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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...
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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
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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...
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A Second Chance
Dear Readers,About a month ago, I started writing again and had at least tried to begin responding to the many queries that have kept coming in the door – some left on posts that are a year or two old. (And for all of you out there who have asked...
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Grand Rounds 4.8 at Dr Anonymous!
Thanks to Dr. Anonymous for including my last minute submission regarding the role of endometriosis in recurrent early pregnancy loss (RPL)in this week's Grand Rounds 4.8. Many women associate infertility with endometriosis, but are not aware of ...
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Recurrent Early Pregnancy Loss - 3 - Chromosomal Causes
Although 50% or more of sporadic pregnancy losses in first trimester are the result of chromosomal abnormalities, these probably account for less than 5% of recurrent early pregnancy losses. There is also usually a difference in the type of chrom...
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A Poignant Story
Maternal-Fetal Medicine can be a rough business sometimes. The highs are great, but the lows can keep you down for days. I have always tried to abide by the admonition in the House of God that one should always remember “the patient has the dise...
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Symptoms Accompanying Methotrexate Therapy for Ectopic Pregnancy
Below is a comment with questions from a reader who is undergoing methotrexate therapy for a tubal ectopic pregnancy. Ectopic pregnancy has been on the rise over the past 30-40 years and current rates are in the range of 1-2 per 1000 pregnancies....
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Diabetes in Pregnancy -6 - Diet and Exercise as the Foundation for Management of GDM
Once we have established the diagnosis of gestational diabetes mellitus (GDM), the first step in management is to counsel the patient regarding the diagnosis, management options, potential risks to the pregnancy, antepartum assessment of the baby,...
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Multiple Gestations - An Introduction
Not long ago I was attending at a twin delivery – one boy and one girl. The mother knew from about 16 weeks into the pregnancy that she had one of each gender. Yet, at the time of the delivery, despite the fact that there really was one of each,...
