Current opinion in obstetrics & gynecology
-
Sepsis is a leading cause of severe maternal morbidity and maternal death. As pregnancy-related sepsis can be difficult to recognize, clinicians should maintain a low threshold for early evaluation and treatment. ⋯ Obstetricians have a heightened understanding of the physiologic changes in pregnancy and play a vital role in coordinating patient care and improving outcomes. The recent 2016 and 2017 revisions of definitions for maternal sepsis and treatment should be incorporated into clinical practice.
-
Curr. Opin. Obstet. Gynecol. · Apr 2019
ReviewOpioid prescribing after childbirth: overprescribing and chronic use.
Overprescribing opioids contributes to the epidemic of drug overdoses and deaths in the United States. Opioids are commonly prescribed after childbirth especially after caesarean, the most common major surgery. This review summarizes recent literature on patterns of opioid overprescribing and consumption after childbirth, the relationship between opioid prescribing and chronic opioid use, and interventions that can help reduce overprescribing. ⋯ Women are commonly exposed to opioids after birth. This exposure leads to an increased risk of chronic opioid use. Physician and providers should judiciously reduce the amount of opioids prescribed after childbirth, although more research is needed to identify the optimal method to reduce opioid exposure without adversely affecting pain management.
-
Curr. Opin. Obstet. Gynecol. · Apr 2019
ReviewRecognizing maternal mental health disorders: beyond postpartum depression.
Maternal mental health disorders, including anxiety and depression, are one of the most common obstetric complications, presenting in pregnancy and postpartum. ⋯ Identification and treatment of maternal mental health disorders has important implications for maternal and child health. Obstetric providers should screen all women using a validated screening instrument and have systems in place to ensure timely diagnosis and treatment.