrasonography before 20 weeks' gestation, but in nearly ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0415/p1199.html

Counseling Patients About Hormone Therapy and Alternatives for Menopausal Symptoms - ...

Oct 1, 2010 - The results of recent large clinical trials have led physicians and patients to question the safety of menopausal hormone therapy. In the past, physicians prescribed hormone therapy in an attempt to improve overall health and prevent cardiac disease. Hormone therapy appears to increase ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1001/p801.html

Ovarian Cancer: An Overview - American Family Physician

Sep 15, 2009 - Although ovarian cancer may occur at any age, it is more common in patients older than 50 years. Patients often present with nonspecific pelvic or abdominal symptoms. Initial diagnostic tests include transvaginal ultrasonography and serum cancer antigen 125 measurement; however, these ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0915/p609.html

Interpretation of the Electronic Fetal Heart Rate During Labor - American Family Physician

May 1, 1999 - Electronic fetal heart rate monitoring is commonly used to assess fetal well-being during labor. Although detection of fetal compromise is one benefit of fetal monitoring, there are also risks, including false-positive tests that may result in unnecessary surgical intervention. Since ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0501/p2487.html

Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2008 - Vaginal delivery is a natural process that usually does not require significant medical intervention. Management guided by current knowledge of the relevant screening tests and normal labor process can greatly increase the probability of an uncomplicated delivery and postpartum course. ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0801/p336.html

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

Preterm Labor - American Family Physician

Feb 15, 2010 - Preventing preterm delivery remains one of the great challenges in modern medicine. Preterm birth rates continue to increase and accounted for 12.7 percent of all U.S. births in 2005. The etiology of preterm delivery is unclear, but is likely to be complex and influenced by genetics and...

American Family Physician : Article

https://www.aafp.org/afp/2010/0215/p477.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jul 1, 2008 - The National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy has defined four categories of hypertension in pregnancy: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension. A maternal ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p93.html

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Alopecia in Women - American Family Physician

Mar 1, 2003 - Alopecia can be divided into disorders in which the hair follicle is normal but the cycling of hair growth is abnormal and disorders in which the hair follicle is damaged. Androgenetic alopecia is the most common cause of hair loss in women. Other disorders include alopecia areata, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0301/p1007.html

Vacuum-Assisted Vaginal Delivery - American Family Physician

Oct 15, 2008 - The second stage of labor is a dynamic event that may require assistance when maternal efforts fail to effect delivery or when there are nonreassuring fetal heart tones. Therefore, knowing how to perform an operative vaginal delivery with forceps or vacuum is vital for family physicians...

American Family Physician : Article

https://www.aafp.org/afp/2008/1015/p953.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

Oral Health During Pregnancy - American Family Physician

Apr 15, 2008 - Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child. Periodontitis is ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1139.html

Diagnosis and Treatment of Atrophic Vaginitis - American Family Physician

May 15, 2000 - Up to 40 percent of postmenopausal women have symptoms of atrophic vaginitis. Because the condition is attributable to estrogen deficiency, it may occur in premenopausal women who take antiestrogenic medications or who have medical or surgical conditions that result in decreased levels ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3090.html

Practical Use of the Pessary - American Family Physician

May 1, 2000 - The pessary is an effective tool in the management of a number of gynecologic problems. The pessary is most commonly used in the management of pelvic support defects such as cystocele and rectocele. Pessaries can also be used in the treatment of stress urinary incontinence. The wide ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0501/p2719.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

Pregnancy Prevention in Adolescents - American Family Physician

Oct 15, 2004 - Although the pregnancy rate in adolescents has declined steadily in the past 10 years, it remains a major public health problem with lasting repercussions for the teenage mothers, their infants and families, and society as a whole. Successful strategies to prevent adolescent pregnancy ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1015/p1517.html

Assessing Breast Cancer Risk in Women - American Family Physician

Dec 15, 2008 - Understanding modifiable and nonmodifiable factors that increase or decrease breast cancer risk allows family physicians to counsel women appropriately. Nonmodifiable factors associated with increased breast cancer risk include advanced age, female sex, family history of breast cancer, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1361.html

Screening and Treatment for Sexually Transmitted Infections in Pregnancy - American ...

Jul 15, 2007 - Many sexually transmitted infections are associated with adverse pregnancy outcomes. The Centers for Disease Control and Prevention recommends screening all pregnant women for human immunodeficiency virus infection as early as possible. Treatment with highly active antiretroviral ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p265.html

Ectopic Pregnancy - American Family Physician

Feb 15, 2000 - Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1080.html

Preventing Postpartum Hemorrhage: Managing the Third Stage of Labor - American Family ...

Mar 15, 2006 - Postpartum hemorrhage is a significant cause of maternal morbidity and mortality. Most postpartum hemorrhages are caused by uterine atony and occur in the immediate postpartum period. Expectant or physiologic management of the third stage of labor has been compared with active ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1025.html

Examination of the Placenta - American Family Physician

Mar 1, 1998 - A one-minute examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant. The findings of this assessment should be documented in the delivery records. During the examination, the size, shape, consistency ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0301/p1045.html

Dystocia in Nulliparous Women - American Family Physician

Jun 1, 2007 - Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise, physicians providing maternity care should be skilled in the diagnosis, management, and prevention of dystocia. If labor ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0601/p1671.html

Nonhormonal Therapies for Hot Flashes in Menopause - American Family Physician

Feb 1, 2006 - Numerous reports in the medical literature and popular media have discussed the effectiveness of various nonhormonal agents in reducing menopausal hot flash symptoms. Data for these therapies are limited, and most of the studies have been conducted in women with a history of breast ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0201/p457.html

Management of Gestational Diabetes Mellitus - American Family Physician

Nov 1, 2003 - Gestational diabetes mellitus is a common but controversial disorder. While no large randomized controlled trials show that screening for and treating gestational diabetes affect perinatal outcomes, multiple studies have documented an increase in adverse pregnancy outcomes in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1101/p1767.html

Screening for Breast Cancer: Current Recommendations and Future Directions - American ...

Jun 1, 2007 - Breast cancer is one of the most significant health concerns in the United States. Recent reviews have questioned the value of traditional breast cancer screening methods. Breast self-examination has been shown not to improve cancer-specific or all-cause mortality in large studies, but ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0601/p1660.html

Down Syndrome: Prenatal Risk Assessment and Diagnosis - American Family Physician

Aug 15, 2000 - Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p825.html

Vasectomy: An Update - American Family Physician

Dec 15, 2006 - Vasectomy remains an important option for contraception. Research findings have clarified many questions regarding patient selection, optimal technique, postsurgical follow-up, and risk of long-term complications. Men who receive vasectomies tend to be non-Hispanic whites, well ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1215/p2069.html

An Approach to the Postpartum Office Visit - American Family Physician

Dec 15, 2005 - The postpartum period (typically the first six weeks after delivery) may underscore physical and emotional health issues in new mothers. A structured approach to the postpartum office visit ensures that relevant conditions and concerns are discussed and appropriately addressed. Common ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1215/p2491.html

Liver Disease in Pregnancy - American Family Physician

Feb 15, 1999 - Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of acute hepatitis is unaffected by pregnancy, except in patients with hepatitis E and disseminated herpes simplex infections, in which maternal and fetal mortality rates are significantly increased. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p829.html

Preventing Cardiovascular Disease in Women - American Family Physician

Oct 15, 2006 - Cardiovascular disease (CVD) has been the primary cause of death in women for almost a century, and more women than men have died of CVD every year since 1984. Although CVD incidence can be reduced by adherence to a heart-healthy lifestyle and detection and treatment of major risk ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1331.html