MedWorm: OBGYN

Challenges pediatricians face: barriers to contraception counseling and provision for adolescents

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Pediatricians are the predominant access to medical care for many adolescents newly engaging in sexual activity and seeking contraceptive information. We sought to characterize the nature of and determine barriers to pediatricians' contraception counseling for adolescent patients. (Source: Contraception)

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Intrauterine device as a contraceptive option for adolescents: practices and perceptions among pediatricians

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Pediatricians are among many health care providers who appear reluctant to offer the intrauterine device (IUD) to an adolescent population. We sought to better understand pediatricians' perspectives related to contraception and IUD use for adolescent patients. (Source: Contraception)

Teen magazines: missed opportunities to promote safer sex

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Unintended pregnancy is a major morbidity for adolescents in the United States, fueled partly by inadequate contraception awareness. Teen-targeted magazines with dedicated health sections have been identified as trusted sources of sexual health information to high-volume readerships. The purpose of this study is to assess coverage of pregnancy and contraception in two popular teen magazines, Seventeen and Teen Vogue, to determine the quantity of reproductive health information distributed through this media outlet. (Source: Contraception)

Pregnancy and contraceptive experiences of women living with HIV in Mexico

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Although new HIV infections in Mexico are occurring increasingly among women, little is known about the information and care HIV-positive women receive regarding contraception and pregnancy. We therefore conducted a qualitative study exploring the experiences of women seeking pregnancy and contraception-related medical care. (Source: Contraception)

Development of a reproductive autonomy measure to predict contraceptive use

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

A broad body of research exists on women's empowerment and reproductive outcomes, but measures of women's empowerment rarely include dimensions of reproductive decision-making power. We aimed to develop a theory-based validated instrument to measure women's reproductive empowerment and to assess whether it predicts contraceptive use. (Source: Contraception)

LNG IUD removals when the strings are not present: a case series

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

This study evaluates levonorgestrel intrauterine devices (LNG IUDs) that were removed per patient request when strings were not visible and assesses the length of the IUD strings. (Source: Contraception)

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Incidence of pregnancy after use of emergency contraception in sexually assaulted women

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

This study aims to determine the pregnancy rate among victims of sexual assault who received a single 1.5-mg dose of levonorgestrel as emergency contraception (LNG-EC). In this retrospective descriptive study, charts were reviewed of sexual assault victims seen by our Violence Intervention Program in an urban county hospital between January 2006 and April 2008. Inclusion criteria include women aged 12–39 years who received LNG-EC within 120 h of sexual assault with documentation of a negative urine pregnancy test at the initial visit and with urine pregnancy test results available from the 6-week follow-up visit. The confidence interval (CI) for rape-related pregnancy in our study is based on the binomial distribution. (Source: Contraception)

Assessment of factors affecting use of intrauterine contraceptive device (IUCD) among family planning (FP) clients in Addis Ababa, Ethiopia

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To assess factors affecting use of IUCD among FP clients of health centers in Addis Ababa. (Source: Contraception)

Contraceptive efficacy, safety and acceptability of SILCS, a novel single-sized diaphragm used with contraceptive gel

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To estimate the risk of pregnancy among users of the SILCS diaphragm used with an acid-buffering gel (BG) or nonoxynol-9 (N-9). We conducted a multicenter trial in which 450 couples, 300 randomized to SILCS with BG and 150 to SILCS with N-9, were followed for at least 190 days and six menstrual cycles. Participants were seen at enrollment and after menstrual cycles 1, 3 and 6. Study outcomes included pregnancy probability, safety, acceptability and fitting. (Source: Contraception)

Assessment and promotion of youth-friendly pharmacy practices in San Diego, CA

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To assess the availability and accessibility of reproductive health pharmacy services and products to youth in the City of San Diego, as well as to encourage pharmacies to adopt youth-friendly practices. (Source: Contraception)

Subdermal contraceptive implant: “typical use” in a California managed care setting

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To compare predictors of early removal of subdermal contraceptive implant (SCI) and reported side effects of obese versus nonobese SCI users. This retrospective observational cohort study included 319 Kaiser Permanente Northern California members with SCI insertion between 2/2007 and 2/2010. Demographic (age, race) and clinical [body mass index (BMI), gravidity, parity] characteristics and reported side effects were compared as predictors of early SCI removal. Analysis included χ2 tests, Cox regression hazard models and survival curves. (Source: Contraception)

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Epidemiology of date rape among female undergraduates of the University of Ibadan, Nigeria

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

The study was designed to determine the prevalence of date rape (DR), context in which DR occurs and help-seeking behavior among female undergraduates (FUs) of the University of Ibadan. (Source: Contraception)

Factors predicting LARC continuation in adolescent/young adults vs. adult women

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

The primary aim of this study was to determine factors contributing to 12-month continuation of long-acting reversible contraception (LARC) methods in adolescent/young adult women compared to adult women. (Source: Contraception)

Emergency contraception skills workshop for first-year pharmacy students

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

It is important that pharmacists be willing to dispense oral emergency contraception (OEC) and provide evidence-based counseling. The purpose of this study is to determine whether changes in knowledge, behavior, confidence and professional responsibility (KBCPR) regarding OEC following a novel educational intervention in first-year pharmacy students are maintained after 8 weeks. (Source: Contraception)

An educational commercial sexual exploitation of children prevention Web site: development and pilot testing in an urban family planning teen

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Although 200,000–300,000 youths are at risk for commercial sexual exploitation of children (CSEC) in the United States, no primary prevention efforts aimed at youths exist. In response, we developed and tested a CSEC educational tool for use in a family planning clinic serving teens. The educational tool seeks to impact youths' attitudes toward CSEC victims and support no tolerance toward pimping and its glorification. (Source: Contraception)

Complications of surgical termination of pregnancy in obese versus nonobese women

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To compare the perioperative risks in obese and nonobese women undergoing surgical termination of pregnancy. Retrospective review of all patients who underwent ultrasound-guided pregnancy termination between 6 and 23 weeks' gestation from July 2007 to June 2010. All cases were performed by residents under the supervision of fellowship-trained family planning physicians. Complication rates, operative times and anesthesia times were compared between obese [body mass index (BMI) >30 kg/m2) and nonobese women (BMI (Source: Contraception)

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Contraceptive uptake among women receiving abortion care in a midlevel health facility in Kumasi, Ghana

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To examine background characteristics, exposure to repeat abortion, fertility preferences and postabortion contraceptive uptake among women receiving comprehensive abortion care in a midlevel health facility in Kumasi. (Source: Contraception)

Acceptability and use of postabortion resources by urban women — a pilot study

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To determine if women undergoing abortion would accept and use reference material listing resources for emotional and psychological support. We performed a pilot study in an urban clinic that provides first- and second-trimester abortion. We provided a convenience sample of patients undergoing elective abortion with a brief explanation of a bilingual (English and Spanish) pamphlet and list of prochoice referral Web sites and talk lines. We called participants after 2 months to determine if they liked and used this low-resource intervention. (Source: Contraception)

Comparison of outcomes following IUD insertion: postaspiration abortion vs. interval insertion

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

The primary objective was to determine if there is a difference in the rate of complications following immediate postaspiration abortion versus interval intrauterine device (IUD) insertion. (Source: Contraception)

Intracervical 2% lidocaine gel as an analgesic during intrauterine device insertion: a randomized controlled trial

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Pain during intrauterine device (IUD) insertion can be a barrier to initiation. Clinical trials have found misoprostol and nonsteroidal drugs to be ineffective. One randomized trial found that 2% lidocaine gel placed into the cervix decreased pain; however, problems with study design limit its validity. We tested whether pretreatment with intracervical 2% lidocaine gel decreased insertion pain compared to placebo gel. (Source: Contraception)

Evaluating the clinical competency of nurse practitioners, nurse midwives and physician assistants learning to provide aspiration abortions

