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Intrahepatic Cholestasis of Pregnancy - Reprise
On January 10 and 13, 2007, I wrote a couple of posts related to intrahepatic cholestasis of pregnancy (ICP), otherwise know as 'obstetric cholestasis.' ICP affects 1-2 of every 1000 pregnancies and is more common in certain subpopulations around ...
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Near Term Birth: No Place for Complacency
Late preterm, or “near-term,” birth is defined as delivery between 34 and 36 completed weeks’ gestation. According to National Center for Health Statistics in 2002, approximately 60% of all preterm births were in this category. The increase in nea...
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Invasive Diagnostic Testing after Reassuring First Trimester Screening for Aneuploidy?
Attached is a comment from a reader who has written to me before because of a history of recurrent early pregnancy losses. She is now pregnant, has successfully gotten through first trimester, and has had very reassuring combined risk assessment f...
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Preterm Birth: An American Tragedy
Yesterday, while I was presenting a talk on preterm birth (PTB) to a large family practice group and their 29 residents who practice obstetrics, an FDA advisory panel was reviewing an application from Adeza Biomedical Corporation to bring the drug...
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Cervical Incompetence and Cerclage - 8 - Shirodkar vs McDonald Cerclage
I just realized that since the outset of this series, we have talked about cervical cerclage but we have not explained what that is for the general reader. A cerclage is a ‘stitch’ placed around the cervix in a fashion that will, hopefully, preve...
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Cervical Incompetence and Cerclage - 1 - An Introduction
I have had several readers request information about cervical incompetence and cerclage. These are interrelated subjects in which I have had a keen interest and much personal experience over the years, but they have also been the topics of consid...
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Breast Cancer Diagnosis During Pregnancy
More than 4 million births are expected in the U.S. this year and at current estimated rates, breast cancer will be diagnosed in at least 1300 of these pregnancies. While this constitutes only a small percentage of the total number of cases diagn...
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Hypertensive Disorders in Pregancy - 7
In our last post on the subject of hypertensive disorders in pregnancy, we pointed out that once preeclampsia has developed, we are limited in our ability to “treat” the condition. Indeed, the only situations I have seen in which the clinical synd...
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Grand Rounds 4.35 at Musings of a Dinosaur!
Thanks to Musings of a Dinosaur for the effort and "Jurassic Park" spectacular presentation of this week's Grand Rounds 4.35. Thanks too for including a link to my recent post on "Polyhydramnios: Causes of Too Much Amniotic Fluid." Grand Rounds of...
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Infertility and Cervical Incompetence: No Time for a "Stitch in Time" this Time
On Saturday night, we admitted a patient at only 19 weeks’ gestation with advanced cervical dilation, occasional contractions, and fetal membranes ballooning through the cervix into the vagina – a history consistent with severe cervical incompeten...
