OBGYN.net Obstetrics, Pregnancy & Birth
Clinical Information on Pregnancy

 

Topics of interest

ANTEPARTUM CARE

Antenatal Diagnosis and Early Surgery for Choledochal Cyst: A Report of Two Cases
Since the advent of routine antenatal sonography to detect fetal abnormalities, two eases of choledochal cyst have been found prenatally in our hospital.
 
Antenatal Steroid Therapy: Indications, Risks, and Benefits
The purpose of this article is to discuss the impact of antenatal steroid therapy on neonatal outcomes.
 
Antepartum Testing
Guidelines from the Inland Northwest Regional Perinatal Center
 
Abstracts from National Library of Medicine

Connective Tissue Disorders and Pregnancy: Recommendations for Prescribing 
Does an amniotic fluid index of 5 cm necessitate delivery in high-risk pregnancies? A case-control study 
Multiple courses of betamethasone to enhance fetal lung maturation do not suppress neonatal adrenal response.
Early risk assessment of severe preeclampsia: Admission battery of symptoms and laboratory tests to predict likelihood of subsequent significant maternal morbidity
Risk factors for abruptio placentae and eclampsia: Analysis of 445 consecutively managed women with severe preeclampsia and eclampsia
Home Uterine Activity Monitoring
 
Auditory Evoked Response Test to Evaluate Fetal Health:
A new method to evaluate intrauterine fetal asphyxia. 
 
Center for Prenatal Diagnosis
Designed to make available obstetric and gynecologic ultrasound images for professional education and information. You may want to use these pages for learning image recognition or to compare with images that you have obtained. On these pages there are both normal and abnormal findings as well as some clinical information pertinent to interpretation / management of the abnormal ones. There are images from all three trimesters of pregnancy both normal and abnormal.
 
The Effect of Antenatal Steroids For Fetal Maturation on Perinatal Outcomes
National Institutes of Health Consensus Development Conference Statement February 28-March 2, 1994 
 
Eurofoetus 
Eurofoetus is a European Commission funded research group launching a registry for fetoscopy, and a randomised and observational study for treatment of twin-to-twin transfusion syndrome
 
The Florida Institute for Fetal Diagnosis and Therapy 
The Florida Institute for Fetal Diagnosis and Therapy is a non-profit organization established to provide patients and physicians with the latest and most advanced resources in the field of Prenatal Diagnosis and Therapy.  Many conditions once thought fatal are treatable including TTTS,acardic twin, amniotic bands, and fetal bladder obstruction.
 
Gestational Age Calculator
 
Gestational Age
Fetal Cardiac Dimensions Calculator
 
Guidelines for Vaccinating Pregnant Women
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
 
Intrapartum Electronic Fetal Monitoring
Recommendation from the Guide to Clinical Preventive Services, Second Edition
Prenatal Disorders, Columbia-Presbyterian Medical Center
 
New and Revised Obstetrical Ultrasound Codes for 2003
Most significant of the radiology CPT® coding changes for 2003 were the revision of the pelvic ultrasound section and the provision of detailed guidelines for the use of the new and revised obstetrical ultrasound codes.
 
Postpartum Depression
 
Prenatal Diagnosis Home Page
This page is designed to provide information for patients, physicians, and other health care professionals relating to diagnostic modalities used in Fetal Medicine. 
 
Prenatal-Diagnostics/bionet.diagnostics.prenatal Newsgroup Archive
A Web front end to the forum with searchable archives.
 
Pregnancy and the Fetus - CHORUS
CHORUS is based on Fact/File, a radiology hypertext reference that has been integrated with a clinical radiology information system (at the University of Chicago) since 1990. 
 
Screening for Chlamydial Infection
Routine testing for Chlamydia trachomatis is recommended for asymptomatic persons at high risk of infection. Pregnant women in high risk categories should be tested at the first prenatal visit.
 
Screening for D (Rh) Incompatibility
Recommendation from the Guide to Clinical Preventive Services, Second Edition Prenatal Disorders, Columbia-Presbyterian Medical Center
 
Screening for Down Syndrome
Recommendation from the Guide to Clinical Preventive Services, Second Edition, Congenital Disorders, Columbia-Presbyterian Medical Center
 
Screening for Neural Tube Defects -- Including Folic Acid/Folate Prophylaxis
Recommendation from the Guide to Clinical Preventive Services, Second Edition, Congenital Disorders, Columbia-Presbyterian Medical Center
 
Screening for Preeclampsia
Recommendation from the Guide to Clinical Preventive Services, Second Edition, Prenatal Disorders, Columbia-Presbyterian Medical Center
 
Screening Ultrasonography in Pregnancy
Guidelines from the Columbia-Presbyterian Medical Center

COMPLICATIONS OF PREGNANCY

Safety of Antidepressant Use in Pregnant and Nursing Women
New research may help physicians who treat depressed pregnant or nursing women better assess the benefits and risks of drug and nondrug therapies for both mother and child.

