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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

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

Prenatal Care - American Family Physician

Oct 1, 2020 - 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

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

Fetal Aneuploidy: Screening and Diagnostic Testing - American Family Physician Restricted content. Login required.

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

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

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

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

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

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

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

Gestational Hypertension and Preeclampsia: A Practice Bulletin from ACOG - Practice ... Restricted content. Login required.

Nov 15, 2019 - Globally, hypertensive disorders of pregnancy are one of the main causes of maternal death. The American College of Obstetricians and Gynecologists has released a practice bulletin to outline diagnosis and treatment recommendations for these conditions.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1115/p649.html

Managing Chronic Hypertension in Pregnant Women: ACOG Releases Updated Practice ... Restricted content. Login required.

Dec 15, 2019 - The American College of Obstetricians and Gynecologists (ACOG) has released an updated practice bulletin to outline diagnosis, effects on pregnancy outcomes, and approaches for management based on new evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1215/p782.html

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

Immunizations in Pregnancy: Updated Recommendations - Editorials - American Family ...

Aug 15, 2020 - Important new data on the immunology of immunization in pregnancy provide greater support for and information on the provision and timing of these immunizations.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0815/p205.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

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

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

Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: ...

Jul 15, 2020 - The USPSTF recommends against screening for bacterial vaginosis in pregnant persons who are not at increased risk for preterm delivery.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2020/0715/p105.html

Potential of Fetal Fibronectin Testing to Prevent Preterm Birth - Cochrane for ... Restricted content. Login required.

Jun 1, 2020 - Fetal fibronectin testing may reduce preterm birth, although the evidence is not strong enough to recommend regular testing.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0601/p652.html

Closing Primary and Prenatal Care Gaps to Prevent Congenital Syphilis - Editorials - ...

Jul 15, 2020 - Family physicians can prevent congenital syphilis by following national screening guidelines; taking accurate, detailed sexual histories; providing evidence-based interventions to people who use injection drugs; and advocating to reduce structural barriers to care.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0715/p78.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

Screening for Hepatitis B Virus Infection in Pregnant Women: Recommendation Statement -...

Jan 15, 2020 - The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2020/0115/p112.html

Screening for Syphilis In Pregnant Women: Recommendation Statement - U.S. Preventive ...

Apr 15, 2019 - The USPSTF recommends early screening for syphilis infection in all pregnant women.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0415/od2.html

Screening for Hepatitis B Virus in Pregnant Women - Putting Prevention into Practice - ... Restricted content. Login required.

Jan 15, 2020 - A 33-year-old U.S.-born pregnant clinician comes to your office for a first prenatal visit. Her most recent menstrual period was six weeks ago, and she has been taking prenatal vitamins for the past eight weeks. She was pregnant once more than two years ago, and at the time she screened...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0115/p115.html

Screening for Elevated Blood Lead Levels in Children and Pregnant Women: Recommendation...

Oct 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/1015/od1.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

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

What Family Physicians Can Do to Reduce Maternal Mortality - Editorials - American ...

Oct 15, 2019 - Family physicians can catalyze efforts to ensure the safety of all people who give birth and to support well-being during the postpartum period.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1015/p460.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

Interventions to Prevent Perinatal Depression: Recommendation Statement - U.S. ...

Sep 15, 2019 - The USPSTF recommends that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0915/od1.html

Interventions to Prevent Perinatal Depression - Putting Prevention into Practice - ...

Sep 15, 2019 - A 25-year-old woman presents to your office after having recently missed her period. A urine pregnancy test confirms that she is pregnant. She takes acyclovir for suppression of genital herpes, which she acquired as a teenager. She reports a history of depression and sexual abuse during...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0915/p365.html

Perinatal Depression: AAP Policy Statement on Recognition and Management - Practice ...

Oct 1, 2019 - The American Academy of Pediatrics has released a policy statement regarding the integration of perinatal depression recognition and management into well-child visits.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1001/p443.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

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

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

Screening for Preeclampsia: Recommendation Statement - U.S. Preventive Services Task ...

Jan 15, 2018 - The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/0115/od1.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

Obesity in Pregnancy: Risks and Management - Editorials - American Family Physician

May 1, 2018 - As obesity becomes more common, it is important for all maternity care clinicians to understand the risks and associated management of obesity in pregnancy. Elevated prepregnancy weight increases the absolute risk of many adverse fetal and maternal outcomes.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0501/p559.html

Epidural Analgesia and Risk of Cesarean Delivery - FPIN's Help Desk Answers - American ...

Nov 1, 2018 - There is no difference in the risk of cesarean delivery in women who receive epidural analgesia before 4 to 5 cm cervical dilation compared with later dilation.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1101/od2.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

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

Safe Reduction of Primary Cesarean Births: National Partnership for Maternal Safety ...

Aug 15, 2018 - The National Partnership for Maternal Safety has developed a patient safety bundle that outlines important practices that every maternity unit should implement to reduce the number of primary cesarean births and improve care to increase the number of vaginal births.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0815/p258.html

Effects of Prenatal Yoga on Labor Pain - FPIN's Help Desk Answers - American Family ...

Jul 1, 2018 - Participation in a prenatal yoga program may help reduce labor pain, but reported effects vary from modest to moderate.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0701/p49.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

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