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Medicine by the numbers

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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

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

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

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

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

Metformin for Improving Maternal and Infant Outcomes in Pregnant Women Who Are Obese - ...

Mar 1, 2019 - This meta-analysis showed no clear benefit for metformin in reducing the risk of large for gestational age infants. Additionally, there was no difference in important secondary outcomes such as gestational diabetes, hypertensive disease in pregnancy, shoulder dystocia, advanced perineal...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0301/od1.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.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

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

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

Vitamin E in Pregnancy - Medicine by the Numbers - American Family Physician

Apr 1, 2017 - Vitamin E supplementation in pregnant women does not show any benefit among the most patient-important outcomes.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0401/od1.html

Labor, Delivery, and Postpartum Issues - American Family Physician

Oct 1, 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

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

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

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

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

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

Common Questions About Late-Term and Postterm Pregnancy - American Family Physician

Aug 1, 2014 - Pregnancy is considered late term from 41 weeks, 0 days’ to 41 weeks, 6 days’ gestation, and postterm at 42 weeks’ gestation. Early dating of the pregnancy is important for accurately determining when a pregnancy is late- or postterm, and first-trimester ultrasonography should be ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p160.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

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

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

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

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

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

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

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

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

Prevention of Group B Streptococcal Disease in the Newborn - American Family Physician

Mar 1, 2005 - Group B streptococcus (GBS) is a leading cause of morbidity and mortality among newborns. Universal screening for GBS among women at 35 to 37 weeks of gestation is more effective than administration of intrapartum antibiotics based on risk factors. Lower vaginal and rectal cultures for ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p903.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

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

Fetal Chromosomal Abnormalities: Antenatal Screening and Diagnosis - American Family ...

Jan 15, 2009 - Pregnant women of all ages should be offered screening and invasive diagnostic testing for chromosomal abnormalities before 20 weeks' gestation. New developments in screening methods have increased the number of options for patients. Diagnostic options include chorionic villus sampling ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0115/p117.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

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

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

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

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

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

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

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

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

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

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

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

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

Vaccines for Preventing Influenza in Healthy Children, Healthy Adults, and Older Adults...

Aug 1, 2019 - Influenza vaccination reduces rates of laboratory-confirmed influenza and symptomatic influenza-like illness in healthy children, healthy adults, and older adults. There is no consistent evidence that influenza vaccination reduces school absenteeism in children, parental absenteeism ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0801/p143.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

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

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

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

The Nature and Management of Labor Pain: Part I. Nonpharmacologic Pain Relief - ...

Sep 15, 2003 - Pain in labor is a nearly universal experience for childbearing women. A recent evidence-based symposium on the nature and management of labor pain brought together family physicians, obstetricians, midwives, obstetric anesthesiologists, and childbirth educators to discuss a series of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1109.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

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

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

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

Risk of Preterm Birth with Vaginal Progesterone in Twin Pregnancies - FPIN's Help Desk ...

Nov 1, 2017 - Women with twin pregnancies should not routinely receive vaginal progesterone because it does not reduce the risk of preterm birth. Vaginal progesterone should be administered to reduce adverse neonatal outcomes in women with twin pregnancies and a short cervix (25 mm or less).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1101/od3.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

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

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

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

Preterm Labor: Diagnosis and Treatment - American Family Physician

May 15, 1998 - Preterm labor and delivery are among the most challenging obstetric complications encountered by the family physician. In the United States, preterm delivery affects approximately one in 10 births and is the cause of at least 75 percent of neonatal deaths, excluding those related to ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0515/p2457.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

Exercise and Pregnancy Loss - FPIN's Clinical Inquiries - American Family Physician

Apr 1, 2015 - Regular exercise for up to seven or more hours per week (including low-intensity and high-intensity aerobics, jogging, cycling, and swimming) is not associated with increased rates of miscarriage in the first to mid-second trimesters. Patients may continue bending and lifting at work, ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0401/p437.html

Rationale for a 39-Week Elective Delivery Policy - Editorials - American Family Physician

Dec 15, 2011 - Several organizations have called for obstetric care professionals to decrease the number of elective (non-medically indicated) deliveries before an estimated gestational age of 39 weeks to prevent iatrogenic neonatal harm. Approximately one out of every three births in the United ...