Cancer and Pregnancy 

 
Management of Breast Cancer During Pregnancy Using a Standardized Protocol
An article by D. L. Berry, R. L. Theriault, F. A. Holmes, V. M. Parisi, D. J. Booser, S. E. Singletary, A. U. Buzdar, & G. N. Hortobagyi

Ectopic Pregnancy

 
Could We Treat More Unruptured Ectopic Pregnancies with Intramuscular Methotrexate?
E. Kucera, M. Schindl, I. Klem, C. Sam, E. Hanzal, H. Kölbl, S. Leodolter, G. Sliutz
Gynecologic and Obstetric Investigation 2000;49:6-11
 
Interventions for tubal ectopic pregnancy (Cochrane Review)
The surgical approach to a tubal ectopic pregnancy has undergone a significant change in the last decade. 
CASE REPORT:  Laparoscopic management of an ovarian ectopic pregnancy after intracytoplasmic sperm injection
Blackwell Synergy, Gynaecological Endoscopy, Volume 11 Issue 6 Page 455  - December 2002 
 
Laparoscopic Images of Ectopic Tubal Pregnancies
Images from the Advanced Fertility Center of Chicago.
 
Laparoscopic Management of Tubal Ectopic Pregnancies - The Irish Experience
Abstract from the Irish Medical Journal, Aug. 1997.
 
The Virtual Naval Hospital Project    
Unrupted Ectopic Pregnancy & Ruptured Ectopic Pregnancy

Emergencies

An overview of some of the most common intrapartum medical emergencies, including cord prolapse, uterine rupture, shoulder dystocia, and undiagnosed twin.
 
Pregnancy, Trauma
The pregnant trauma patient presents a unique challenge to emergency physicians because there are 2 patients that need to be cared for. Anatomic and physiologic changes that occur in pregnancy can mask or mimic injury, making the diagnosis of trauma-related problems more difficult.
 
Surgical Emergencies in Obstetrics & Gynecology
 
The Surgical Care of Women in Operational Settings
The need for gynecologic surgery may arise in isolated settings, or during military operations when consultation is restricted and medical support limited. At such times, surgeons of varying experience and training may be required to perform gynecologic surgery. The Virtual Naval Hospital

Gestational Diabetes

 
CDC's Diabetes Program - South Dakota Gestational Diabetes Care Guidelines

MedlinePlus: Diabetes and Pregnancy

Gestational Diabetes - Obstetrics and Gynecology - MedStudents 

Daniela Contage Siccardi, Obstetrics & Gynecology Resident   "Gestational diabetes(GDM) is defined as glucose intolerance of variable degree with onset or first recognition during the present pregnancy."

Group B Strep

Group B Streptococcal Infections
Group B streptococcus (GBS) is a type of bacterium that causes illness in newborn babies, pregnant women, the elderly, and adults with other illnesses, such as diabetes or cancer. GBS is the most common cause of life-threatening infections in newborns. 
 
Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective
CDC guidelines for prevention of perinatal GBS disease.
 
Risk Factors for Early-onset Group B Streptococcal Sepsis: Estimation of Odds Ratios by Critical Literature Review
Abstract from PEDIATRICS Vol. 103 No. 6 June 1999, p. e77

Intrauterine Growth Retardation

Emedicine.com 
     Intrauterine Growth Retardation
     Fetal Growth Restriction 

Sonographic Diagnosis of Fetal Growth Disorders. - Mintz MC, & Landon MB.  - NCBI

Copyright © 2005 by the American College of Obstetricians and Gynecologists.
Fetal Growth and Body Proportion in Preeclampsia - Svein Rasmussen, MD, PhD and Lorentz M. Irgens, MD, PhD
 
Psychosocial and Environmental Pregnancy Risks - Patricia Newcomb, MD, & Victor Poleshuck, MD
© 1996-2005 eMedicine.com, Inc. All Rights Reserved

Placental Abnormalities

Placenta Previa  
Valuable information on this pregnancy complication, including frequency and mortality rates, differentials, diagnostic work-ups, and treatments.
 
Southern Medical Association
PLACENTA ACCRETA PERCRETA By: Fergal D. Malone, MD Originally published: April 1, 2002
 Source: Contemporary Ob/Gyn 2002;4:116-142.
 
