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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

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

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

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

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

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

Fetal Chromosomal Abnormalities: Antenatal Screening and Diagnosis - American Family ...

Jan 15, 2009 - Pregnant women of all ages should be offered screening and invasive diagnostic testing for chromosomal abnormalities before 20 weeks' gestation. New developments in screening methods have increased the number of options for patients. Diagnostic options include chorionic villus sampling ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0115/p117.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

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

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

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

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

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

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

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

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

Prevention of Group B Streptococcal Disease in the Newborn - American Family Physician

Mar 1, 2005 - Group B streptococcus (GBS) is a leading cause of morbidity and mortality among newborns. Universal screening for GBS among women at 35 to 37 weeks of gestation is more effective than administration of intrapartum antibiotics based on risk factors. Lower vaginal and rectal cultures for ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p903.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

Management of Pregnancy Beyond 40 Weeks' Gestation - American Family Physician

May 15, 2005 - A post-term or prolonged pregnancy is one that reaches 42 weeks' gestation; approximately 5 to 10 percent of pregnancies are post-term. Studies have shown a reduction in the number of pregnancies considered post-term when early ultrasound dating is performed. Maternal and fetal risks ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0515/p1935.html

Evidence-Based Prenatal Care: Part I. General Prenatal Care and Counseling Issues - ...

Apr 1, 2005 - Effective prenatal care should integrate the best available evidence into a model of shared decision making. Pregnant women should be counseled about the risks of smoking and alcohol and drug use. Structured educational programs to promote breastfeeding are effective. Routine fetal ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1307.html

Blunt Trauma in Pregnancy - American Family Physician

Oct 1, 2004 - Trauma is the most common cause of nonobstetric death among pregnant women in the United States. Motor vehicle crashes, domestic violence, and falls are the most common causes of blunt trauma during pregnancy. All pregnant patients with traumatic injury should be assessed formally in a ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1001/p1303.html

Evidence-Based Prenatal Care: Part II. Third-Trimester Care and Prevention of ...

Apr 15, 2005 - All pregnant women should be offered screening for asymptomatic bacteriuria, syphilis, rubella, and hepatitis B and human immunodeficiency virus infection early in pregnancy. Women at increased risk should be tested for hepatitis C infection, gonorrhea, and chlamydia. All women should ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1555.html

Vaccinations in Pregnancy - American Family Physician

Jul 15, 2003 - Adult immunization rates have fallen short of national goals partly because of misconceptions about the safety and benefits of current vaccines. The danger of these misconceptions is magnified during pregnancy, when concerned physicians are hesitant to administer vaccines and patients ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0715/p299.html

Safety of Radiographic Imaging During Pregnancy - American Family Physician

Apr 1, 1999 - Maternal illness during pregnancy is not uncommon and sometimes requires radiographic imaging for proper diagnosis and treatment. The patient and her physician may be concerned about potential harm to the fetus from radiation exposure. In reality, however, the risks to the developing ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0401/p1813.html

Epidural Analgesia During Labor - American Family Physician

Nov 15, 1998 - Epidural analgesia is a commonly employed technique of providing pain relief during labor. The number of parturients given intrapartum epidural analgesia is reported to be over 50 percent at many institutions in the United States. The procedure has few contraindications, the primary ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1115/p1785.html

Uterine Rupture: What Family Physicians Need to Know - American Family Physician

Sep 1, 2002 - Vaginal birth after cesarean section is common in this country. Physicians providing obstetric care should be aware of the potential complications. Uterine rupture occurs in approximately one of every 67 to 500 women (with one prior low-transverse incision) undergoing a trial of labor ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p823.html

The Nature and Management of Labor Pain: Part I. Nonpharmacologic Pain Relief - ...

Sep 15, 2003 - Pain in labor is a nearly universal experience for childbearing women. A recent evidence-based symposium on the nature and management of labor pain brought together family physicians, obstetricians, midwives, obstetric anesthesiologists, and childbirth educators to discuss a series of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1109.html

Preterm Labor: Diagnosis and Treatment - American Family Physician

May 15, 1998 - Preterm labor and delivery are among the most challenging obstetric complications encountered by the family physician. In the United States, preterm delivery affects approximately one in 10 births and is the cause of at least 75 percent of neonatal deaths, excluding those related to ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0515/p2457.html

Intrauterine Growth Retardation - American Family Physician

Oct 15, 1998 - Intrauterine growth retardation (IUGR), which is defined as less than 10 percent of predicted fetal weight for gestational age, may result in significant fetal morbidity and mortality if not properly diagnosed. The condition is most commonly caused by inadequate maternal-fetal ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1015/p1384.html

The Nature and Management of Labor Pain: Part II. Pharmacologic Pain Relief - American ...

Sep 15, 2003 - A group of family physicians, obstetricians, midwives, obstetric anesthesiologists, and childbirth educators attended an evidence-based symposium in 2001 on the nature and management of labor pain and discussed a series of systematic reviews that focused on methods of labor pain ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1115.html

Transcervical Amnioinfusion - American Family Physician

Feb 1, 1998 - Amnioinfusion is being used to treat intrapartum problems known to be associated with fetal compromise, including prophylactic treatment of oligohydramnios during labor and after premature rupture of the membranes, treatment of severe variable decelerations during labor and reducing the...

