{"title":"Induction and Augmentation of Labor","authors":"C. Morosky","doi":"10.2310/obg.19023","DOIUrl":"https://doi.org/10.2310/obg.19023","url":null,"abstract":"Certain maternal and fetal conditions require induction of labor for the safety and well-being of either the mother or baby. Similarly, once fetal maturity has been reached, elective induction of labor remains an option for delivery timing and patient request. A thorough understanding of the physiologic mechanisms of labor onset and maintenance has allowed obstetrical providers to induce labor from the quiescent state and augment spontaneous labor in the latent or prolonged state. The goal of labor induction and augmentation is the successful and expedited delivery of the neonate in a manner that is safe to both the mother and the infant. Positive maternal outcomes include a shortened admission to onset of labor time, shortened first stage of labor, successful vaginal delivery, and avoidance of intraamniotic infection or postpartum hemorrhage. Positive fetal outcomes include absence of meconium amniotic fluid staining, regular newborn nursery admission, and hospital discharge with the mother. In this review, we outline the various mechanical, chemical, and natural methods of labor induction and augmentation, including a detailed assessment of the risks and benefits of each method for both the mother and baby.\u0000\u0000This review contains 7 figures, 4 tables, and 33 references.\u0000Key Words: amniotomy, augmentation of labor, cervical ripening, induction of labor, oxytocin, membrane sweeping, nipple stimulation, prostaglandins, transcervical balloon catheter","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114560005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Peripartum Cardiomyopathy","authors":"K. Gray, M. Foley","doi":"10.2310/obg.19065","DOIUrl":"https://doi.org/10.2310/obg.19065","url":null,"abstract":"Peripartum cardiomyopathy (PPCM) is a serious and rare disease of late pregnancy or the early postpartum period. It is defined as idiopathic, nonfamilial, nongenetic, heart failure occurring in the absence of any other identifiable causes of heart disease within the last month of pregnancy or within the first 5 months postdelivery in otherwise previously healthy woman. The incidence in the United States is 1 per 3,000 to 4,000 live births. Left ventricular systolic dysfunction develops, almost always leading to a left ventricular ejection fraction of less than 45%. PPCM is unique in its rapid medical course and propensity to spontaneously resolve within 3 to 6 months of disease onset. The mortality rate is high, up to 10%, and the risk of relapse in subsequent pregnancies is also elevated. Treatment for PPCM varies slightly based on whether the woman is pregnant or postpartum. Conventional pharmacologic treatment includes diuretics, angiotensin-converting enzyme inhibitors (postpartum only), vasodilators such as hydralazine, digoxin, β-blockers, and anticoagulants.\u0000\u0000This review contains 5 figures, 5 tables, and 36 references.\u0000Key Words: critical care obstetrics, ejection fraction, heart failure, left ventricular systolic dysfunction, management, maternal mortality, peripartum cardiomyopathy, preeclampsia, pregnancy","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125377467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bacterial Infections in Pregnancy","authors":"P. Duff, J. Jackson","doi":"10.2310/obg.19047","DOIUrl":"https://doi.org/10.2310/obg.19047","url":null,"abstract":"All pregnant women should be screened on the first prenatal visit for chlamydia infection and gonorrhea. High-risk patients should be rescreened in the third trimester. Patients with symptomatic bacterial vaginosis should be treated with metronidazole to prevent complications such as preterm delivery, chorioamnionitis, and puerperal endometritis. All patients should be screened for GBS infection at 35 to 37 weeks and treated intrapartum with prophylactic antibiotics if they test positive. Prompt diagnosis and treatment of chorioamnionitis are essential to prevent neonatal and maternal complications. The treatment of choice intrapartum is ampicillin plus gentamicin. Patients who require cesarean delivery should also receive either clindamycin or metronidazole postpartum to strengthen coverage against anaerobes. Two highly effective treatment regimens for puerperal endometritis are clindamycin plus gentamicin or metronidazole plus ampicillin plus gentamicin.\u0000\u0000This review contains 5 figures, 7 tables and 43 references.