Time to Reevaluate Cesarean Section Techniques
The other day I attended a session entitled “Myths and Truths of Cesarean Delivery Technique” presented by Dr. Aviva Lee-Parritz from Boston Medical Center. The discussion critically evaluated the surgical techniques commonly employed to accomplis...
Asherman's Syndrome: Diagnosis, Treatment, and Prevention
In our last post, we described the condition called “Asherman’s syndrome” wherein scarring of the intrauterine cavity can cause aberrations of menstrual bleeding (in the most extreme cases very light or absent periods), infertility, recurrent preg...
Grand Thanks to Dr. R.W. Donnell
Thanks to Notes from Dr. RW and to Dr. Donnell himself for including my post regarding Infertility and Cervical Incompetence in patients with insulin resistance syndromes in his weekly edition of medical bloggers Grand Rounds vol. 10 no. 3
Cervical Incompetence and Cerclage - 3 - Significance of the Internal Cervical Os
The incidence of cervical incompetence in the general population is really not known and probably varies by population subgroups. Estimates range between 1 in 100 and 1 in 2000. My sense over the years (considering the number of cerclages I have...
Plasminogen Activator Inhibitor-1 (PAI-1): Role in Adverse Pregnancy Outcome? - 6 - Treatment and Response Accompany Improved Outcomes
In the last several posts, we have presented support from the literature that links imbalances in the fibrinolytic system, as reflected in increased activity of PAI-1, or a genetic predisposition for the same, with adverse pregnancy outcome, both ...
More on Meds and Pregnancy: Adderall and Cymbalta
The following comment was received in response to one of my previous posts: “My friend has just discovered she was pregnant...at her yearly exam. The problem is she takes several meds…Adderall…(and) Cymbalta. She is around 13 weeks and is stress...
ACOG Annual Meeting - San Diego
Hey guys. On the road again. Decided to go to the American College of Obstetricians and Gynecologists (ACOG) Annual Meeting in San Diego starting this weekend. Since my specialty area is in Maternal-Fetal Medicine, I don’t get to the ACOG Meet...
Preterm Birth: Paths to Early Delivery
“Preterm labor can no longer be considered a single disease…(it) is the clinical expression of different pathologic insults to the feto-maternal unit.” Roberto Romero, 1993It is clear that there are a variety of initiating factors that can lead to...
Readers' Featured Comments/Questions - Why Wait to Conceive after Miscarriage and Rh-negative Concerns
Anonymous has left a new comment on your post "Early Pregnancy Loss - 2": I found out from my OB today that I miscarried (I found out I was pregnant on 8/22, and began bleeding on 8/29, he ordered a hCG level test which went from 12 to 2 in a 48 h...
Quintuplet Story - A Physician's Perspective
Before I became distracted by a plethora of administrative responsibilities, I was in the middle of writing a series about multiple gestations. Although I did not want to spend a lot of time discussing 'high order multiples' (three or more babies)...