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Postpartum Hemorrhage: Prevention and Treatment - American Family Physician

Apr 1, 2017 - Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p442.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

Labor, Delivery, and Postpartum Issues - American Family Physician

Oct 15, 2019 - 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

Preterm Labor: Prevention and Management - American Family Physician

Mar 15, 2017 - In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks’ gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p366.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

Identification and Management of Peripartum Depression - American Family Physician

May 15, 2016 - Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p852.html

Management of Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2015 - Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p202.html

Prevention and Management of Postpartum Hemorrhage - American Family Physician

Mar 15, 2007 - Postpartum hemorrhage, the loss of more than 500 mL of blood after delivery, occurs in up to 18 percent of births and is the most common maternal morbidity in developed countries. Although risk factors and preventive strategies are dearly documented, not all cases are expected or ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0315/p875.html

Cesarean Delivery: Counseling Issues and Complication Management - American Family ...

Feb 1, 2015 - Nearly one-third of all deliveries in the United States are cesarean deliveries. Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Interventions that decrease the chance of a cesarean delivery ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0201/p178.html

Intrapartum Fetal Monitoring - American Family Physician

Dec 15, 2009 - Continuous electronic fetal monitoring was developed in the 1960s to assist in the diagnosis of fetal hypoxia during labor. Continuous electronic fetal monitoring has been shown to reduce the incidence of neonatal seizures, but there has been no beneficial effect in decreasing cerebral ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1388.html

Preterm Premature Rupture of Membranes: Diagnosis and Management - American Family ...

Feb 15, 2006 - Preterm premature rupture of membranes is the rupture of membranes during pregnancy before 37 weeks' gestation. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p659.html

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

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

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

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

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

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

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

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

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

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

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

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

Interpretation of the Electronic Fetal Heart Rate During Labor - American Family Physician

May 1, 1999 - Electronic fetal heart rate monitoring is commonly used to assess fetal well-being during labor. Although detection of fetal compromise is one benefit of fetal monitoring, there are also risks, including false-positive tests that may result in unnecessary surgical intervention. Since ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0501/p2487.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

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

Repair of Obstetric Perineal Lacerations - American Family Physician

Oct 15, 2003 - Family physicians who deliver babies must frequently repair perineal lacerations after episiotomy or spontaneous obstetric tears. Effective repair requires a knowledge of perineal anatomy and surgical technique. Perineal lacerations are classified according to their depth. Sequelae of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1015/p1585.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

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

Maternal Obesity and Labor Induction - FPIN's Help Desk Answers - American Family ...

May 15, 2018 - Pregnant women who are obese have nearly double the rate of cesarean delivery, and obesity increases the median duration of active labor by up to four hours when labor is induced. The difference in cesarean delivery rate is larger in obese primigravida patients presenting with cervical ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0515/p671.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

Intercontraction Intervals for Predicting Timing of Labor Evaluation - FPIN's Help Desk...

Mar 1, 2018 - Women at term who have at least 12 contractions per hour are more likely to be diagnosed with active labor within 24 hours. A reduction in the interval between contractions is associated with the onset of active labor.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0301/od3.html

Immediate Postpartum LARC: An Underused Contraceptive Option - Editorials - American ...

Jan 1, 2018 - Providing immediate postpartum LARC to women who want it is an evidence-based, patient-centered, and safe practice.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0101/p9.html

Tranexamic Acid Decreased Death from Bleeding but Not All-Cause Mortality in Women with...

Oct 15, 2017 - In this really large study, tranexamic acid did not decrease the frequency of the primary outcome of death or hysterectomy in women with postpartum hemorrhage. However, there was a very small reduction in the rate of death from bleeding in the women treated with tranexamic acid.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od1.html

ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation - Practice...

Sep 15, 2008 - The American College of Obstetricians and Gynecologists (ACOG) has released guidelines on psychiatric medication used by women during pregnancy and lactation. The use of psychotropic medications in these women is a concern because of the risks of adverse perinatal and postnatal outcomes.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2008/0915/p772.html

Membrane Sweeping to Decrease Rates of Postdate Induction - FPIN's Help Desk Answers - ...

Jan 1, 2017 - In uncomplicated pregnancies, membrane sweeping at 38 to 40 weeks' gestation safely decreases the rate of postdate inductions. Membrane sweeping increases the incidence of spontaneous labor, especially in the subsequent seven days, and results in fewer pregnancies extending beyond 41 ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0101/p35.html

Preventing Postpartum Hemorrhage: Managing the Third Stage of Labor - American Family ...

Mar 15, 2006 - Postpartum hemorrhage is a significant cause of maternal morbidity and mortality. Most postpartum hemorrhages are caused by uterine atony and occur in the immediate postpartum period. Expectant or physiologic management of the third stage of labor has been compared with active ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1025.html

Dystocia in Nulliparous Women - American Family Physician

Jun 1, 2007 - Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise, physicians providing maternity care should be skilled in the diagnosis, management, and prevention of dystocia. If labor ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0601/p1671.html

Oral NSAIDs for Perineal Pain in the Early Postpartum Period - Medicine by the Numbers ...

May 1, 2017 - Oral nonsteroidal anti-inflammatory drugs were able to adequately relieve perineal pain for many postpartum women at four hours and longer.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0501/od1.html

An Approach to the Postpartum Office Visit - American Family Physician

Dec 15, 2005 - The postpartum period (typically the first six weeks after delivery) may underscore physical and emotional health issues in new mothers. A structured approach to the postpartum office visit ensures that relevant conditions and concerns are discussed and appropriately addressed. Common ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1215/p2491.html

FDA Implements New Labeling for Medications Used During Pregnancy and Lactation - ...

Jul 1, 2016 - Deciding which medications to take during pregnancy and lactation can be a complex and individualized decision that should be discussed with a physician. The new PLLR can help remove some of the uncertainty clinicians and patients face by replacing the potentially confusing letter ...

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0701/p12.html

Examination of the Placenta - American Family Physician

Mar 1, 1998 - A one-minute examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant. The findings of this assessment should be documented in the delivery records. During the examination, the size, shape, consistency ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0301/p1045.html

Labor Induction at Term - FPIN's Help Desk Answers - American Family Physician

Feb 15, 2016 - Oral misoprostol (Cytotec), vaginal and intracervical prostaglandins, and mechanical methods are effective for induction of labor at term. The use of intravenous oxytocin (Pitocin) increases the risk of failure to achieve vaginal delivery at 24 hours and the risk of cesarean delivery ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0215/p266.html

ACOG Releases Recommendations on Screening for Perinatal Depression - Practice ...

Oct 1, 2015 - The American College of Obstetricians and Gynecologists (ACOG) has released recommendations on screening women for perinatal depression, with the purpose of increasing awareness of depression and lessening the effects it has on pregnant and post-partum women and their families.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/1001/p648.html

Reducing Obstetric Hemorrhage: Recommendations from the National Partnership for ...

Oct 1, 2015 - A consensus bundle, with recommendations for reducing and managing obstetric hemorrhage and improving overall maternal care, has been published by the National Partnership for Maternal Safety.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/1001/p643.html

Management of Pregnancy Beyond 40 Weeks' Gestation - American Family Physician

May 15, 2005 - A post-term or prolonged pregnancy is one that reaches 42 weeks' gestation; approximately 5 to 10 percent of pregnancies are post-term. Studies have shown a reduction in the number of pregnancies considered post-term when early ultrasound dating is performed. Maternal and fetal risks ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0515/p1935.html

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