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

A combination of self-directed didactic learning and precepted clinical skill development has been used to expand the skill set of nurse practitioners, nurse midwives and physician assistants to perform manual and electric vacuum aspiration as part of the Health Workforce Pilot Project #171 in California. We have used a variety of evaluation methods to ensure that the curricular tools and clinical experiences that have been provided to the trainees produce the expected clinical competency for independent practice. (Source: Contraception)

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Short-term IUD discontinuation at an urban center

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To determine the rate of short-term (12 months) discontinuation of intrauterine contraceptive devices (IUDs) in an urban clinic and to evaluate reasons and possible predictors associated with early discontinuation. (Source: Contraception)

Knowledge, attitudes and practices regarding emergency contraceptive pills among female undergraduate students of Makerere University, Uganda

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To determine knowledge, attitudes and practices regarding emergency contraceptive pills (ECPs) among female undergraduate students of Makerere University, Kampala, Uganda. A cross-sectional study was conducted among 424 female undergraduate students residing in Makerere University. Simple random sampling was used to select the participants. The selected students had to be female, aged 18 years and above and residents. Data were collected through self-administered questionnaires, and confidentiality was enhanced by use of self-adhesive envelopes. Knowledge was measured using multiple choice questions. Attitudes were measured using the Likert scale. Practices were measured using factors associated with past sexual experiences. Data entry and analysis were done using EPI-DATA and SPSS softwa...

Sexually transmitted infection prevalence in women choosing the copper-T 380A IUD for emergency contraception

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

This study determined the sexually transmitted infection (STI) prevalence in women who chose the copper-T 380A IUD for EC. Women presenting for EC who chose the copper IUD had gonorrhea and chlamydia testing prior to IUD insertion. The laboratory results were then compared to a modification of Morrison's historical criteria for STI testing. This included history of prior STI, age (Source: Contraception)

Patient travel time and distance for second-trimester dilation and evacuation in the Intermountain West

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To determine patient travel times and distances for second trimester dilation and evacuation (D&E) in the Intermountain West. We conducted a retrospective case series of all second trimester D&Es at 17 to 23 weeks of gestation performed at a private clinic in Salt Lake City, UT, over a 10-year period using zip code data. (Source: Contraception)

Postpartum unintended pregnancy and contraception use among rural-to-urban migrant women in Shanghai

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

The objectives of this study were to describe the occurrence of postpartum unintended pregnancy and contraception use among a sample of rural-to-urban migrant women in Shanghai and to plan appropriate interventions based on results. (Source: Contraception)

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Identification of charges associated with a tubal ligation (TL) and complications post-TL as well as changes in these variables over time

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To identify the changes in post-TL complications and their associated charges over time. Data were obtained from the i3 Invision™ Data Mart. Data collected spanned the period from January, 2006, through March, 2010. Procedure and diagnosis codes were used to identify patients who received a TL as well as post-TL complications. Patients were also subcategorized based upon year of TL (2007, 2008 or 2009) to examine if there were any noticeable trends over time. (Source: Contraception)

Maternal demographic and clinical variables do not predict IUC placement: evidence for postplacental IUC placement

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Determine if specific demographic and clinical variables are associated with intrauterine contraception (IUC) placement by 8 weeks postpartum. This retrospective cohort study included patients who delivered at Dartmouth-Hitchcock Medical Center (DHMC) (July–December 2008) who identified IUC as their preferred postpartum contraception method and for whom outcome data were available. The DHMC birth log identified patients; then medical records were reviewed for preferred contraception, demographics, medical, obstetric and social histories, and payer status. χ2 analysis was performed for categorical variables. For continuous variables, nonparametric Mann–Whitney U test was performed. For regression modeling, nonparametric continuous variables were categorized. Multivariate regression an...

The Healthy Teens Initiative: a collaborative model for improving access to highly effective contraception for adolescents

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To describe the impact of a collaborative quality improvement model for increasing access to highly effective contraception for adolescents visiting community health centers. The New York City Department of Health and Mental Hygiene's Healthy Teens Initiative led multidisciplinary teams from community health centers through a collaborative program to increase access to contraception among sexually active adolescents. Two cohorts participated: 8 in 2009 (1 was a primary care site) and 10 in 2010 (9 were primary care sites). To assess the impact of the initiative, data were collected to track changes in contraceptive coverage, the proportion of female patients aged 12-19 receiving contraception, and, in QuickStart prevalence, the proportion of visits where contraception was dispensed using ...

Enablers and barriers to abortion training in New York City

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Few obstetrics and gynecology (OB/GYN) programs provide routine abortion training. A 2002 New York City (NYC) political initiative marked the first time a city government provided leadership and financial support for abortion training. We set out to identify enablers and barriers to OB/GYN abortion training in the context of the NYC training initiative from the perspective of a wide range of stakeholders using qualitative methodology. (Source: Contraception)

Efficacy of quercetin in treatment of benign prostatic hyperplasia in a double-blind randomized clinical trial in Iran — 2011

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

In this study, we assessed the efficacy of quercetin drop in alleviating BPH symptoms. (Source: Contraception)

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Efficacy of a self-administered computerized counseling module in improving contraceptive method choice and continuation

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Half of pregnancies in the United States are unplanned, and millions of women are at risk of unintended pregnancy. Interventions are needed to help women choose and use acceptable and effective contraceptive methods. (Source: Contraception)

Differences in birth control use and unintended pregnancy among Latina and white populations giving birth in Utah, 2004–2007

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To examine differences in contraception use and pregnancy intentions among US-born Latinas (USBLs), foreign-born Latinas (FBLs) and non-Latina Whites. Cross-sectional study of data from the Pregnancy Risk Assessment Monitoring System survey linked to birth certificates. Complex survey design and weighting methods were used to analyze data from 190,948 women delivering a singleton, live birth ≥20 weeks gestation from 2004 to 2007 in Utah. (Source: Contraception)

How do young, Black women view birth control and talk to their health care providers about family planning?

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To understand how young, Black women use contraception and conceptualize pregnancy prevention and interactions with their health care providers regarding family planning. We conducted semistructured qualitative interviews with 15 young, Black/African–American women aged 18–23 years. Using techniques informed by grounded theory, we performed line-by-line coding to identify themes across interviews. We analyzed relationships among themes and ways women constructed themselves and interactions with providers. (Source: Contraception)

The availability of behind-the-counter emergency contraception in Atlanta, GA: a comparison of national pharmacy chain policies and their implementation at local stores

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To assess company policy on dispensing practices of levonorgestrel-based emergency contraceptive pills (EC) among national pharmacy companies and local stores' compliance with these policies. (Source: Contraception)

Study of male knowledge and influence on partner emergency contraception (EC) use

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Gather baseline data on men's attitudes, knowledge and beliefs surrounding EC (Source: Contraception)

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Reason for removal of US etonogestrel subdermal implant is significantly associated with age, BMI and postpartum status

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To determine if body mass index (BMI), age and postpartum placement rate differs between etonogestrel implant users who have implant removal for bleeding, desired pregnancy or side effects. (Source: Contraception)

Use of intrauterine contraception among nulliparous adolescents: a qualitative approach to exploring counseling experiences and preferences

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

Intrauterine contraception (IUC) has recently become available to nulliparous adolescents. However, little is known on how health care providers can counsel this population about IUC in such a way that promotes informed decision-making about use of the method. The present study aims to understand the IUC counseling experience and preferences of nulliparous adolescent IUC users in order to develop counseling recommendations that promote informed decision-making about the use of the device. (Source: Contraception)

Contraception and abortion decision-making in Accra, Ghana: the lesser of two evils

