Early pregnancy is one of the most exciting- and nerve-wracking- times for a new mother. Amidst the joy of expecting a new baby are usually worries about whether the pregnancy is healthy and normal. Early pregnancy loss occurs when there is an intrauterine pregnancy either with no embryo or with an embryo without a heartbeat, before 13 weeks. Early pregnancy loss occurs in 15% of clinically recognized pregnancies. Doctors can use levels of the pregnancy hormone hCG and ultrasound to assist in this diagnosis. But how certain is the diagnosis of a healthy versus nonviable early pregnancy? How can we be sure that we do not misdiagnose a viable pregnancy as an early pregnancy loss and intervene inappropriately? Read on to learn about the new ultrasound guidelines meant to increase certainty in diagnosing early pregnancy loss.
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.
In addition to celebrating the wonders of leftover Thanksgiving dinner (how is it possible everything tastes even better 4 days later?), this week was marked by some excellent Women's Health articles. This week's most popular health articles include: ultrasound and IUDs, the Commonwealth Fund healthcare report, ethics and ART, sales reps in the OR, and vaccination requirements.