American Family Physician : Editorials

https://www.aafp.org/afp/2011/1215/p1335.html

Micronutrient Supplementation During Pregnancy - FPIN's Clinical Inquiries - American ...

Aug 1, 2015 - A multimicronutrient supplement is an oral tablet containing the recommended daily allowance of several vitamins and minerals. The World Health Organization does not recommend multimicronutrient supplementation because of the potential for increased neonatal mortality in some situations.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0801/p222.html

Calcium Supplementation for Preventing Hypertensive Disorders in Pregnancy - Cochrane ...

Oct 1, 2015 - High-dose calcium supplementation (i.e., at least 1,000 mg per day) during pregnancy reduces the risk of developing hypertension and preeclampsia. The most significant risk reduction occurs in women at risk of hypertensive disorders and those with low-calcium diets.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1001/p570.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.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

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

Antenatal Perineal Massage to Prevent Birth Trauma - Cochrane for Clinicians - American...

Mar 1, 2014 - Antenatal digital perineal massage in the final month of pregnancy is safe and well tolerated. Women who have not had a previous vaginal delivery and perform digital perineal massage in the final month of pregnancy experience less perineal birth trauma, mostly through fewer ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0301/p335.html

Prevention of Neonatal Group B Streptococcal Infection - American Family Physician

Jun 1, 1998 - Neonatal group B streptococcal infection is the primary cause of neonatal morbidity related to infection. It can often be prevented by identifying and treating pregnant women who carry group B streptococci or who are at highest risk of transmitting the bacteria to newborns. Increasing ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0601/p2713.html

Epidural Analgesia for Labor Pain - Cochrane for Clinicians - American Family Physician

Aug 1, 2012 - Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0801/p241.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

Transcervical Amnioinfusion - American Family Physician

Feb 1, 1998 - Amnioinfusion is being used to treat intrapartum problems known to be associated with fetal compromise, including prophylactic treatment of oligohydramnios during labor and after premature rupture of the membranes, treatment of severe variable decelerations during labor and reducing the...

American Family Physician : Article

https://www.aafp.org/afp/1998/0201/p504.html

Screening for Gestational Diabetes Mellitus: Recommendation Statement - U.S. Preventive...

Dec 1, 2014 - The U.S. Preventive Services Task Force (USPSTF) recommends screening for gestational diabetes mellitus (GDM) in asymptomatic pregnant women after 24 weeks of gestation.

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

https://www.aafp.org/afp/2014/1201/od1.html

Steroids at 34 to 36 Weeks’ and Before Term Cesarean Decrease Respiratory Distress ...

Feb 15, 2017 - For women admitted for imminent premature delivery at 34 to 36 weeks of gestation, one or two doses of betamethasone or dexamethasone (8 to 12 mg) decrease the likelihood of neonatal respiratory distress syndrome and shorten lengths of stay in the intensive care unit.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0215/od2.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

Management Options for Early Incomplete Miscarriage - Cochrane for Clinicians - ...

Feb 1, 2011 - For the management of incomplete miscarriage, limited-quality evidence shows that medical treatment with misoprostol (Cytotec), expectant care, and surgical evacuation have a completion of miscarriage success rate between 80 to 99 percent in pregnancies at less than 13 weeks' ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/0201/p258.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

Postpartum Major Depression: Detection and Treatment - American Family Physician

Apr 15, 1999 - Postpartum major depression occurs in approximately one of 10 childbearing women and is considerably underdiagnosed. If left untreated, the disorder can have serious adverse effects on the mother and her relationship with significant others, and on the child's emotional and psychologic ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2247.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

Predicting the Likelihood of Successful Vaginal Birth After Cesarean Delivery - ...

Oct 15, 2007 - The American College of Obstetricians and Gynecologists and the American Academy of Family Physicians recommend that pregnant women with a single previous cesarean delivery and a low-transverse incision be offered a trial of labor.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2007/1015/p1192.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

Home Visits for Pregnant Adolescents - FPIN's Help Desk Answers - American Family ...

Jan 1, 2016 - Nurse home visits for pregnant adolescents seem to improve resource utilization and prenatal clinic visit show rates.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0101/p25.html

Treatment of HSV Infection in Late Pregnancy - FPIN's Clinical Inquiries - American ...