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To identify, using a novel vignette-based card-sorting exercise, the key reasons why urban Ghanaian women choose not to contracept and not to abort. A total of 259 women were recruited from antenatal and postnatal clinics at a district hospital in Accra, Ghana. Women completed an interviewer-administered survey that included a vignette-based card-sorting exercise. Women were randomized to hear a vignette about one of two female characters with distinct demographic and reproductive profiles. Through a series of randomized card pairings, women selected key reasons why the characters were not using contraception or were not seeking an abortion. (Source: Contraception)

A time and charge analysis of the management of incomplete abortion with a manual vacuum aspirator in the emergency department versus electric suction curettage in the operating room

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

This study was conducted to determine if MVA in the ED is a more efficient and cost-effective method of managing incomplete abortions. (Source: Contraception)

Complications of intrauterine device placement in postpartum women

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

Postpartum placement of intrauterine devices (IUDs) offers numerous advantages and is associated with high continuation rates. There is a concern that perforation rates may be greatly increased when placement occurs in the early postpartum period ( (Source: Contraception)

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Program assessment of the introduction of Multiload-375 in the family welfare program of the Government of India

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

The intrauterine contraceptive device (IUCD), a widely used reversible contraceptive worldwide, is underutilized in India. The Government of India is attempting to revive the IUCD by introducing the Multiload-375 (ML-375), along with the existing copper-T 380A, in the National Family Planning Program (NFPP). The study aimed to identify operational issues associated with the introduction of the ML-375 in NFPP-supported health facilities. (Source: Contraception)

Serum ethinyl estradiol levels with a low-dose combination transdermal contraceptive (AG200-15) compared with a low-dose combination oral contraceptive

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

To evaluate the pharmacokinetic profile of ethinyl estradiol (EE) from a transdermal contraceptive (AG200-15) compared with a combination oral contraceptive (COC). Healthy women were enrolled in an open-label, comparative, crossover study. Cycle 1 was a run-in cycle with AG200-15 administered to all subjects. Subjects were then randomly assigned to either AG200-15 or COC for one cycle and then crossed over to the other treatment for the next cycle. AG200-15 was applied weekly to the buttock for 3 weeks followed by a patch-free week. The COC was administered for 21 days followed by a pill-free week. Maximum plasma concentration (Cmax), average concentration (calculated at steady state from the 24-h trapezoidal area under the curve) and steady-state concentration (Css) levels for EE measure...

Ulipristal acetate versus low-dose mifepristone for emergency contraception: a systematic review

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

The objective of this systematic review is to assess differences in efficacy and side effect profiles among ulipristal acetate and low-dose mifepristone. (Source: Contraception)

A comparison of sexual behavior and contraceptive use among students in coeducational and non-coeducational secondary schools in Ibadan, Nigeria

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

The school environment provides a setting for sexual interaction between students, which may be different in coeducational (CE) and non-coeducational (NCE) schools, with more risk of unintended pregnancies in CE schools. (Source: Contraception)

Patients' experiences of first-trimester abortion in public facilities in Mexico City: a mixed-methods study 3 years after decriminalization

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

Aims were to understand the knowledge, attitudes and satisfaction of patients of Mexico City's public abortion-care program and to derive recommendations for improving public abortion-care provision. (Source: Contraception)

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Female genital mutilation (FGM) in Sudan: what do men think?

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

To determine men's perception towards FGM and to identify whether men prefer circumcised or noncircumcised women. Anonymous detailed questionnaires were distributed to 300 men in Khartoum, Khartoum North and Omdurman in April 2011. Questions were written in Arabic, and an English translation was also provided. Demographic data collected included age, sex, marital status, religion, tribe and occupation. (Source: Contraception)

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

(Source: Contraception)

Editorial Board

Contraception — Thu, 09 Feb 2012 03:36:54 +0100

(Source: Contraception)

Major Study Finds Miscarriage Risk Higher for Nurses...

NurseZone.com Nursing News — Thu, 09 Feb 2012 02:39:58 +0100

January 27, 2012 - A recent study published by the American Journal of Obstetrics and Gynecology has found the rate of spontaneous abortion in nurses who handle chemotherapy drugs to be twice that in nurses who did not handle these drugs. Past studies have yielded similar results, but this study, done in partnership with National Institute for Occupational Safety and Health (NIOSH) and the Nurses’ Health Study 2, used a significantly larger sample size of nearly 7,000 nurse pregnancies. The study looked at five potentially hazardous exposures: x-rays, chemotherapy drugs, sterilizing agents, anesthetic gases and antiviral drugs. (Source: NurseZone.com Nursing News)

'Untreatable' Gonorrhea Looms, CDC Warns (with audio)

MedPage Today OB/GYN — Thu, 09 Feb 2012 01:43:07 +0100

(MedPage Today) -- Gonorrhea is putting up increasing resistance to the last antibiotic class highly effective against it, the CDC has again warned. (Source: MedPage Today OB/GYN)

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Screening Moms-to-Be for Thyroid Trouble May Not Help Offspring

The Doctors Lounge - Neurology — Wed, 08 Feb 2012 23:00:00 +0100

Study finds intervening early in pregnancy had no effect on children's mental function later (Source: The Doctors Lounge - Neurology)

Umbilical Cord Cleansing Vital For Newborn Health And Survival

Health News from Medical News Today — Wed, 08 Feb 2012 22:00:00 +0100

Two recent studies published in The Lancet indicate that cleansing of the umbilical cord during childbirth could substantially reduce the risk of infection and rate of mortality in babies in developing countries. One of the studies, led by Prof Zulfiqar A Bhutta, Division of Women and Child Health, The Aga Khan University, assessed whether or not umbilical cord cleansing with 4% chlorhexidine (CHX) solution had any effect on the rate of cord infection (omphalitis) and neonatal mortality in babies... (Source: Health News from Medical News Today)

Arterial Microcalcifications in the Breast Mimicking Malignancy

Advances in Pharmacological Sciences — Wed, 08 Feb 2012 18:37:00 +0100

Microcalcifications in the breast are highly suggestive of malignancy; they can occur in many pathological conditions. A 36-years-old nondiabetic woman came to the gynaecologist with a suspect palpable mass in the upper outer quadrant of the right breast. Histopathological examination confirmed a calcification of a small artery (diameter: 0.45 mm). Arterial calcifications can mimic a malignant lesion in the breast. (Source: Advances in Pharmacological Sciences)

Female Soccer Players May Face Health Problems: Study

Gynecology News - Doctors Lounge — Wed, 08 Feb 2012 18:00:00 +0100

Intense training, poor nutrition might lead to menstrual abnormalities, stress fractures in young players (Source: Gynecology News - Doctors Lounge)

Kenya: Turkana Women Prefer Giving Birth At Home - Medical Officer

AllAfrica News: Pregnancy and Childbirth — Wed, 08 Feb 2012 16:55:08 +0100

[Nairobi Star] MORE women in Turkana county give birth at home compared tothose who deliver in hospitals, area medical officer Joseph Epem hassaid. Epem attributed this to high illiteracy level, hugegeographical area of the county and poverty. Epem said the nearest medicalfacility is over 50km away from where people reside. "Turkana county is 77,000 km and health facilities are scarce bearing in mind that most of the roads are impassable,"Epem said. (Source: AllAfrica News: Pregnancy and Childbirth)

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Health Tip: Coping With Migraines During Pregnancy

The Doctors Lounge - Neurology — Wed, 08 Feb 2012 13:00:00 +0100

Here's what you can do (Source: The Doctors Lounge - Neurology)

Nigeria: FG to Probe Maternal and Infant Deaths

AllAfrica News: Pregnancy and Childbirth — Wed, 08 Feb 2012 11:38:36 +0100

[Daily Trust] The Federal Government will probe all incidences of maternal and infant deaths in the country as a means closing gaps associated with the midwives scheme and meet MDGs goal 4 and 5. (Source: AllAfrica News: Pregnancy and Childbirth)

