Obstetrics and Gynecology Clinics of North America (OBSTET GYN CLIN N AM)

Publications in this journal

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  Available from: touchbriefings.com

  Article: Trauma during pregnancy.

  Steffen Brown, Ellen Mozurkewich
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  ABSTRACT: Traumatic injuries in pregnancy are both common and burdensome. Optimal management includes proper triage, maternal resuscitation, fetal monitoring, and diagnostic imaging.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):47-57.
• Article: Maternal sepsis.

  Jamie Morgan, Scott Roberts
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  ABSTRACT: Maternal sepsis is relatively common. Most of these infections are the result of tissue damage during labor and delivery and physiologic changes normally occurring during pregnancy. These infections, whether directly pregnancy-related or simply aggravated by normal pregnancy physiology, ultimately have the potential to progress to severe sepsis and septic shock. This article discusses commonly encountered entities and septic shock. The expeditious recognition of common maternal sepsis and meticulous attention to appropriate management to prevent the progression to severe sepsis and septic shock are emphasized. Also discussed are principles and new approaches for the management of septic shock.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):69-87.
• Article: Placenta accreta, increta, and percreta.

  Alison C Wortman, James M Alexander
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  ABSTRACT: Placenta accreta is an abnormal adherence of the placenta to the uterine wall that can lead to significant maternal morbidity and mortality. The incidence of placenta accreta has increased 13-fold since the early 1900s and directly correlates with the increasing cesarean delivery rate. The prenatal diagnosis of placenta accreta by ultrasound along with risk factors including placenta previa and prior cesarean delivery can aid in delivery planning and improved outcomes. Referral to a tertiary care center and the use of a multidisciplinary care team is recommended.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):137-54.
• Article: Endocrine emergencies.

  Scott A Sullivan, Christopher Goodier
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  ABSTRACT: Several potentially fatal endocrine emergencies in relation to obstetrics and gynecology are discussed in the article. Rates of case fatality vary in different series, but range from 10% to 30%. Rapid recognition, prompt supportive care, and intervention likely maximize maternal and fetal outcomes.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):121-35.
• Article: Foreword.

  William F Rayburn
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):ix.
• Article: Emergency cesarean delivery: special precautions.

  Joey E Tyner, William F Rayburn
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  ABSTRACT: An emergent cesarean delivery is performed to immediately intervene to improve maternal or fetal outcome for such indications as fetal distress, prolapsed cord, maternal hemorrhage from previa or trauma, uterine rupture, and complete placental abruption. It is paramount to reduce morbidity and mortality by preparing health care providers for special precautions.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):37-45.
• Article: Hypertensive emergencies of pregnancy.

  James M Alexander, Karen L Wilson
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  ABSTRACT: Hypertension is commonly encountered in pregnancy and has both maternal and fetal effects. Acute hypertensive crisis most commonly occurs in severe preeclampsia and is associated with maternal stroke, cardiopulmonary decompensation, fetal decompensation due to decreased uterine perfusion, abruption, and stillbirth. Immediate stabilization of the mother including the use of intervenous antihypertensives is required and often delivery is indicated. With appropriate management, maternal and fetal outcomes can be excellent.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):89-101.
• Article: Preface.

  James M Alexander
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):xi-xii.
• Article: Umbilical cord prolapse.

  Bradley D Holbrook, Sharon T Phelan
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  ABSTRACT: Umbilical cord prolapse is an obstetric emergency that can have negative outcomes for the fetus. It is diagnosed by a palpable or visible cord and is often accompanied by severe, rapid fetal heart rate decelerations. Cases of cord prolapse should be delivered as soon as possible, usually by cesarean section. While awaiting delivery, the fetal presenting part should be elevated off the cord either manually or by filling the bladder. Although an untreated case of umbilical cord prolapse can lead to severe fetal morbidity and mortality, prompt and appropriate management leads to good overall outcomes.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):1-14.
• Article: Intrapartum hemorrhage.

  James M Alexander, Alison C Wortman
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  ABSTRACT: Intrapartum hemorrhage is a serious and sometimes life-threatening event. Several etiologies are known and include placental abruption, uterine atony, placenta accreta, and genital tract lacerations. Prompt recognition of blood loss, identification of the source of the hemorrhage, volume resuscitation, including red blood cells and blood products when required, will result in excellent maternal outcomes.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):15-26.
• Article: Pulmonary embolism and amniotic fluid embolism in pregnancy.

  Matthew C Brennan, Lisa E Moore
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  ABSTRACT: Amniotic fluid embolism and pulmonary embolism are 2 of the most common causes of maternal mortality in the developed world. Symptoms of pulmonary embolism include tachycardia, tachypnea, and shortness of breath, all of which are common complaints in pregnancy. Heightened awareness leads to rapid diagnosis and institution of therapy. Amniotic fluid embolism is associated with maternal collapse. There are currently no proven therapies, although rapid initiation of supportive care may decrease the risk of mortality.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):27-35.
• Article: Shoulder dystocia.