Feb 15, 2012 - Pregnant women with a primary or recurrent episode of genital HSV infection who are later than 36 weeks of gestation should be treated with acyclovir (Zovirax) or valacyclovir (Valtrex) for viral suppression.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/0215/p390.html

Increasing Patient Access to VBAC: New NIH and ACOG Recommendations - Editorials - ...

Jan 15, 2011 - The increasing rate of cesarean deliveries and the lack of access to TOLAC have created a major public health concern. Maternal morbidity and mortality seem to be increasing in the United States, partly as a result of the increase in repeat cesarean deliveries.

American Family Physician : Editorials

https://www.aafp.org/afp/2011/0115/p121.html

Screening for Bacterial Vaginosis in Pregnancy to Prevent Preterm Delivery - U.S. ...

Jul 1, 2008 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations and supporting scientificevidence on screening for bacterial vaginosis in pregnancy to prevent preterm delivery.

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

https://www.aafp.org/afp/2008/0701/p106.html

ACOG Releases Guidelines on Screening for Fetal Chromosomal Abnormalities - Practice ...

Sep 1, 2007 - The American College of Obstetricians and Gynecologists (ACOG) has developed guidelines that provide recommendations on screening for fetal chromosomal abnormalities.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0901/p712.html

Magnesium Sulfate and Other Anticonvulsants for Women with Preeclampsia - Cochrane for ...

Jun 1, 2011 - Magnesium sulfate should be considered first-line treatment to prevent eclamptic seizures during labor.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/0601/p1269.html

Screening for Elevated Blood Lead Levels in Children and Pregnant Women: Recommendation...

Sep 1, 2007 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for elevated blood lead levels in children and pregnant women and the supporting scientific evidence, and it updates the 1996 recommendations contained in the Guide to Clinical ...

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

https://www.aafp.org/afp/2007/0901/p691.html

Caregiver Support for Women During Childbirth: Does the Presence of a Labor-Support ...

Oct 1, 2002 - This review indicates that continuous caregiver support during childbirth has a number of benefits with minimal to no risks. It was less likely that women would need pain medications or have an operative vaginal delivery, a cesarean section, or a five-minute Apgar score of less than 7 ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2002/1001/p1205.html

Screening for Iron Deficiency Anemia, Including Iron Supplementations for Children and ...

Aug 1, 2006 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for iron deficiency anemia and the supporting scientific evidence.

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

https://www.aafp.org/afp/2006/0801/p461.html

Why Can't I Get My Patients to Exclusively Breastfeed Their Babies? - Curbside ...

Jul 15, 2008 - A recent report from the Agency for Health-care Research and Quality has confirmed the numerous benefits of breastfeeding to mothers and their babies.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2008/0715/p265.html

Prenatal Care: Examining the Evidence for an Evolving Paradigm - Editorials - American ...

Apr 1, 2005 - ...YINKA OYELESE, M.D., Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey Am Fam Physician. 2005 Apr 1;71(7):1264-1266. Related Article The chief objective of prenatal care is to ensure good pregnancy outcomes. The...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0401/p1264.html

AAFP Releases Guidelines on Trial of Labor After Cesarean Delivery - Practice ...

Nov 15, 2005 - The American Academy of Family Physicians (AAFP) has released an evidence-based clinical practice guideline on trial of labor after cesarean delivery (TOLAC).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2005/1115/p2126.html

Screening for Rh(D) Incompatibility: Recommended Statement - U.S. Preventive Services ...

Sep 15, 2005 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for Rh(D) incompatibility and the supporting scientific evidence and updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, 2d ed.

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

https://www.aafp.org/afp/2005/0915/p1087.html

Antiviral Agents for Pregnant Women with Genital Herpes - FPIN's Clinical Inquiries - ...

Nov 1, 2005 - There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/1101/p1807.html

The ALSO Article Series - Editorials - American Family Physician

Apr 1, 2004 - ...CHARLES J. CARTER, M.D.Atlanta Medical Center Family Medicine Residency Morrow, Georgia BARBARA APGAR, M.D., M.S.University of Michigan Medical Center Ann Arbor, Michigan Am Fam Physician. 2004 Apr 1;69(7):1610-1613. In this issue of American Family Physician, we begin an article...

American Family Physician : Editorials

https://www.aafp.org/afp/2004/0401/p1610.html

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