Nigeria: Oshiomhole Vows to Combat Infant Mortality

AllAfrica News: Pregnancy and Childbirth — Wed, 08 Feb 2012 11:23:30 +0100

[Vanguard] Benin - EDO State Governor, Mr Adams Oshiomhole, has expressed dismay over the increasing cases of infant mortality in the state and promised to ensure that modern facilities were provided in state hospitals to check the trend. (Source: AllAfrica News: Pregnancy and Childbirth)

Kenya: WHO Experts Now Fail to Agree On Contraceptives

AllAfrica News: Pregnancy and Childbirth — Wed, 08 Feb 2012 10:39:34 +0100

[Nairobi Star] Health experts have failed to agree on the use of injectable contraceptives, which were linked to increased HIV infections in Kenya. World Health Organisation said the decision will now be made when another team meets on February 15. (Source: AllAfrica News: Pregnancy and Childbirth)

South Africa: Cry the Beloved Province

AllAfrica News: Pregnancy and Childbirth — Wed, 08 Feb 2012 10:30:22 +0100

[Health-e] There has been an increase in newborn baby deaths and newborns with brain damage at Chris Hani Baragwanath (CHB) Hospital's labour ward since November, including two avoidable stillbirths, as a staffing crisis linked to non-payment of nursing agencies hit the academic hospital. (Source: AllAfrica News: Pregnancy and Childbirth)

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Severe postpartum haemorrhage and mode of delivery: a retrospective cohort study

BJOG: An International Journal of Obstetrics and Gynaecology — Wed, 08 Feb 2012 05:00:00 +0100

Conclusion Compared with intended vaginal delivery, planned caesarean delivery was associated with a reduced risk of severe postpartum haemorrhage indicated by use of red blood cell transfusion. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Regeneration of uterine cervix at 6 months after large loop excision of the transformation zone for cervical intraepithelial neoplasia

BJOG: An International Journal of Obstetrics and Gynaecology — Wed, 08 Feb 2012 05:00:00 +0100

Conclusions Cervical regeneration at 6 months after excision is dependent on the percentage of initial cervical volume excised and on the remaining cervical tissue immediately after conisation. The greater the cone and the less cervical tissue remaining, the less the degree of cervical regeneration achieved. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Gender Differences in Health Service Utilization Among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder

Journal of Women — Wed, 08 Feb 2012 04:02:50 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

New Antibiotic for Bladder Infection Disappoints in Trial

Gynecology News - Doctors Lounge — Tue, 07 Feb 2012 22:00:00 +0100

But other drugs can still get the job done, experts say (Source: Gynecology News - Doctors Lounge)

Africa: Obstetric Fistula Fact Sheet

AllAfrica News: Pregnancy and Childbirth — Tue, 07 Feb 2012 17:38:06 +0100

[Worldwide Fistula Fund] Obstetric fistula, also known as vesicovaginal or rectovaginal fistula, is a debilitating condition resulting from prolonged, obstructed and/or unassisted labor that affects women in developing nations. The World Health Organization estimates that more than two million women are currently suffering from untreated obstetric fistula in Asia and Africa. (Source: AllAfrica News: Pregnancy and Childbirth)

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The Need for Gynecologic Follow-Up Among Women Veterans: The Association of Sexual Assault and Abnormal Cervical Cytology

Journal of Women — Tue, 07 Feb 2012 17:08:20 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Nigeria: Oshiomhole Decries Increase in Child Mortality

AllAfrica News: Pregnancy and Childbirth — Tue, 07 Feb 2012 13:51:55 +0100

[Vanguard] Benin City - OVERNOR Adams Oshiomhole of Edo State has decried what he described as the increase in child related deaths and promised to ensure that modern facilities were provided in the hospitals across the state to check the trend. (Source: AllAfrica News: Pregnancy and Childbirth)

Eritrea: Health Station in Aimen Rendering Commendable Pre-and Post-Delivery Care Service

AllAfrica News: Pregnancy and Childbirth — Tue, 07 Feb 2012 11:53:41 +0100

[Shabait] Assab - The health station in Aimen administrative area, Southern Red Sea region, is rendering commendable service particularly in pre-and post-delivery service. (Source: AllAfrica News: Pregnancy and Childbirth)

Eritrea: Health Service to Mothers and Pregnant Women in Massawa Sub-Zone Registering Satisfactory Outcome

AllAfrica News: Pregnancy and Childbirth — Tue, 07 Feb 2012 10:01:04 +0100

[Shabait] Massawa - Health service provided to mothers and pregnant women at Amatere Mother and Childcare Center in Massawa has registered satisfactory outcome, reports indicated.The beneficiaries commended the devotion of professionals at the center. (Source: AllAfrica News: Pregnancy and Childbirth)

Non-Invasive DNA Test That Identifies Down Syndrome In Pregnancy Can Also Detect Trisomy 18 And Trisomy 13

Health News from Medical News Today — Tue, 07 Feb 2012 08:00:00 +0100

A newly available DNA-based prenatal blood test that can identify a pregnancy with Down syndrome can also identify two additional chromosome abnormalities: trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome).The test for all three defects can be offered as early as 10 weeks of pregnancy to women who have been identified as being at high risk for these abnormalities. These are the results of an international, multicenter study published on-line today in the journal Genetics in Medicine... (Source: Health News from Medical News Today)

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Health Highlights: Feb. 6, 2012

MedicineNet Womens Health General — Tue, 07 Feb 2012 07:00:00 +0100

Title: Health Highlights: Feb. 6, 2012Category: Health NewsCreated: 2/6/2012 2:05:00 PMLast Editorial Review: 2/7/2012 (Source: MedicineNet Womens Health General)

Insomnia

MedicineNet Womens Health General — Tue, 07 Feb 2012 07:00:00 +0100

Title: InsomniaCategory: Diseases and ConditionsCreated: 6/6/2005Last Editorial Review: 2/7/2012 (Source: MedicineNet Womens Health General)

Clinical utility of array comparative genomic hybridisation for prenatal diagnosis: a cohort study of 3171 pregnancies

BJOG: An International Journal of Obstetrics and Gynaecology — Tue, 07 Feb 2012 05:00:00 +0100

Conclusion Prenatal array CGH is effective in screening for submicroscopic genomic imbalance. Array CGH may add 8.2% to the diagnostic field, compared with conventional karyotyping, for fetuses with abnormal ultrasound results, and is particularly useful in fetuses with karyotypic balanced translocation or marker chromosomes. There is a 0.52% baseline risk of submicroscopic genomic imbalance, even in women with an uneventful prenatal examination. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Full‐length visfatin levels are associated with inflammation in women with polycystic ovary syndrome

European Journal of Clinical Investigation — Tue, 07 Feb 2012 02:06:28 +0100

Conclusion Our results suggest that circulating visfatin levels correlate with WBC and CRP but are not associated with PCOS, obesity or metabolic markers, suggesting that visfatin may act as a proinflammatory cytokine. (Source: European Journal of Clinical Investigation)

Smoking May Be Especially Tough on Men’s Brains

Gynecology News - Doctors Lounge — Mon, 06 Feb 2012 22:00:00 +0100

Study found declines in thinking skills for males, but not females (Source: Gynecology News - Doctors Lounge)

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Human Papillomavirus Vaccination Practices Among Providers in Indian Health Service, Tribal and Urban Indian Healthcare Facilities

Journal of Women — Mon, 06 Feb 2012 21:47:50 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Perinatal Depression Screening and Intervention: Enhancing Health Provider Involvement

Journal of Women — Mon, 06 Feb 2012 21:47:46 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Maternal mortality due to trauma. - Romero VC, Pearlman M.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of al... (Source: SafetyLit: All (Unduplicated))

Nigeria: The Joy and Sorrow of Fatima's Strange Birth

AllAfrica News: Pregnancy and Childbirth — Mon, 06 Feb 2012 11:18:40 +0100

[Leadership] The ecstasy of a Bauchi peasant family was cut short when their baby girl was born without the vital parts of hands and legs. NAJIB SANI, reports (Source: AllAfrica News: Pregnancy and Childbirth)

