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.
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.
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.
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.
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.
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!)
Modern medicine is full of wonders, from mechanical ventilators that enable tiny preemies to breathe when their lungs are too small to catheters that deliver all the nutrition a neonate needs to survive the first few weeks. Advances in modern medicine, and particularly in technologies and treatments in the Neonatal Intensive Care Unit (NICU), have drastically increased survival rates. Take the same infant born at 1,000 grams birthweight (2.2 pounds). In 1960, that newborn had a 5% chance of living. In 2000, she had a 95% chance. As advances have enabled more infants to survive this critical period, attention has been directed towards interventions that will improve their long-term outcomes and reduce neurologic disability. Chief amongst these therapies is “therapeutic hypothermia” also known as “head cooling.” What is this intervention and who does it work for?