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Ectopic Pregnancy: Diagnosis and Management - American Family Physician

May 15, 2020 - Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p599.html

Fetal Aneuploidy: Screening and Diagnostic Testing - American Family Physician

Apr 15, 2020 - Aneuploidy is the presence of one or more extra chromosomes or the absence of one or more chromosomes. The risk of fetal aneuploidy rises with increasing maternal age. Because fetal aneuploidy can affect any pregnancy, all pregnant women should be offered screening. First-trimester ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p481.html

The Pregnant Patient: Managing Common Acute Medical Problems - American Family Physician

Nov 1, 2018 - Women often see their primary care physicians for common acute conditions during pregnancy. These conditions may be caused by pregnancy (obstetric problems) or worsened by pregnancy (obstetrically aggravated problems), or they may require special consideration during pregnancy because ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p595.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jan 15, 2016 - Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks’ gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks’ gestation), preeclampsia, or preeclampsia superimposed on chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p121.html

Options for Women with Unintended Pregnancy - American Family Physician

Apr 15, 2015 - Unintended pregnancy refers to unwanted, unplanned, or mistimed pregnancies. One-half of all pregnancies in the United States are unintended, and family physicians are often asked to provide counseling, support, and resources for women with unintended pregnancies. Options include ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p544.html

Screening, Diagnosis, and Management of Gestational Diabetes Mellitus - American Family...

Apr 1, 2015 - Gestational diabetes mellitus (GDM) affects approximately 6% of pregnancies in the United States, and it is increasing in prevalence. Pregnant women without known diabetes mellitus should be screened for GDM after 24 weeks of gestation. Treatment of GDM results in a statistically ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p460.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

Trauma in Pregnancy: Assessment, Management, and Prevention - American Family Physician

Nov 15, 2014 - Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1115/p717.html

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

Oct 15, 2014 - Many pregnant women take over-the-counter (OTC) medications despite the absence of randomized controlled trials to guide their use during pregnancy. Most data come from case-control and cohort studies. In 1979, the U.S. Food and Drug Administration began reviewing all prescription and ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1015/p548.html

Diagnosis and Management of Ectopic Pregnancy - American Family Physician

Jul 1, 2014 - Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p34.html

Nausea and Vomiting of Pregnancy - American Family Physician

Jun 15, 2014 - Nausea and vomiting of pregnancy affects nearly 75% of pregnant women. The exact cause is unknown. In most cases, it is a mild, self-limited condition that can be controlled with conservative measures and has no adverse fetal sequelae. About 1% of women develop hyperemesis gravidarum, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p965.html

Thyroid Disease in Pregnancy - American Family Physician

Feb 15, 2014 - Thyroid disease is the second most common endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction. Current guidelines recommend ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0215/p273.html

Update on Prenatal Care - American Family Physician

Feb 1, 2014 - Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor....

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p199.html

Recommendations for Preconception Counseling and Care - American Family Physician

Oct 15, 2013 - Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1015/p499.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

Office Management of Early Pregnancy Loss - American Family Physician

Jul 1, 2011 - The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p75.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

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

Hypertensive Disorders of Pregnancy - American Family Physician

Jul 1, 2008 - The National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy has defined four categories of hypertension in pregnancy: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension. A maternal ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p93.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

Oral Health During Pregnancy - American Family Physician

Apr 15, 2008 - Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child. Periodontitis is ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1139.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

Screening and Treatment for Sexually Transmitted Infections in Pregnancy - American ...

Jul 15, 2007 - Many sexually transmitted infections are associated with adverse pregnancy outcomes. The Centers for Disease Control and Prevention recommends screening all pregnant women for human immunodeficiency virus infection as early as possible. Treatment with highly active antiretroviral ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p265.html

Late Pregnancy Bleeding - American Family Physician

Apr 15, 2007 - Effective management of vaginal bleeding in late pregnancy requires recognition of potentially serious conditions, including placenta previa, placental abruption, and vasa previa. Placenta previa is commonly diagnosed on routine ultrasonography before 20 weeks' gestation, but in nearly ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0415/p1199.html

Common Skin Conditions During Pregnancy - American Family Physician

Jan 15, 2007 - Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0115/p211.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

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

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

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

Evidence-Based Prenatal Care: Part II. Third-Trimester Care and Prevention of ...

Apr 15, 2005 - All pregnant women should be offered screening for asymptomatic bacteriuria, syphilis, rubella, and hepatitis B and human immunodeficiency virus infection early in pregnancy. Women at increased risk should be tested for hepatitis C infection, gonorrhea, and chlamydia. All women should ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1555.html

Evidence-Based Prenatal Care: Part I. General Prenatal Care and Counseling Issues - ...

