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Labor Analgesia - American Family Physician

Mar 1, 2012 - Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0301/p447.html

Fetal Alcohol Spectrum Disorders - American Family Physician

Jul 15, 2005 - To complement the 2005 Annual Clinical Focus on medical genomics, AFP will be publishing a series of short reviews on genetic syndromes. This series was designed to increase awareness of these diseases so that family physicians can recognize and diagnose children with these disorders ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0715/p279.html

Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline - American...

Jul 1, 2012 - Group B streptococcus is the leading cause of early-onset neonatal sepsis in the United States. Universal screening is recommended for pregnant women at 35 to 37 weeks’ gestation. The Centers for Disease Control and Prevention recently updated its guideline for the prevention of ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p59.html

Health Effects of Prenatal Radiation Exposure - American Family Physician

Sep 1, 2010 - Pregnant women are at risk of exposure to nonionizing and ionizing radiation resulting from necessary medical procedures, workplace exposure, and diagnostic or therapeutic interventions before the pregnancy is known. Nonionizing radiation includes microwave, ultrasound, radio frequency,...

American Family Physician : Article

https://www.aafp.org/afp/2010/0901/p488.html

Over-the-Counter Medications in Pregnancy - American Family Physician

Jun 15, 2003 - Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0615/p2517.html

Managing Adverse Birth Outcomes: Helping Parents and Families Cope - American Family ...

May 1, 2012 - Unexpected adverse fetal and neonatal outcomes (e.g., stillbirth, birth trauma, congenital anomalies) present a crisis for the family and the medical care team. In cases of stillbirth, the family physician should be flexible in supporting the parents’ choices, validate the loss, and ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0501/p900.html

Postpartum Major Depression - American Family Physician

Oct 15, 2010 - Postpartum major depression is a disorder that is often unrecognized and must be distinguished from baby blues. Antenatal depressive symptoms, a history of major depressive disorder, or previous postpartum major depression significantly increase the risk of postpartum major depression. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p926.html

Diagnosis and Management of Preeclampsia - American Family Physician

Dec 15, 2004 - Preeclampsia is a pregnancy-specific multisystem disorder of unknown etiology. The disorder affects approximately 5 to 7 percent of pregnancies and is a significant cause of maternal and fetal morbidity and mortality. Preeclampsia is defined by the new onset of elevated blood pressure ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1215/p2317.html

Gestational Hypertension and Preeclampsia: A Practice Bulletin from ACOG - Practice ...

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

Second Trimester Pregnancy Loss - American Family Physician

Nov 1, 2007 - Second trimester pregnancy loss is uncommon, but it should be regarded as an important event in a woman's obstetric history. Fetal abnormalities, including chromosomal problems, and maternal anatomic factors, immunologic factors, infection, and thrombophilia should be considered; ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1101/p1341.html

Nausea and Vomiting in Pregnancy - American Family Physician

Jul 1, 2003 - Nausea and vomiting of pregnancy, commonly known as 'morning sickness,' affects approximately 80 percent of pregnant women. Although several theories have been proposed, the exact cause remains unclear. Recent research has implicated Helicobacter pylori as one possible cause. Nausea and...

American Family Physician : Article

https://www.aafp.org/afp/2003/0701/p121.html

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

Feb 15, 2019 - The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus ...

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

https://www.aafp.org/afp/2019/0215/od1.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

Screening for Osteoporosis to Prevent Fractures: Recommendation Statement - U.S. ...

Nov 15, 2018 - The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.

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

https://www.aafp.org/afp/2018/1115/od1.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

Treatment of Breast Cancer - American Family Physician

Jun 1, 2010 - Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment. This article reviews typical treatments based on stage, histology, and biomarkers. Lobular carcinoma in situ does not require treatment. Ductal carcinoma ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0601/p1339.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

Counseling Patients About Hormone Therapy and Alternatives for Menopausal Symptoms - ...

Oct 1, 2010 - The results of recent large clinical trials have led physicians and patients to question the safety of menopausal hormone therapy. In the past, physicians prescribed hormone therapy in an attempt to improve overall health and prevent cardiac disease. Hormone therapy appears to increase ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1001/p801.html

Management of Spontaneous Abortion - American Family Physician

Oct 1, 2005 - Spontaneous abortion, which is the loss of a pregnancy without outside intervention before 20 weeks' gestation, affects up to 20 percent of recognized pregnancies. Spontaneous abortion can be subdivided into threatened abortion, inevitable abortion, incomplete abortion, missed abortion,...

American Family Physician : Article

https://www.aafp.org/afp/2005/1001/p1243.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

Venous Thromboembolism During Pregnancy - American Family Physician

Jun 15, 2008 - Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1709.html

Methods for Cervical Ripening and Induction of Labor - American Family Physician

May 15, 2003 - Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0515/p2123.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

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

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.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

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

Shoulder Dystocia - American Family Physician

Apr 1, 2004 - Shoulder dystocia can be one of the most frightening emergencies in the delivery room. Although many factors have been associated with shoulder dystocia, most cases occur with no warning. Calm and effective management of this emergency is possible with recognition of the impaction and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1707.html

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

Interpregnancy Care: Guidelines from ACOG and SMFM - Practice Guidelines - American ...

Jul 15, 2019 - The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have published guidelines focusing on interpregnancy care to improve outcomes of future pregnancies and the overall health of women, regardless of their future pregnancy plans.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0715/p121.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

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

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

Screening for Cervical Cancer - Putting Prevention into Practice - American Family ...

Feb 15, 2019 - P.J., a 48-year-old woman, presents to your office for a well-woman examination. She has been married for eight years, has no history of sexually transmitted diseases, and has nothing remarkable in her medical history.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0215/p253.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.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

Urinary Tract Infections During Pregnancy - American Family Physician

Feb 1, 2000 - Urinary tract infections are common during pregnancy, and the most common causative organism is Escherichia coli. Asymptomatic bacteriuria can lead to the development of cystitis or pyelonephritis. All pregnant women should be screened for bacteriuria and subsequently treated with ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0201/p713.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

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Ovarian Cancer: An Overview - American Family Physician

Sep 15, 2009 - Although ovarian cancer may occur at any age, it is more common in patients older than 50 years. Patients often present with nonspecific pelvic or abdominal symptoms. Initial diagnostic tests include transvaginal ultrasonography and serum cancer antigen 125 measurement; however, these ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0915/p609.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

Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2008 - Vaginal delivery is a natural process that usually does not require significant medical intervention. Management guided by current knowledge of the relevant screening tests and normal labor process can greatly increase the probability of an uncomplicated delivery and postpartum course. ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0801/p336.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

Prasterone (Intrarosa) for Dyspareunia - STEPS - American Family Physician

Jan 15, 2019 - Prasterone is similarly effective to nonprescription options for treating vaginal dryness and itching associated with menopause and may offer a small benefit in the treatment of dyspareunia.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0115/p117.html

Management of Uterine Fibroids - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2019 - What are the comparative effectiveness and harms of treatments for uterine fibroids, and what is the risk of finding unexpected leiomyosarcoma in women with fibroids?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0301/p330.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.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

Urinary Incontinence: Screening Recommendation from the WPSI - Practice Guidelines - ...

Feb 1, 2019 - Urinary incontinence adversely affects health, quality of life, and function for most women at some point in their lives. However, it is underreported because of embarrassment, stigma, or acceptance as normal. Early intervention may reduce progression, improve quality of life, and limit...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0201/p194.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

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