Tanzania: Campaign Against Fistula Gets Boost

AllAfrica News: Health and Medicine — Mon, 06 Feb 2012 09:23:53 +0100

[Daily News] VODACOM Tanzania in collaboration with CCBRT yesterday launched a nationwide campaign to raise more than 1bn/- from the public in support of maternal healthcare for women suffering from obstetric fistula. (Source: AllAfrica News: Health and Medicine)

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Kenya: Couples Turn to Donated Eggs to Have Babies

AllAfrica News: Pregnancy and Childbirth — Mon, 06 Feb 2012 09:04:37 +0100

[Nation] The number of women seeking eggs donated by other women to have children of their own is on the rise in Kenya, if the trend at the Nairobi IVF Centre is anything to go by. (Source: AllAfrica News: Pregnancy and Childbirth)

Kenya: Prepare Your Child for the New Born

AllAfrica News: Pregnancy and Childbirth — Mon, 06 Feb 2012 07:51:23 +0100

[Nation] The arrival of a new born usually is a joyful affair. It also brings about changes in the family dynamics which can confuse, scare or make an older sibling feel displaced. (Source: AllAfrica News: Pregnancy and Childbirth)

Diabetes Takes Toll on Women's Hearing: Study

MedicineNet Womens Health General — Mon, 06 Feb 2012 07:00:00 +0100

Title: Diabetes Takes Toll on Women's Hearing: StudyCategory: Health NewsCreated: 2/3/2012 4:06:00 PMLast Editorial Review: 2/6/2012 (Source: MedicineNet Womens Health General)

fluorouracil topical, Carac, Efudex, Fluoroplex

MedicineNet Womens Health General — Mon, 06 Feb 2012 07:00:00 +0100

Title: fluorouracil topical, Carac, Efudex, FluoroplexCategory: MedicationsCreated: 9/30/2001 2:36:00 PMLast Editorial Review: 2/6/2012 (Source: MedicineNet Womens Health General)

Screening mammography beliefs and recommendations: a web-based survey of primary care physicians

BMC Health Services Research — Mon, 06 Feb 2012 05:00:00 +0100

This study explored primary care physicians' (PCPs) perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to the hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before recently revised United States Preventive Services Task Force (USPSTF) guidelines. Methods: A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684); (41%) 271 family physicians (FP), (36%) 232 general internal medicine physicians (IM), (23%) 150 obstetrician-gynaecologists (OBG), and (0.2%) 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in respon...

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Heavy smoking during pregnancy as a marker for other risk factors of adverse birth outcomes: a population-based study in British Columbia, Canada

BMC Public Health - Latest articles — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: Our data suggests that self reports of heavy smoking early in pregnancy could be used as a marker for lifestyle risk factors that in combination with smoking influence birth outcomes. This information may be used for planning targeted intervention programs for not only smoking cessation, but potentially other support services such as nutrition and healthy pregnancy education. (Source: BMC Public Health - Latest articles)

Depression medications during pregnancy increase newborn’s hypertension risk

MedWire News - Ob/Gyn — Mon, 06 Feb 2012 03:31:01 +0100

Use of selective serotonin reuptake inhibitors during late pregnancy to treat depression more than doubles the risk for persistent pulmonary hypertension in the newborn, researchers say. (Source: MedWire News - Ob/Gyn)

Fluvoxamine/risperidone: Gynaecomastia and galactorrhoea: case report

Reactions — Sun, 05 Feb 2012 18:29:54 +0100

(Source: Reactions)

Attention Deficit Hyperactivity Symptoms and Risky Sexual Behavior in Young Adult Women

Journal of Women — Sat, 04 Feb 2012 04:09:40 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Asthmatic Moms Who Breast-feed May Help Their Children’s Lungs

The Doctors Lounge - Health News — Fri, 03 Feb 2012 22:00:00 +0100

At age 12, those kids had better lung function than formula-fed kids (Source: The Doctors Lounge - Health News)

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Epidural Plus Fever in Mom May Raise Risks for Baby

The Doctors Lounge - Infections — Fri, 03 Feb 2012 20:00:00 +0100

Study found as mother's temperature rose, problems were more likely at birth (Source: The Doctors Lounge - Infections)

Vaginal repair of supratrigonal vesicovaginal fistulae—a 10-year review

International Urogynecology Journal — Fri, 03 Feb 2012 17:11:02 +0100

Conclusions Majority of supratrigonal VVF can be approached vaginally with success rate comparable to abdominal approach. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00192-012-1665-7Authors N. Rajamaheswari, Department of Urogynecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai, 600005 IndiaArchana Bharti, Department of Urogynecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai, 600005 IndiaK. Seethalakshmi, Department of Urogynecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai, 600005 India Journal International Urogyn...

Urogynecology digest

International Urogynecology Journal — Fri, 03 Feb 2012 17:10:49 +0100

Content Type Journal ArticleCategory Urogynecology DigestPages 1-2DOI 10.1007/s00192-012-1674-6Authors Alexandros Derpapas, Department of Urogynaecology, St Mary’s Hospital, Imperial College Healthcare NHS London, London, UK Journal International Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urogynecology Journal)

Underuse of Aspirin for Primary and Secondary Prevention of Cardiovascular Disease Events in Women

Journal of Women — Fri, 03 Feb 2012 16:36:29 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Health Tip: Prepare for Breast-feeding

Pediatrics News - Doctors Lounge — Fri, 03 Feb 2012 13:00:00 +0100

Suggestions for getting ready (Source: Pediatrics News - Doctors Lounge)

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UNFPA 2011 Maternal Health Highlights - 05 January 2012

UNFPA News — Fri, 03 Feb 2012 12:20:46 +0100

It was a busy, successful year for UNFPA as it continued to work in 2011 with partners to address universal access to reproductive health, including maternal health, treatment for obstetric fistula and family planning, and to improve the lives of women and young people around the world. (Source: UNFPA News)

Childhood blood lead levels and intellectual development after ban of leaded gasoline in Taiwan: A 9-year prospective study.

Environment International — Fri, 03 Feb 2012 09:48:12 +0100

CONCLUSIONS: Low-level postnatal BPb levels in children at 2-5years may have lagged effects on neurodevelopment in those at 5 to 8years. Action is warranted to reduce even very low environmental Pb levels to reduce the developmental burden of Pb on children. PMID: 22280932 [PubMed - in process] (Source: Environment International)

New Heart Failure Risks: Fractures and Memory Problems

MedicineNet Womens Health General — Fri, 03 Feb 2012 07:00:00 +0100

Title: New Heart Failure Risks: Fractures and Memory ProblemsCategory: Health NewsCreated: 2/3/2012 11:01:00 AMLast Editorial Review: 2/3/2012 (Source: MedicineNet Womens Health General)

Sex and the Elderly: STD Risk Often Ignored

MedicineNet Womens Health General — Fri, 03 Feb 2012 07:00:00 +0100

Title: Sex and the Elderly: STD Risk Often IgnoredCategory: Health NewsCreated: 2/3/2012 11:00:00 AMLast Editorial Review: 2/3/2012 (Source: MedicineNet Womens Health General)

Married Men Seek Help for Stroke Sooner Than Their Wives

MedicineNet Womens Health General — Fri, 03 Feb 2012 07:00:00 +0100

Title: Married Men Seek Help for Stroke Sooner Than Their WivesCategory: Health NewsCreated: 2/2/2012 6:06:00 PMLast Editorial Review: 2/3/2012 (Source: MedicineNet Womens Health General)

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Impact of maternal characteristics on fetal growth in the third trimester of pregnancy. A population-based study.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions. Fetal third trimester growth was positively associated with increasing maternal BMI, height, and pre-existing diabetes mellitus, and was negatively associated with maternal smoking. No significant association between fetal growth and maternal parity or gestational diabetes mellitus was detected when adjustments were made for gestational age and the other maternal characteristics. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302307 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

A population-based review of tetralogy of fallot with absent pulmonary valve: is prenatal diagnosis really associated with a poor prognosis?

