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.
Everyone who has ever overdosed on entire pint of Ben & Jerry's knows: you can have too much of a good thing. Modern medicine has brought about miracles, increasing our health and lifespans. However, sometimes, medicine can be too much of a good thing. Too many procedures lead to more complications. Too many medications lead to more side effects. Too many hospitalizations lead to more infections. The list goes on and on. So how can we find a balance between too much and too little in OBGYN?
We'd all love to be able to predict the future, especially when it comes to how a baby will be born: by vaginal, operative, or cesarean delivery. A cesarean delivery after labor is significantly more likely to lead to complications like hemorrhage or infection than a scheduled cesarean delivery. However, for the average low-risk woman, a spontaneous vaginal delivery is safer than any cesarean delivery. Obstructed (or stalled) labor is one of the largest contributors to our rising cesarean delivery rate. Therefore, predicting which women will ultimately need a cesarean delivery for obstructed labor could potentially lead to more effective care and possibly fewer complications. One approach to predicting mode of delivery is by analyzing the pelvic muscles as viewed through ultrasound.
A c-section is a c-section is a c-section. Right? Nope. There are a variety of techniques that vary from one surgeon to the next. Most patients do not realize that there are options in the ways to execute certain maneuvers, but there are quite a few for this common surgery. While each obstetrician has her favorite technique, do these variations actually make a difference in outcomes for patients? Thanks to the CORONIS trial, we now have a look into 5 different techniques.