\u0000Key Words: bacterial vaginosis, chorioamnionitis, lower genital tract infection, puerperal infection, urinary tract infection","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114151440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Management of Fecal Incontinence","authors":"Asya Ofshteyn, D. Popowich","doi":"10.2310/obg.19159","DOIUrl":"https://doi.org/10.2310/obg.19159","url":null,"abstract":"Fecal incontinence is a common yet socially stigmatized condition that results from a complex interplay of various etiologies. In commonly seen scenarios, obstetric injuries can result in fecal incontinence after assisted or uncomplicated vaginal births and can become symptomatic years after delivery. Postpartum women may initially present to their obstetrician-gynecologist or urogynecologist with fecal incontinence symptoms and require appropriate evaluation, initial management, and possible referral to further specialists. This chapter outlines the surgical assessment, work-up, and management of fecal incontinence.\u0000\u0000This review contains 21 figures, 1 tables, and 97 references.\u0000Keywords: Fecal incontinence, postpartum complications, pudendal nerve neuropathy, anal sphincter injury, operative management, preoperative workup, sacral nerve stimulation, MRI defecography, endanal ultrasound","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116874578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonobstetrical Surgical Conditions","authors":"S. Kim, Joong-Shin Park","doi":"10.2310/obg.19061","DOIUrl":"https://doi.org/10.2310/obg.19061","url":null,"abstract":"Prompt diagnosis and appropriate interventions for nonobstetrical surgical emergencies are important in pregnancy because a delay in diagnosis can result in increased morbidity and mortality to both mother and fetus. Generally, neither anesthesia nor surgical procedures increase the risk of congenital malformations or miscarriage. The diagnosis of a surgical condition is often more difficult in pregnant women than in nonpregnant adults because the traditional signs and symptoms of a specific disorder may not be exhibited due to the anatomic and physiologic changes of pregnancy. Moreover, the surgeon may need to make accommodations and adjustments as a result of the anatomic and physiologic changes associated with pregnancy, which may include limitations imposed by uterine size, unusual clinical presentation, and adjustments to accommodate fetal monitoring and optimize fetal well-being. Therefore, a multidisciplinary team approach (involving obstetricians, general surgeons, anesthesiologists, and neonatologists) is required in nonobstetrical surgeries involving pregnant women.\u0000\u0000This review contains 3 figures, 3 tables, and 32 references.\u0000Key Words: adnexal torsion, anesthesia, appendicitis, cholecystitis, laparoscopy, pregnancy, radiation, surgery","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114845426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexual Dysfunction: Hypoactive Sexual Desire Disorder","authors":"J. Buster","doi":"10.2310/obg.19105","DOIUrl":"https://doi.org/10.2310/obg.19105","url":null,"abstract":"Healthy female sexual functioning is driven by sexual desire. Sexual desire, traditionally defined as sexual thoughts and fantasies, is a natural life force and an art form affecting all aspects of a woman’s interpersonal and professional life. Virtually, all diagnostic categories of female sexual dysfunction, including arousal disorder, anorgasmia, and sexual pain disorder are linked to, caused by, or aggravated by loss of sexual desire. Decreased sexual desire is a diagnosis (hypoactive sexual desire disorder, HSDD) with its own International Classification of Diseases code (F52.0).. Impact is often subtle. HSDD may express as seemingly unrelated emotional disturbances that degrade life quality in family relationships, in the workplace, or both. For some women, it is severely distracting. The diagnosis of HSDD is made when symptoms are sufficient to cause distress. In older women, HSDD is heavily impacted by menopause-associated withdrawal of reproductive hormones, particularly testosterone and estradiol. HSDD greatly improves with transdermal replacement of these steroids. Side effects of transdermal hormones are minimal but response can be gratifying. In premenopausal women, HSDD behaves more as a psychoendocrine disorder that is responsive in some patients to flibanserin, a nonhormonal 5-HT1A receptor agonist. Side effects of flibanserin are significant but manageable.\u0000\u0000This review contains 12 figures, 6 tables, and references.\u0000Key Words: estradiol, flibanserin, hypoactive sexual desire disorder, menopause, selective serotonin reuptake inhibitors, sexual desire, sexuality, testosterone, transdermal, women","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134618537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexual Assault","authors":"Nisha Verma, Celeste S Royce","doi":"10.2310/obg.19017","DOIUrl":"https://doi.org/10.2310/obg.19017","url":null,"abstract":"Sexual assault affects as many as one-third of women around the world. Sexual assault includes individual traumatic events as well as chronic sexually abusive relationships, and can involve a partner, acquaintance, or stranger. Many women who have experienced sexual assault develop long-term mental and physical effects of their sexual trauma, including post-traumatic stress disorder, alcohol abuse, and dyspareunia. OBGYNs are able to have long-lasting impacts on the many survivors of sexual assault by screening effectively and providing compassionate, trauma-informed care.