Preterm Birth

Cervical Dysplasia Now... Pregnancy Complications Later?

Screening for cervical cancer starts at a young age- 21 for most women- which often occurs before childbearing and pregnancy. When we screen women for cervical dysplasia and subsequently treat it, it's easy to get caught up in the primary objective (prevent or stop cancer) and to forget about considerations for long term health, such as the implications for future pregnancy. Since the cervix plays a key role in pregnancy (keeping the fetus safely in the uterus!), it follows that treating cervical dysplasia could affect pregnancy in the future. Read on to learn four ways treatment of cervical dysplasia can affect pregnancy outcomes.

A Balancing Act: Ideal Delivery Timing & Chronic Hypertension

Delivery, like all things in life, is a balancing act, especially in the case of pregnancies with complications. Depending on the complication, be it high blood pressure or diabetes, scheduled delivery earlier than labor starts naturally can be in everyone's best interest- if the risks & benefits balance. In the case of chronic hypertension, timing of delivery must balance the risks to the infant of being born too early with the risk of stillbirth as pregnancy continues. ACOG recommendations for timing of delivery for pregnancies complicated by chronic hypertension are broad (anywhere from 36 to 39 weeks), so a new study examined the risks and benefits of delivery at each week of gestation. 

Teamwork makes the Dream Work for PTB in Ohio

"Individually we are one drop, but together we are an ocean." -Ryunosuke Satoro. The wisdom underlying the power of teamwork has never been so true as when it is applied to delivering medical care. From restructuring care teams to center around patients and their families to encouraging collaboration between medical centers, improvements in medicine rely on increasing teamwork. A collaborative in Ohio has recently shown the tremendous benefits that can be achieved in the field of obstetrics when groups team up to prevent preterm birth through better access to progesterone treatments. 

12/9/16 Weekly Top 5: Vasopressin, Conception, & Delivering Bad News

This week the Florida governor reported that Florida is now free of Zika transmission. Hopefully that statement holds true once winter is over. In the meantime, here are this week's Top 5 Women's Health Articles, covering vasopressin for cesarean section, odds of conception depending on age, effects on patients and doctors after stillbirth, progesterone for preterm labor, and the annual MD&M conference.

Late Preterm Steroids Are Here

Medical students on their OBGYN rotations have long memorized the corticosteroid rule: If delivery is imminent in the next week, before 34 weeks gestational age, give corticosteroids for lung maturity. Two doses, 24 hours apart have been shown to improve respiratory outcomes in strong, randomized clinical trials. However, what about the 70% of preterm deliveries that occur between 34 weeks and 36 weeks 6 days? Do these infants benefit from corticosteroids? The Society for Maternal Fetal Medicine is spreading the word about the new ALPS study on this very topic.

Picking Their Birthday: Timing of Twin Delivery

Most of our parents didn’t get to choose our birthdays, but in the case of scheduled deliveries, exactly which day to plan for delivery is an important question for doctors and patients. The American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal Fetal Medicine (SMFM) currently recommend delivery for dichorionic-diamniotic (di-di) twins during the 38th week of pregnancy. A new meta-analysis calls this recommendation into question, with results suggesting that delivery at 37 weeks could decrease stillbirths.

11/18/16 This Week's Top 5 for World Prematurity Day

This week marked the annual World Prematurity Day (Nov. 17) in which parents, providers, researchers and others come together to work towards advancements in preventing preterm births. As the number one cause of neonatal death, prematurity is one of the biggest challenges facing obstetrics. Read on for the Top Five facts about prematurity from this week.

11/11/2016 This Week's Top Health Articles

No matter how we spent this past week, we can all agree on one thing: sometimes a hug is all we need to feel better. By far the favorite health article of the week is applicable for men and women: hugs were associated with 32% decreased risk of getting a cold. Other popular article topics for the week included: birth control for men, the cost of healthcare in America, preterm labor & multiples, and the TOLAC calculator.

11/4/2016 This Week’s Must-Read Women’s Health Articles

Welcome to November! It’s hard to believe the fall is coming to a close, especially here in San Francisco where the weather has been sunny! This week’s most popular women’s health articles are all pregnancy and obstetrics-related.  Three of the articles seek to explain risk factors for preterm birth: obesity and prior cesarean delivery. The fourth article provides an update on the fight to curb the spread of Zika, and finally we take a “sunny-side-up” look at OP fetal positioning.

Confused by the 3rd Presidental Debate? What is peri-viable birth?

After the third presidential debate, you may have left scratching your head: what exactly are “partial births”? The Society for Maternal Fetal Medicine and the American College of Obstetricians and Gynecologists recently published a consensus statement on “periviable birth,” which are births between 20 and 25 weeks gestation. Read on to learn exactly why birth at this age is controversial and what interventions are recommended and not. (For the record, I am just assuming that’s what the candidates were discussing. I could be wrong!)