American Family Physician : Article

https://www.aafp.org/afp/1998/0201/p504.html

Benefits and Risks of Psychiatric Medications During Pregnancy - American Family Physician

Aug 15, 2002 - Traditionally, psychiatric medications were withheld during pregnancy because of fear of teratogenic and other effects. The emergence of evidence of the safety of most commonly used psychiatric medications, the availability of this information in the form of online databases, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p629.html

Maternal Serum Triple Analyte Screening in Pregnancy - American Family Physician

Mar 1, 2002 - According to the American College of Obstetricians and Gynecologists, it has become standard in prenatal care to offer screening tests for neural tube defects and genetic abnormalities. There have been some changes in the recommended method of prenatal screening over the past few years,...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p915.html

Management of Suspected Fetal Macrosomia - American Family Physician

Jan 15, 2001 - Fetal macrosomia, arbitrarily defined as a birth weight of more than 4,000 g (8 lb, 13 oz) complicates more than 10 percent of all pregnancies in the United States. It is associated with increased risks of cesarean section and trauma to the birth canal and the fetus. Fetal macrosomia is...

American Family Physician : Article

https://www.aafp.org/afp/2001/0115/p302.html

Assisted Vaginal Delivery Using the Vacuum Extractor - American Family Physician

Sep 15, 2000 - Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0915/p1316.html

Genitourinary Infections and Their Association with Preterm Labor - American Family ...

Jan 15, 2002 - Genitourinary tract infections are one cause of preterm delivery. Prematurity is one of the leading causes of perinatal mortality in the United States. Uterine contractions may be induced by cytokines and prostaglandins, which are released by microorganisms. Asymptomatic bacteriuria, ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0115/p241.html

NHBPEP Report on High Blood Pressure in Pregnancy: A Summary for Family Physicians - ...

Jul 15, 2001 - The National High Blood Pressure Education Program's Working Group on High Blood Pressure in Pregnancy recently issued a report implicating hypertension as a complication in 6 to 8 percent of pregnancies. Hypertension in pregnancy is related to one of four conditions: (1) chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0715/p263.html

External Cephalic Version - American Family Physician

Sep 1, 1998 - External cephalic version is a procedure that externally rotates the fetus from a breech presentation to a vertex presentation. External version has made a resurgence in the past 15 years because of a strong safety record and a success rate of about 65 percent. Before the resurgence of ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0901/p731.html

Evaluation of Pregnant Women Exposed to Respiratory Viruses - American Family Physician

May 15, 2000 - Prenatal patients are often exposed to respiratory viruses at home and at work. Understandably, these patients may be concerned and want immediate answers and advice from their physicians. While most women who are exposed to chickenpox are immune, serologic testing can be performed and ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3065.html

Preterm Labor - American Family Physician

Feb 1, 1999 - Preterm labor is the leading cause of perinatal morbidity and mortality in the United States. It is characterized by cervical effacement and/or dilatation and increased uterine irritability before 37 weeks of gestation. Women with a history of preterm labor are at greatest risk. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0201/p593.html

Exercise During Pregnancy - American Family Physician

Apr 15, 1998 - Exercise has become a vital part of many women's lives. However, theoretic concerns have been raised about the safety of some forms of exercise during pregnancy. Because of the physiologic changes associated with pregnancy, as well as the hemodynamic response to exercise, some ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0415/p1846.html

Postpartum Major Depression: Detection and Treatment - American Family Physician

Apr 15, 1999 - Postpartum major depression occurs in approximately one of 10 childbearing women and is considerably underdiagnosed. If left untreated, the disorder can have serious adverse effects on the mother and her relationship with significant others, and on the child's emotional and psychologic ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2247.html

Acute and Post-traumatic Stress Disorder After Spontaneous Abortion - American Family ...

Mar 15, 2000 - When a spontaneous abortion is followed by complicated bereavement, the primary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1689.html

Common Peripartum Emergencies - American Family Physician

Nov 1, 1998 - Peripartum emergencies occur in patients with no known risk factors. When the well-being of the fetus is in question, the fetal heart rate pattern may offer etiologic clues. Repetitive late decelerations may signify uteroplacental insufficiency, and a sinusoidal pattern may indicate ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1101/p1593.html

Promoting and Supporting Breast-Feeding - American Family Physician

Apr 1, 2000 - The family physician can significantly influence a mother's decision to breast-feed. Prenatal support, hospital management and subsequent pediatric and maternal visits are all-important components of breast-feeding promotion. Prenatal encouragement increases breast-feeding rates and ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2093.html

Initial Management of Breastfeeding - American Family Physician

Sep 15, 2001 - Breast milk is widely accepted as the ideal source of nutrition for infants. In order to ensure success in breastfeeding, it is important that it be initiated as early as possible during the neonatal period. This is facilitated by skin-to-skin contact between the mother and infant ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0915/p981.html

Obstetric Care of Patients with HIV Disease - American Family Physician

Jan 1, 2001 - Appropriate management of pregnant patients who have human immunodeficiency virus (HIV) disease can have a major impact on maternal and infant health. The goals of therapy are to properly manage the pregnancy, treat the maternal HIV infection and minimize the risk of vertical ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0101/p107.html

Prevention of Neonatal Group B Streptococcal Infection - American Family Physician

Jun 1, 1998 - Neonatal group B streptococcal infection is the primary cause of neonatal morbidity related to infection. It can often be prevented by identifying and treating pregnant women who carry group B streptococci or who are at highest risk of transmitting the bacteria to newborns. Increasing ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0601/p2713.html

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