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: This study was a population-based retrospective analysis of TETAPV cases identified over three decades. The prognosis of TETAPV is better than that previously reported in the obstetric literature. This information should be used to guide prenatal counseling. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302386 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Prospective risk of late stillbirth in monochorionic twins: a regional cohort study.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: The risk of stillbirth in MC twins does not appear to increase significantly near term. This observation may be due to a policy of routine surveillance and elective delivery from 36 weeks, the data does support a policy of elective birth before 36 weeks' gestation in MC pregnancies. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302586 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Arterio-Arterial Anastomosis Rescues Early Onset A/REDV in Monochorionic Diamniotic Twin.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Lin T, Lin C, Shih J, Su Y, Wu E, Lee C PMID: 22302609 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Neurodevelopmental delay in small babies at term. A systematic review.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Arcangeli T, Thilaganathan B, Hooper R, Khan KS, Bhide A Abstract Background: Being small for gestational age (SGA) or having fetal growth restriction (FGR) may be associated with poorer neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper was to evaluate the existence and magnitude of decrease in neurodevelopmental scores in SGA and FGR infants born at term from a systematic review of the existing literature. Methods: Studies of neurodevelopment in SGA/FGR babies were identified from a search of the internet scientific databases. Studies which included preterm births and those that did not define absolute indices of standardised cognitive outcome were excluded. SGA was defined as birthweight below the 10(th) centile fo...

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Four-dimensional STIC / Volumetric Doppler impedance indices from spherical samples of the placenta: intra-observer reliability study and correlation with conventional umbilical artery Doppler indices.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion Volumetric impedance indices assessed from spherical samples of placenta are sufficiently reliable but they do not correlate with UA Doppler indices in healthy pregnancies. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302650 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

A Clinical Trial of Ultrasound Treatment for TRAP Sequence.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

We present a case of TRAP sequence for which high-intensity focused ultrasound (HIFU) was applied as a totally non-invasive fetal therapy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302667 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Effect of letrozole on the uterine Doppler flow indices during early pregnancy: a randomised trial.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: We demonstrated that the use of letrozole in first trimester pregnancy suppressed serum estradiol level, but resulted in an increase in blood flow to the uterus. Further studies should be carried out to elucidate the mechanism of letrozole pretreatment in medical abortion. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302719 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Can we identify the limits of the puborectalis/ pubovisceralis muscle on tomographic translabial ultrasound?

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: On standardised tomographic imaging of the levator hiatus and muscle, slices located 1 cm or more over the plane of minimal dimensions are very likely to contain iliococcygeus rather than puborectalis/ pubovisceralis muscle. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302734 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

An easier approach to fetal head direction quantification using transperineal ultrasound.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Iliescu D, Adam G, Tudorache S, Antsaklis P, Cernea N PMID: 22302748 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

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Prefrontal Space Ratio: comparison between trisomy 21 and euploid fetuses in the second trimester.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: The PFSR appears to be a highly sensitive and specific marker of trisomy 21 in the second-trimester of pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302766 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Radio Frequency Ablation vs. Bipolar Umbilical Cord Coagulation in the Management of Complex Monochorionic Pregnancies.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

CONCLUSION: Despite the smaller caliber of the instrument, RFA is not associated with a decrease in the overall complication rate for selective termination procedures. The technique used for selective termination should still be determined by technical considerations but patients should be informed of the survival associated with each technique. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 22302774 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Pitfalls for diagnosis of uterine artery pseudoaneurysm after cesarean section.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Bouchet P, Chabrot P, Fontarensky M, Delabaere A, Bonnin M, Gallot D PMID: 22302777 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Rare Combination of Exomphalos with Umbilical Cord Teratoma.

The Ultrasound Review of Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Keene DJ, Shawkat E, Gillham J, Craigie RJ PMID: 22302782 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Prospective risk of late stillbirth in monochorionic twins: a regional cohort study

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

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Arterio‐Arterial Anastomosis Rescues Early Onset A/REDV in Monochorionic Diamniotic Twin

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Ultrasound in Obstetrics and Gynecology)

Neurodevelopmental delay in small babies at term. A systematic review

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

AbstractBackground: Being small for gestational age (SGA) or having fetal growth restriction (FGR) may be associated with poorer neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper was to evaluate the existence and magnitude of decrease in neurodevelopmental scores in SGA and FGR infants born at term from a systematic review of the existing literature.Methods: Studies of neurodevelopment in SGA/FGR babies were identified from a search of the internet scientific databases. Studies which included preterm births and those that did not define absolute indices of standardised cognitive outcome were excluded. SGA was defined as birthweight below the 10th centile for gestation and FGR as the same birthweight standard with abnormal umbilical a...

Four‐dimensional STIC / Volumetric Doppler impedance indices from spherical samples of the placenta: intra‐observer reliability study and correlation with conventional umbilical artery Doppler indices

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

A Clinical Trial of Ultrasound Treatment for TRAP Sequence

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

We present a case of TRAP sequence for which high‐intensity focused ultrasound (HIFU) was applied as a totally non‐invasive fetal therapy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Source: Ultrasound in Obstetrics and Gynecology)

Effect of letrozole on the uterine Doppler flow indices during early pregnancy: a randomised trial

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

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Can we identify the limits of the puborectalis/ pubovisceralis muscle on tomographic translabial ultrasound?

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

An easier approach to fetal head direction quantification using transperineal ultrasound

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Ultrasound in Obstetrics and Gynecology)

Prefrontal Space Ratio: comparison between trisomy 21 and euploid fetuses in the second trimester

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: The PFSR appears to be a highly sensitive and specific marker of trisomy 21 in the second‐trimester of pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Source: Ultrasound in Obstetrics and Gynecology)

Radio Frequency Ablation vs. Bipolar Umbilical Cord Coagulation in the Management of Complex Monochorionic Pregnancies

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Pitfalls for diagnosis of uterine artery pseudoaneurysm after cesarean section

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Ultrasound in Obstetrics and Gynecology)

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Rare Combination of Exomphalos with Umbilical Cord Teratoma

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Ultrasound in Obstetrics and Gynecology)

Impact of maternal characteristics on fetal growth in the third trimester of pregnancy. A population‐based study

Ultrasound in Obstetrics and Gynecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions. Fetal third trimester growth was positively associated with increasing maternal BMI, height, and pre‐existing diabetes mellitus, and was negatively associated with maternal smoking. No significant association between fetal growth and maternal parity or gestational diabetes mellitus was detected when adjustments were made for gestational age and the other maternal characteristics. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Source: Ultrasound in Obstetrics and Gynecology)

Disproportionate body composition and perinatal outcome in large‐for‐gestational‐age infants to mothers with type 1 diabetes

BJOG: An International Journal of Obstetrics and Gynaecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions High birthweight, irrespective of body proportionality, is a risk factor for neonatal complications in offspring of women with type 1 diabetes. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

The impact of maternal body mass index on the phenotype of pre‐eclampsia: a prospective cohort study

BJOG: An International Journal of Obstetrics and Gynaecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions Among women with pre‐eclampsia, those who are overweight or obese in early pregnancy are not more likely to have term pre‐eclampsia compared with women with a normal BMI. Overweight and obese women require vigilant surveillance for the development of preterm as well as term pre‐eclampsia. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Agreement between colposcopic impression and histological diagnosis among human papillomavirus type 16‐positive women: a clinical trial using dynamic spectral imaging colposcopy

BJOG: An International Journal of Obstetrics and Gynaecology — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions The sensitivity of DSI colposcopy for CIN2+ is higher in HPV16+ than in non‐16 hrHPV+ women. Furthermore, regardless of HPV16 status, the sensitivity of DSI for CIN2+ is higher than that of the colposcopist, probably because colposcopists tend to miss smaller cervical lesions. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

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Visceral hypersensitivity in endometriosis: a new target for treatment?