Apr 1, 2005 - Effective prenatal care should integrate the best available evidence into a model of shared decision making. Pregnant women should be counseled about the risks of smoking and alcohol and drug use. Structured educational programs to promote breastfeeding are effective. Routine fetal ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1307.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

Blunt Trauma in Pregnancy - American Family Physician

Oct 1, 2004 - Trauma is the most common cause of nonobstetric death among pregnant women in the United States. Motor vehicle crashes, domestic violence, and falls are the most common causes of blunt trauma during pregnancy. All pregnant patients with traumatic injury should be assessed formally in a ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1001/p1303.html

Vaccinations in Pregnancy - American Family Physician

Jul 15, 2003 - Adult immunization rates have fallen short of national goals partly because of misconceptions about the safety and benefits of current vaccines. The danger of these misconceptions is magnified during pregnancy, when concerned physicians are hesitant to administer vaccines and patients ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0715/p299.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

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

Benefits and Risks of Psychiatric Medications During Pregnancy - American Family Physician

Aug 15, 2002 - Traditionally, psychiatric medications were withheld during pregnancy because of fear of teratogenic and other effects. The emergence of evidence of the safety of most commonly used psychiatric medications, the availability of this information in the form of online databases, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p629.html

Maternal Serum Triple Analyte Screening in Pregnancy - American Family Physician

Mar 1, 2002 - According to the American College of Obstetricians and Gynecologists, it has become standard in prenatal care to offer screening tests for neural tube defects and genetic abnormalities. There have been some changes in the recommended method of prenatal screening over the past few years,...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p915.html

Genitourinary Infections and Their Association with Preterm Labor - American Family ...

Jan 15, 2002 - Genitourinary tract infections are one cause of preterm delivery. Prematurity is one of the leading causes of perinatal mortality in the United States. Uterine contractions may be induced by cytokines and prostaglandins, which are released by microorganisms. Asymptomatic bacteriuria, ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0115/p241.html

NHBPEP Report on High Blood Pressure in Pregnancy: A Summary for Family Physicians - ...

Jul 15, 2001 - The National High Blood Pressure Education Program's Working Group on High Blood Pressure in Pregnancy recently issued a report implicating hypertension as a complication in 6 to 8 percent of pregnancies. Hypertension in pregnancy is related to one of four conditions: (1) chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0715/p263.html

Obstetric Care of Patients with HIV Disease - American Family Physician

Jan 1, 2001 - Appropriate management of pregnant patients who have human immunodeficiency virus (HIV) disease can have a major impact on maternal and infant health. The goals of therapy are to properly manage the pregnancy, treat the maternal HIV infection and minimize the risk of vertical ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0101/p107.html

Down Syndrome: Prenatal Risk Assessment and Diagnosis - American Family Physician

Aug 15, 2000 - Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p825.html

Evaluation of Pregnant Women Exposed to Respiratory Viruses - American Family Physician

May 15, 2000 - Prenatal patients are often exposed to respiratory viruses at home and at work. Understandably, these patients may be concerned and want immediate answers and advice from their physicians. While most women who are exposed to chickenpox are immune, serologic testing can be performed and ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3065.html

Promoting and Supporting Breast-Feeding - American Family Physician

Apr 1, 2000 - The family physician can significantly influence a mother's decision to breast-feed. Prenatal support, hospital management and subsequent pediatric and maternal visits are all-important components of breast-feeding promotion. Prenatal encouragement increases breast-feeding rates and ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2093.html

Acute and Post-traumatic Stress Disorder After Spontaneous Abortion - American Family ...

Mar 15, 2000 - When a spontaneous abortion is followed by complicated bereavement, the primary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1689.html

Ectopic Pregnancy - American Family Physician

Feb 15, 2000 - Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1080.html

HELLP Syndrome: Recognition and Perinatal Management - American Family Physician

Sep 1, 1999 - HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p829.html

Safety of Radiographic Imaging During Pregnancy - American Family Physician

Apr 1, 1999 - Maternal illness during pregnancy is not uncommon and sometimes requires radiographic imaging for proper diagnosis and treatment. The patient and her physician may be concerned about potential harm to the fetus from radiation exposure. In reality, however, the risks to the developing ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0401/p1813.html

Liver Disease in Pregnancy - American Family Physician

Feb 15, 1999 - Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of acute hepatitis is unaffected by pregnancy, except in patients with hepatitis E and disseminated herpes simplex infections, in which maternal and fetal mortality rates are significantly increased. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p829.html

Preterm Labor - American Family Physician

Feb 1, 1999 - Preterm labor is the leading cause of perinatal morbidity and mortality in the United States. It is characterized by cervical effacement and/or dilatation and increased uterine irritability before 37 weeks of gestation. Women with a history of preterm labor are at greatest risk. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0201/p593.html

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