Risk of Hemorrhage and Scarring in Placenta Accreta
American Academy of Family Physicians  - August 1999
 
Maternal and Neonatal Outcome in Major Placenta Previa - An article written by Tariq Khashoggi, Arab Board.
 
Risk factors for post-partum complications occurring after preeclampsia and HELLP syndrome: A study in 453 consecutive pregnancies - Abstract Only
Copyright © 2005 Elsevier B.V. All rights reserved. ScienceDirect® is a registered trademark of Elsevier B.V.
Philippe Deruelle, Elodie Coudoux, Anne Ego, Véronique Houfflin-Debarge, Xavier Codaccioni and Damien Subtil
 
Clinician to Clinician: Have you ruled out a placental site nodule? By: Ie-Ming Shih, MD., Ruchi Garg, MD., Robert E. Bristow, MD.,  James J.Russell, MD.

Preeclampsia

 
Preeclampsia Definitions
This list was compiled in 1993, these books and organizations may have more recent versions of their criteria not reflected here.  
 
Screening for Preeclampsia - Guide to Clinical Preventive Services
Screening for preeclampsia with blood pressure measurement is recommended for all pregnant women at the first prenatal visit and periodically throughout the remainder of pregnancy.

General Complications

 
Abdominal defects
Discussion regarding the two most common defects: gastroschisis and omphalocele.
 
Abiding Hearts, Inc.
Gives support and encouragement to parents, grandparents, caregivers and friends when parents are continuing their pregnancy after adverse prenatal diagnosis. (Fatal or non-fatal birth defects) Offers pregnancy management information
 
Anemia During Pregnancy
RxMed provides a clinical explanation of anemia during pregnancy.
 
Anencephaly Support Foundation
A non-profit foundation dedicated to serving parents, families and the educational and medical communities.
 
Antimicrobials in Pregnancy
Listing of antibacterial, antifungal, antiparasitic, antimycobacterial, and antiviral agents, along with their FDA pregnancy risk categories. 
 
Brachial Plexus Injuries in the Newborn
Information from Neonatology On the Web
The Center for Prenatal Diagnosis (An excellent site offering a wide range of information)
Transabdominal Cerclage
Prenatal Diagnosis Case Studies: 
  • Pallister-Killian Syndrome
  • Trisomy 13
  • Achondrogenesis, Type II
  • Spinal Muscular Atrophy, Type I
 
Connective Tissue Disorders and Pregnancy: Recommendations for Prescribing
Abstract from the Journal of Reproductive Medicine
 
Folic Acid Helps Prevent Some Birth Defects
 "Although we do not know the cause of most birth defects, the good news is that we know how to prevent some birth defects"  Centers for Disease Control and Prevention
 
The Florida Institute for Fetal Diagnosis and Therapy
The Florida Institute for Fetal Diagnosis and Therapy is a non-profit organization established to provide patients and physicians with the latest and most advanced resources in the field of Prenatal Diagnosis and Therapy.  Many conditions once thought fatal are treatable including TTTS,acardic twin, amniotic bands, and fetal bladder obstruction.  
 
Herpes and Pregnancy
If you are pregnant and know you have genital herpes, that fact alone gives you a significant advantage in protecting your baby. Studies show that most cases of neonatal herpes occur in babies whose mothers don't have any idea they are infected.
 
Hyperemesis Gravidarum
While morning sickness can occur in up to 70% of all pregnancies, it is usually more troublesome than serious. The more severe and disturbing condition, hyperemesis gravidarum, may complicate up to .3% of pregnancies, causing physiological changes that may effect the mother and fetus. By Richard Chudacoff, MD 
 
Hypertensive Disorders In Pregnancy
Outline of hypertensive disorders in pregnancy by Dr. Velumagan.
 
Medical Complications in Pregnancy
A patient with pre-existing medical diseases during pregnancy presents a particular challenge to the obstetrician. Article by R. J. Blaskiewicz, M.D.
 
Neonatology On the Web

Pregnancy Complications  Listing from HON

Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.

Shoulder Dystocia
The site covers all aspects of shoulder dystocia and brachial plexus injuries. It explores in particular depth the evidence for and against the predictability and the preventability of shoulder dystocia based on a review of over 258 articles. The site also includes excellent graphics illustrating various aspects of shoulder dystocia and the injuries that may be associated with it.
 
Teen Sex and Pregnancy
Each year, almost one million teenage women -11% of all women aged 15-19 and 20% of those who have had sexual intercourse - become pregnant. A fact sheet provided by The Alan Guttmacher Institute (AGI).

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