Gut — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion Visceral hypersensitivity is extremely common in endometriosis and could be intensifying the pain. This finding might explain why mildly affected individuals often complain of severe symptoms out of proportion to the extent of their disease. This study has introduced a completely new concept into the understanding of pain in endometriosis and could open up new opportunities for treatment. (Source: Gut)

Uganda: Taking Care of a Birth Tear

AllAfrica News: Pregnancy and Childbirth — Fri, 03 Feb 2012 04:17:35 +0100

[Monitor] Mariam Namaganda, 37, a small scale business owner with four children, got a birth tear while giving birth to her fourth child. "I gave birth to a baby girl last year in June. But before, I had serious labour pains that forced me to go to hospital at night because I knew time had come for me to have my baby." (Source: AllAfrica News: Pregnancy and Childbirth)

Subject Index

International Journal of Gynaecology and Obstetrics — Fri, 03 Feb 2012 03:46:17 +0100

(Source: International Journal of Gynaecology and Obstetrics)

Author Index

International Journal of Gynaecology and Obstetrics — Fri, 03 Feb 2012 03:46:17 +0100

(Source: International Journal of Gynaecology and Obstetrics)

John J. Sciarra Prize Paper Award for 2012

International Journal of Gynaecology and Obstetrics — Fri, 03 Feb 2012 03:46:17 +0100

(Source: International Journal of Gynaecology and Obstetrics)

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Effect of Terbutaline on Latency Period in Preterm Premature Rupture of Membranes

Gynecologic and Obstetric Investigation — Thu, 02 Feb 2012 23:00:00 +0100

Gynecol Obstet Invest (DOI:10.1159/000331661) (Source: Gynecologic and Obstetric Investigation)

Countertransference: When Is Yours Mine?

Psychology Today Depression Center — Thu, 02 Feb 2012 22:21:37 +0100

Meeting Lyn and Rob was hard from the start. I knew from her phone message that they had lost their dear son after nine months gestation, during delivery. It never gets any easier even after years of hearing one very sad story after another. "He was perfect," she sat close to her husband in my office and shook her head in disbelief.read more (Source: Psychology Today Depression Center)

Africa: Empowering Women to Fight HIV

AllAfrica News: HIV-Aids and STDs — Thu, 02 Feb 2012 22:10:51 +0100

[allAfrica.com] What makes a young African doctor decide to devote her career to helping women fight HIV? Dr. Sengeziwe Sibeko is a 37-year-old medical researcher with a degree in obstetrics and gynecology from the University of KwaZulu Natal (UKZN) in South Africa, an MSc in epidemiology from Columbia University in the United States, and is about to take up a fellowship to study for her PhD at Oxford University in the United Kingdom. AllAfrica's Julie Frederikse interviewed Dr. Sibeko at the (Source: AllAfrica News: HIV-Aids and STDs)

Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses

International Urogynecology Journal — Thu, 02 Feb 2012 18:15:41 +0100

Conclusions Preoperative diagnosis using exam, MRI, and cystourethroscopy have a high diagnostic accuracy for anterior vaginal wall masses. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00192-012-1666-6Authors Tirsit S. Asfaw, Department of Obstetrics and Gynecology, Division of Urogynecology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, J-130, New York, NY 10065, USAJoy A. Greer, Department of Obstetrics and Gynecology, Division of Urogynecology, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104-3339, USAParvati Ramchandani, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine at t...

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Estrogen suppresses expression of the matrix metalloproteinase inhibitor reversion-inducing cysteine-rich protein with Kazal motifs (RECK) within the mouse uterus

Endocrine — Thu, 02 Feb 2012 18:15:13 +0100

Abstract RECK (reversion-inducing cysteine-rich protein with Kazal motifs) is a membrane-anchored glycoprotein which regulates MMP2 and MMP9 activity and has been proposed to play a role in embryo implantation while misexpression of RECK has been associated with a variety of carcinomas. Unfortunately, understanding on the steroidal regulation of uterine RECK is lacking. To address this gap in our knowledge, we examined steroidal regulation and cellular expression of Reck mRNA and protein within the mouse uterus in vivo. Uterine Reck mRNA and protein were decreased by estrogen, while progesterone alone had no effect. The estrogen-induced down regulation could be partially blocked by progesterone. RECK was localized primarily to luminal and glandular epithelial cells and the ...

Vitamin E effect on controlled ovarian stimulation of unexplained infertile women

Journal of Assisted Reproduction and Genetics — Thu, 02 Feb 2012 18:13:00 +0100

Conclusion Vit E administration may improve the endometrial response in unexplained infertile women via the likely antioxidant and the anticoagulant effects. It may also modulate the antiestrogenic effect of clomiphene citrate and the problem of a thin endometrium in these cycles may be adjusted. Content Type Journal ArticleCategory ASSISTED REPRODUCTION TECHNOLOGIESPages 1-4DOI 10.1007/s10815-012-9714-1Authors Nedim Cicek, Zekai Tahir Burak Women Education and Research Hospital, Obstetrics and Gynecology, Devlet Mah. Subay Loj.Hızırreis Apt.No:19/11 Yenisehir, Ankara, TurkeyOzlem Gun Eryilmaz, Zekai Tahir Burak Women Education and Research Hospital, Obstetrics and Gynecology, Devlet Mah. Subay Loj.Hızırreis Apt.No:19/11 Yenisehir, Ankara, TurkeyEsma Sarikaya, Z...

Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial

Clinical Oral Investigations — Thu, 02 Feb 2012 18:12:31 +0100

Conclusions Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00784-012-0679-3Authors Patricia Weidlich, Section of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, Bra...

The use of novel hemostatic sealant (Tisseel®) in laparoscopic myomectomy: a case–control study

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:53 +0100

Conclusions The use of Tisseel® during LM may represent a valid alternative solution for obtaining hemostasis, reducing intra- and postoperative bleeding. Furthermore, it may help the surgeon to obtain a rapid healing of the injured surfaces, probably reducing the use of electrocoagulation and traumatisms. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2154-2Authors Roberto Angioli, Department of Obstetrics and Gynecology, “Campus Bio Medico” University of Rome, Via Álvaro del Portillo, 200-00128 Rome, ItalyFrancesco Plotti, Department of Obstetrics and Gynecology, “Campus Bio Medico” University of Rome, Via Álvaro del Portillo, 200-00128 Rome, ItalyRoberto Ricciardi, Department of Obstetrics and Gynecology, “Campus Bio Medico” University...

Prolonged propriospinal myoclonus following spinal anesthesia for cesarean section: case report and literature review

Archives of Gynecology and Obstetrics — Thu, 02 Feb 2012 17:57:19 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00404-012-2246-1Authors Anna Lev, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, POB 3235, 91031 Jerusalem, IsraelIsabell Korn-Lubezki, Department of Neurology, Shaare Zedek Medical Center, Jerusalem, IsraelBettina Steiner-Birmanns, Department of Neurology, Shaare Zedek Medical Center, Jerusalem, IsraelArnon Samueloff, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, IsraelYaakov Gozal, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, POB 3235, 91031 Jerusalem, IsraelAlexander Ioscovich, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zede...

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The effect of micronutrient supplements on female fertility: a systematic review

Archives of Gynecology and Obstetrics — Thu, 02 Feb 2012 17:57:18 +0100

Conclusion Although some studies suggest possible effects of micronutrients on female fertility general recommendations are not possible since all studies had methodological or statistical limitations. Further investigations using evidence-based criteria are necessary to analyze and to confirm these non-evident appearances. Content Type Journal ArticleCategory Reproductive MedicinePages 1-9DOI 10.1007/s00404-012-2237-2Authors Donata Grajecki, Department of Gynecological Endocrinology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, GermanyBirgit-Christine Zyriax, Endocrinology and Metabolism of Ageing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, GermanyKai J. Buhling, Department of Gynecological Endocrin...