  William Grobman
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  ABSTRACT: The frequency of shoulder dystocia in different reports has varied, ranging 0.2-3% of all vaginal deliveries. Once a shoulder dystocia occurs, even if all actions are appropriately taken, there is an increased frequency of complications, including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and neonatal brachial plexus palsies. Health care providers have a poor ability to predict shoulder dystocia for most patients and there remains no commonly accepted model to accurately predict this obstetric emergency. Consequently, optimal management of shoulder dystocia requires appropriate management at the time it occurs. Multiple investigators have attempted to enhance care of shoulder dystocia by utilizing protocols and simulation training.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):59-67.
• Article: Seizures and intracranial hemorrhage.

  Karen L Wilson, James M Alexander
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  ABSTRACT: Seizures and intracranial hemorrhage are possible medical diseases that any obstetrician may encounter. This article reviews the cause, treatment, and medical management in pregnancy for seizures and intracranial hemorrhage, and how the two can overlap into preeclampsia or eclampsia. This article also highlights some challenging management issues from the obstetrician's perspective.
  Obstetrics and Gynecology Clinics of North America 03/2013; 40(1):103-20.
• Article: Foreword.

  William F Rayburn
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):xi-xii.
• Article: Infertility evaluation.

  Janet F McLaren
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  ABSTRACT: Infertility is a common condition, affecting 15% of couples trying to conceive. The infertility evaluation includes an assessment of both the female and the male partner to discern the factors contributing to their difficulty in conceiving. The basic evaluation includes a careful history of both partners, physical examination of the female partner, investigation of ovulatory function and tubal status, and semen analysis. A more detailed investigation is performed as dictated by individual factors.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):453-63.
• Article: Evaluation and treatment of anovulatory and unexplained infertility.

  Anthony M Propst, G Wright Bates
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  ABSTRACT: Anovulatory disorders are a primary cause of female infertility. Polycystic ovarian syndrome is the major cause of anovulation and is generally associated with obesity. Lifestyle changes to encourage weight loss are the initial therapy for overweight and obese patients, followed by clomiphene citrate for ovulation induction. For those patients who fail to ovulate on clomiphene citrate, alternatives, such as letrozole; gonadotropins; and complimentary agents to enhance clomiphene citrate, such as metformin and glucocorticoids, are reviewed. Women with unexplained infertility (no identifiable cause of infertility on a routine evaluation) may benefit from ovulation induction with clomiphene citrate, letrozole, or gonadotropins.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):507-19.
• Article: Endometriosis and Infertility: A Review of the Pathogenesis and Treatment of Endometriosis-associated Infertility.

  Matthew Latham Macer, Hugh S Taylor
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  ABSTRACT: Endometriois has been associated with infertility; however, the mechanisms by which it affects fertility are still not fully understood. This article reviews the proposed mechanisms of endometriosis pathogenesis, its effects on fertility, and treatments of endometriosis-associated infertility. Theories on the cause of the disease include retrograde menstruation, coelomic metaplasia, altered immunity, stem cells, and genetics. Endometriosis affects gametes and embryos, the fallopian tubes and embryo transport, and the eutopic endometrium; these abnormalities likely all impact fertility. Current treatment options of endometriosis-associated infertility include surgery, superovulation with intrauterine insemination, and in vitro fertilization. We also discuss potential future treatments for endometriosis-related infertility.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):535-49.
• Article: Obesity and reproductive function.

  Emily S Jungheim, Jennifer L Travieso, Kenneth R Carson, Kelle H Moley
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  ABSTRACT: Obesity is associated with multiple adverse reproductive outcomes, but the mechanisms involved are largely unknown. Obesity has been referred to as a "complex system," defined as a system of heterogeneous parts interacting in nonlinear ways to influence the behavior of the parts as a whole. Human reproduction is also a complex system; hence the difficulty in identifying the mechanisms linking obesity and adverse reproductive function. This review discusses the adverse reproductive outcomes associated with obesity and the mechanisms involved and concludes with a discussion of public health policy with respect to the treatment of infertility in obese women.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):479-93.
• Article: Optimizing natural fertility: the role of lifestyle modification.

  Mamie McLean, Melissa F Wellons
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  ABSTRACT: Preconception counseling provides an opportunity for health care providers to promote maternal and neonatal health, and to make recommendations regarding the optimization of natural fertility. While educating patients on the negative impact of maternal obesity on fertility and maternal and neonatal health; many health care providers recommend weight loss to reduce these negative outcomes. The recommendations start with lifestyle modifications, including diet and exercise. This article focuses on the available evidence regarding lifestyle modifications and fertility, and on the type of lifestyle modifications that health care providers should recommend to patients seeking to optimize their natural fertility.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):465-77.
• Article: The impact and management of fibroids for fertility: an evidence-based approach.

  Xiaoxiao Catherine Guo, James H Segars
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  ABSTRACT: Fibroids affect 35% to 77% of reproductive-age women. When selecting a treatment plan for symptomatic fibroids, the fibroid location, size, and number must be considered. Myomectomy remains the preferred method for women with fibroid-related infertility who wish to have children or maintain fertility. Currently available medical therapies reduce symptoms in the short term but may involve side effects when used long term. Initial fertility studies are encouraging but trials are needed. Recent medical advances have led to minimally invasive approaches for women with fibroid disease, but there is a strong demand for additional treatment options.
  Obstetrics and Gynecology Clinics of North America 12/2012; 39(4):521-33.