Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Mar 2017
ReviewFamily Planning American Style Redux: Unintended Pregnancy Improves, Barriers Remain.
This article discusses barriers to reducing unintended pregnancy. Numerous factors may explain the high rate of unintended pregnancy in the United States, including inadequate sex education, confusing media messages about sex, cultural attitudes about sex and young parenting, conflation of contraception with abortion, inadequate health care access, burdensome contraceptive dispensing practices, and hospital merger limitations on care. Successful and promising approaches to expanding access to reproductive health care and reducing unintended pregnancy are discussed.
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Obstet. Gynecol. Clin. North Am. · Dec 2016
ReviewManagement of Infection for the Obstetrician/Gynecologist.
Pregnant women have an increased morbidity and mortality for certain illnesses owing to the physiologic and immunologic changes in pregnancy. Certain infections are common during pregnancy, including urinary tract infections and pneumonia. Others are uncommon, but yield increased severity, including influenza. Human immunodeficiency virus, although it does not increase in pathogenesis during pregnancy, requires specific attention and management in the context of pregnancy.
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Obstet. Gynecol. Clin. North Am. · Dec 2016
ReviewCritical Care for the Obstetrician and Gynecologist: Obstetric Hemorrhage and Disseminated Intravascular Coagulopathy.
Obstetric hemorrhage accounts for 5% all deliveries in the United States and accounts for high maternal morbidity and mortality. Many hemorrhages are secondary to uterine atony and are quickly ameliorated with appropriate uterotonic use. However, for a subset of cases, severe hemorrhage may require advanced resuscitative techniques, and innovative procedural and surgical techniques. This article guides a provider through such a resuscitation.
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Obstet. Gynecol. Clin. North Am. · Sep 2016
ReviewCesarean Hysterectomy and Uterine-Preserving Alternatives.
Hysterectomy at the time of an obstetric delivery or postpartum is an uncommon time to perform one of the most common gynecologic procedures. Hysterectomy associated with pregnancy is often unplanned and undesired. ⋯ Postpartum hemorrhage is caused by uterine atony, genital tract laceration, uterine rupture, invasive placentation, infection, or coagulopathy. Multidisciplinary teams improve outcomes and are capable of managing complex medical and surgical complications that occur postpartum.
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Obstet. Gynecol. Clin. North Am. · Jun 2016
ReviewClinical Management of Obesity in Women: Addressing a Lifecycle of Risk.
The World Health Organization estimates that nearly 2 billion people worldwide are overweight, 600 million of whom are obese. The increasing prevalence of this condition in women is of particular concern given its impact on reproductive health and mortality. ⋯ However, health care professionals are infrequently engaged in obesity management. This article provides a conceptual understanding of obesity and a rational approach to treatment.