\u0000\u0000This review contains 10 figures and 33 references.\u0000Keywords: human trafficking, intimate partner violence, primary care, rape, sexual assault, sexual violence, trauma-informed care, women","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"275 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123064099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neurologic Diseases in Pregnancy","authors":"Emily L. Johnson, P. Kaplan","doi":"10.2310/obg.19044","DOIUrl":"https://doi.org/10.2310/obg.19044","url":null,"abstract":"Neurologic conditions commonly affect women during pregnancy. The severity of some chronic conditions, such as headaches, epilepsy, and multiple sclerosis, may be affected by pregnancy. Due to teratogenicity, some medications used prior to pregnancy should be avoided or used at a lower dose during pregnancy. The physiologic changes of pregnancy put women at risk for new neurologic conditions, including posterior reversible encephalopathy syndrome, venous sinus thrombosis, and restless legs syndrome. Compression neuropathies may arise during pregnancy or delivery. Increased experience with neuroimaging has provided reassurance that magnetic resonance imaging may be used safely during pregnancy.\u0000\u0000This review contains 7 figures, 7 tables, and 30 references\u0000Key Words: epilepsy, headache, multiple sclerosis, myasthenia gravis, neurology, neuropathy, pregnancy, posterior reversible encephalopathy syndrome, stroke, venous sinus thrombosis","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126815270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In Vitro Fertilization","authors":"J. Zolton, R. Chattopadhyay, A. DeCherney","doi":"10.2310/obg.19099","DOIUrl":"https://doi.org/10.2310/obg.19099","url":null,"abstract":"Assisted reproductive technology (ART) encompasses all procedures that manipulate the oocytes, sperm, and embryos outside of the body. Decades of research have allowed the field to emerge as a reliable and safe treatment for infertile men and women. Indications for in vitro fertilization (IVF) include tubal factor infertility, anovulation, male factor infertility, and decreased ovarian reserve. Treatment is not limited to the infertile population, as IVF with preimplantation genetic diagnosis also offers patients an opportunity to prevent transmission of a genetic condition for which they have been found to carry. The field of ART continues to rapidly evolve, as more knowledge is gained from studies reporting on ovarian stimulation protocols, reproductive techniques such as intracytoplasmic sperm injection, and blastocyst transfer. Techniques are aimed to improve live birth rates while ensuring the optimal health of children conceived using IVF.\u0000\u0000This review contains 8 figures, 5 tables and 63 references\u0000\u0000Key Words: assisted reproductive technology, blastocyst, decreased ovarian reserve, embryo transfer, gonadotropin-releasing hormone agonist, gonadotropin-releasing hormone antagonist, intracytoplasmic sperm injection, luteal phase support, ovarian hyperstimulation syndrome, vitrification","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"2019 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128071299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonsurgical Management Options for Pelvic Organ Prolapse: Review of the Current Evidence","authors":"Nathan Kow","doi":"10.2310/obg.19156","DOIUrl":"https://doi.org/10.2310/obg.19156","url":null,"abstract":"Pelvic organ prolapse (POP) is a common disorder that impacts a woman’s quality of life and has been projected to increase in the near future. Although many different treatments are currently available, healthcare practioners should be familiar with the common nonsurgical options that are considered the first-line therapy. Advances in nonsurgical interventions have traditionally included pessaries and pelvic floor muscle therapy. These optiosn have not changed much over time, however there have been recent trials providing more evidence with regards to their efficacy. The objective of this article is to review the current evidence for nonsurgical treatment options for POP.\u0000\u0000 This review contains 2 tables and 19 references\u0000Key Words: pelvic floor muscle training, pelvic floor physical therapy, pelvic organ prolapse, pessary, kegel excercises, uterine prolapse, cystocele, rectocele","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116513166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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