Serum screening tests for hepatitis, diabetes, fetal neural tube defects, and fetal trisomy 21 are offered to almost all obstetric patients.
Inadequate patterns of prenatal weight gain are associated with decreased birth weight, particularly when second-trimester gain is low.
Angiotensin-converting enzyme gene polymorphism does not affect pregnancy outcome, BP, or plasma zinc levels.
Twenty-four-hour BP monitoring suggests the need for specific normal thresholds for pregnancy and objectively evaluates BP alterations in pregnancy-induced hypertension, preeclampsia, and chronic hypertension.
Advanced maternal age and increased parity relate strongly to placenta previa and, to a lesser extent, to placental abruption, but not to other causes of uterine bleeding.
Administration of low-dose IV propranolol in combination with oxytocin in patients with dysfunctional labor is associated with a reduction in cesarean rate.
Vaginal placement of commercially available oral misoprostol leads to shorter labor induction to vaginal birth intervals without adverse maternal or fetal effects.
Routine clinical detection of macrosomia is inaccurate, and most cases of shoulder dystocia and birth trauma are not preventable.
Compared with white women, older, nulliparous African-Americans are at an increased risk of cesarean delivery.
Preterm labor in women without intrauterine infection is associated with elevated cytokine release by placental cells, suggesting that cytokine-mediated mechanisms participate in the pathogenesis of labor.
A randomized trial comparing endocervical placement of PGE2 gel versus induction of labor with oxytocin in women with PROM at term and a Bishop score less than 4 shows no difference in the incidence of clinical anmionitis and endometritis.
As shown in a selected, low-risk, low-income population, mother-infant discharge at 24 hours postpartum with a home follow-up visit is safe and cost-effective.
Laparoscopy may be an acceptable alternative to laparoctomy for interval evaluation of epithelial ovarian cancer, with possibly less morbidity, shorter hospital stay, and lower total hospital charges.
Using case-control data, analyses suggest PCOS is associated with ovarian cancer.
Uterine morcellation during vaginal hysterectomy is safe and does not increase perioperative morbidity over that with vaginal hysterectomy alone.
Concomitant abdominal hysterectomy or posterior colpoperineorrhaphy do not prolong voiding dysfunction experienced after Burch colposuspension.
Preoperative ketoprofen administered in combination with mesosalpinx infiltration effectively reduces postoperative pain after outpatient laparoscopic sterilization.
The vaginal Gram stain as interpreted by the Nugent criteria is a sensitive test for the diagnosis of bacterial vaginosis.
Sexual behavior is not associated with either the incidence or degree of vaginal colonization by group B streptococcus.
Prolonging stimulation for IVF increases follicle size and results in an increased implantation rate and a tendency toward increased pregnancy rate.
A new, low-dose, 7-day E2 transdermal system is effective in the reduction of menopausal vasomotor symptoms, and it is well tolerated.
Although vaginal delivery appears to be safe for twins weighing more than 1000 g, outcome in twins weighing less than 1000 g is improved with cesarean delivery.
The vibroacoustic stimulus-evoked fetal startle response observed with ultrasound reliably predicts a score of 8 or greater and, after the availability of large-scale studies, could be used as a rapid antepartum test to predict fetal well-being.
Oral acyclovir prophylaxis in late pregnancy for women with recurrent genital herpes is more cost-effective than cesarean delivery for women presenting with genital herpes lesions.
Obstetrician-gynecologists expect women found to have a BRCA1 mutation to be motivated to conduct surveillance, but also to expericence anxiety and possible discrimination.
Most triploid first-trimester spontaneous abortions are not molar, but histologic criteria are accurate and reproducible and can be used in screening for this chromosomal anomaly.
Use of a combination sharp and dull trocar direct entry technique for laparoscopy is cost-effective and causes no increased morbidity.
North American residency programs instruct residents in operative vaginal delivery by forceps and vacuum; forceps are more common, but vacuum is preferred in one third of training programs.
Prenatal ultrasonographic assessment of the ductus venosus depicts physiologic and pathophysiologic hemodynamic changes in this vessel and may improve diagnosis and management of fetal disease.
Surgical procedures have an internal ritual structure that may convey unconscious meaning to patients.
In vitro fertilization-induced abdominal pregnancy can occur in a patient after bilateral salpingectomy.
Preeclampsia, HELLP syndrome, and liver infarction, though rare, can present before 20 weeks' gestation in association with the antiphospholipid syndrome.
A pelvic arteriovenous malformation diagnosed antepartum presents a treatment dilemma.
Uterine arteriovenous malformations can be diagnosed noninvasively and managed medically.
Patients with placenta increta managed conservatively can have long-term persistence of invasive placental tissue.
Immediate coronary angioplasty can be life-saving in the setting of acute myocardial infarction during the third trimester of pregnancy.
Severe iron deficiency anemia, resulting from malabsorption caused by gastric bypass surgery for morbid obesity, can complicate subsequent pregnancy.
Fetal seizures documented on ultrasound indicate neurologic impairment and seizures in the neonate.
Fetal seizure activity is demonstrable by real-time ultrasound and can be subtle when fetal anomalies that induce joint contractures are present.
Selective fetal evacuation can be performed safely in the second trimester after repture of the lower sac.
Maternal cardiopulmonary bypass has adverse effects on uterine and fetal hemodynamics and may result in poor fetal outcome.
The traction forces exerted by the vacuum extractor are sufficient to cause fetal skull fracture.
These cases of isoloated hypoplastic left heart syndrome suggest an autosomal method of inheritance.
Several unusual prenatal ultrasonographic findings are associated with poor neonatal outcome with gastroschisis.
Malformation of a fetal cerebral artery can lead to brain hypoplasia and severe mental handicap.
Pulmonary sequestration associated with nonimmune fetal hydrops is not always fatal.
Fluorescence in situ hybridization allows chromosomal analysis without the need for cell culture, enhancing the study of archived fetal tissues for specific cytogenetic abnormalities.
A case of fatal congenital varicella syndrome with detection of varicella-zoster virus DNA in formalin-fixed tissue samples by PCR is reported.
In utero transmission of hepatitis A virus in second trimester may present as fetal ascites.
Fatal sepsis in a premature infant caused by non-typhoid salmonella acquired prenatally argues in favor of antibiotic treatment for non-typhoid salmonella infection in pregnancy.
Life-threatening neutropenia is reported in two patients treated with methotrexate for ectopic pregnancy.
Excision by hysterotomy of localized placental site trophoblastic tumor is an option for selected patients who wish preservation of fertility.
Neurofibromatosis may exist in a patient without a family history of von Reckinhausen's diesease or other manifestations of that disease.
Human papillomavirus may be transmitted by lesbian sexual activity.
Long-term tamoxifen treatment may be complicated by recurrent vulvovaginal candidiasis in postmenopausal women.
Lymphoma with ovarian involvement may be a cause of pelvic pain in women with AIDS.
Bacillary angiomatosis is a treatable infection that occurs most often in AIDS patients, causes pseudoneoplastic vascular lesions, and may involve the female genital tract.
Dural ectasia from the sacrum may present as an adnexal mass.
Pudendal nerve entrapment should be considered in the differential diagnosis of perineal or buttock pain after sacrospinous colpopexy.
Laparoscopic shortening of the utero-ovarian ligament can preserve fertility in cases of recurrent, intermittent ovarian torsion.
The use of the harmonic scalpel can be associated with tissue injury remote from the site of surgery.
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