Somalia: Mortality Rates Among World's Highest

AllAfrica News: Pregnancy and Childbirth — Thu, 02 Feb 2012 14:21:30 +0100

[IRIN] Hargeisa - The self-declared Republic of Somaliland is grappling with high child and maternal mortality rates, malnutrition and inadequate medical personnel, health officials told IRIN. (Source: AllAfrica News: Pregnancy and Childbirth)

Mozambique: Maputo Seeking to Reduce Maternal Mortality

AllAfrica News: Pregnancy and Childbirth — Thu, 02 Feb 2012 10:40:16 +0100

[AIM] Maputo - The Maputo City Health Directorate plans to reduce the maternal mortality ratio to 30 deaths per 100,000 births by the end of 2015. (Source: AllAfrica News: Pregnancy and Childbirth)

During Pregnancy, Consuming Fish Improves Offspring's Cognitive Development And Prosocial Conduct

Health News from Medical News Today — Thu, 02 Feb 2012 09:00:00 +0100

This study was conducted within the framework of the NUTRIMENTHE project ("Effect of diet on offspring's cognitive development"), which received funding of 5... (Source: Health News from Medical News Today)

MedWorm: OBGYN

Challenges pediatricians face: barriers to contraception counseling and provision for adolescents

Intrauterine device as a contraceptive option for adolescents: practices and perceptions among pediatricians

Teen magazines: missed opportunities to promote safer sex

Pregnancy and contraceptive experiences of women living with HIV in Mexico

Development of a reproductive autonomy measure to predict contraceptive use

LNG IUD removals when the strings are not present: a case series

Incidence of pregnancy after use of emergency contraception in sexually assaulted women

Assessment of factors affecting use of intrauterine contraceptive device (IUCD) among family planning (FP) clients in Addis Ababa, Ethiopia

Contraceptive efficacy, safety and acceptability of SILCS, a novel single-sized diaphragm used with contraceptive gel

Assessment and promotion of youth-friendly pharmacy practices in San Diego, CA

Subdermal contraceptive implant: “typical use” in a California managed care setting

Epidemiology of date rape among female undergraduates of the University of Ibadan, Nigeria

Factors predicting LARC continuation in adolescent/young adults vs. adult women

Emergency contraception skills workshop for first-year pharmacy students

An educational commercial sexual exploitation of children prevention Web site: development and pilot testing in an urban family planning teen

Complications of surgical termination of pregnancy in obese versus nonobese women

Contraceptive uptake among women receiving abortion care in a midlevel health facility in Kumasi, Ghana

Acceptability and use of postabortion resources by urban women — a pilot study

Comparison of outcomes following IUD insertion: postaspiration abortion vs. interval insertion

Intracervical 2% lidocaine gel as an analgesic during intrauterine device insertion: a randomized controlled trial

Evaluating the clinical competency of nurse practitioners, nurse midwives and physician assistants learning to provide aspiration abortions

Short-term IUD discontinuation at an urban center

Knowledge, attitudes and practices regarding emergency contraceptive pills among female undergraduate students of Makerere University, Uganda

Sexually transmitted infection prevalence in women choosing the copper-T 380A IUD for emergency contraception

Patient travel time and distance for second-trimester dilation and evacuation in the Intermountain West

Postpartum unintended pregnancy and contraception use among rural-to-urban migrant women in Shanghai

Identification of charges associated with a tubal ligation (TL) and complications post-TL as well as changes in these variables over time

Maternal demographic and clinical variables do not predict IUC placement: evidence for postplacental IUC placement

The Healthy Teens Initiative: a collaborative model for improving access to highly effective contraception for adolescents

Enablers and barriers to abortion training in New York City

Efficacy of quercetin in treatment of benign prostatic hyperplasia in a double-blind randomized clinical trial in Iran — 2011

Efficacy of a self-administered computerized counseling module in improving contraceptive method choice and continuation

Differences in birth control use and unintended pregnancy among Latina and white populations giving birth in Utah, 2004–2007

How do young, Black women view birth control and talk to their health care providers about family planning?

The availability of behind-the-counter emergency contraception in Atlanta, GA: a comparison of national pharmacy chain policies and their implementation at local stores

Study of male knowledge and influence on partner emergency contraception (EC) use

Reason for removal of US etonogestrel subdermal implant is significantly associated with age, BMI and postpartum status

Use of intrauterine contraception among nulliparous adolescents: a qualitative approach to exploring counseling experiences and preferences

Contraception and abortion decision-making in Accra, Ghana: the lesser of two evils

A time and charge analysis of the management of incomplete abortion with a manual vacuum aspirator in the emergency department versus electric suction curettage in the operating room

Complications of intrauterine device placement in postpartum women

Program assessment of the introduction of Multiload-375 in the family welfare program of the Government of India

Serum ethinyl estradiol levels with a low-dose combination transdermal contraceptive (AG200-15) compared with a low-dose combination oral contraceptive

Ulipristal acetate versus low-dose mifepristone for emergency contraception: a systematic review

A comparison of sexual behavior and contraceptive use among students in coeducational and non-coeducational secondary schools in Ibadan, Nigeria

Patients' experiences of first-trimester abortion in public facilities in Mexico City: a mixed-methods study 3 years after decriminalization

Female genital mutilation (FGM) in Sudan: what do men think?

Contents

Editorial Board

Major Study Finds Miscarriage Risk Higher for Nurses...

'Untreatable' Gonorrhea Looms, CDC Warns (with audio)

Screening Moms-to-Be for Thyroid Trouble May Not Help Offspring

Umbilical Cord Cleansing Vital For Newborn Health And Survival

Arterial Microcalcifications in the Breast Mimicking Malignancy

Female Soccer Players May Face Health Problems: Study

Kenya: Turkana Women Prefer Giving Birth At Home - Medical Officer

Health Tip: Coping With Migraines During Pregnancy

Nigeria: FG to Probe Maternal and Infant Deaths

Nigeria: Oshiomhole Vows to Combat Infant Mortality

Kenya: WHO Experts Now Fail to Agree On Contraceptives

South Africa: Cry the Beloved Province

Severe postpartum haemorrhage and mode of delivery: a retrospective cohort study

Regeneration of uterine cervix at 6 months after large loop excision of the transformation zone for cervical intraepithelial neoplasia

Gender Differences in Health Service Utilization Among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder

New Antibiotic for Bladder Infection Disappoints in Trial

Africa: Obstetric Fistula Fact Sheet

The Need for Gynecologic Follow-Up Among Women Veterans: The Association of Sexual Assault and Abnormal Cervical Cytology

Nigeria: Oshiomhole Decries Increase in Child Mortality

Eritrea: Health Station in Aimen Rendering Commendable Pre-and Post-Delivery Care Service

Eritrea: Health Service to Mothers and Pregnant Women in Massawa Sub-Zone Registering Satisfactory Outcome

Non-Invasive DNA Test That Identifies Down Syndrome In Pregnancy Can Also Detect Trisomy 18 And Trisomy 13

Health Highlights: Feb. 6, 2012

Insomnia

Clinical utility of array comparative genomic hybridisation for prenatal diagnosis: a cohort study of 3171 pregnancies

Full‐length visfatin levels are associated with inflammation in women with polycystic ovary syndrome

Smoking May Be Especially Tough on Men’s Brains

Human Papillomavirus Vaccination Practices Among Providers in Indian Health Service, Tribal and Urban Indian Healthcare Facilities

Perinatal Depression Screening and Intervention: Enhancing Health Provider Involvement

Maternal mortality due to trauma. - Romero VC, Pearlman M.