Q.What are some of the issues involved with vacuum assisted deliveries?
A.The mechanics are one issue, larger issues are when to use and when not. (WORD 80k)
Q. How can you predict if a placenta previa will persist based on US at 15-24 weeks?
A. If the placental edge is > 1 cm over the os, or if the cord insertion is over the os. (WORD 43k)
Q. Is it standard of care to obtain a 2nd ultrasound on low risk patients for a fetal survey?
A. There is evidence to obtain one ultrasound. The optimal timing (WORD 41k) is at 16 to 20 week.
Q. What is the significance 2nd trimester of ultrasound (US markers for Down syndrome?
A. If US markers are negative, then decrease the risk by serum testing in ~1/2. See the details (WORD 66k)
Q. What can I do about urinary leakage or the sudden loss of urine? [10/01]
A. There are many strategies on how to manage that problem. Some are very simple. Take a look.
Q. How can physical therapy help with urinary incontinence? [12/01]
A. Irene Boyd, BS, MPT has developed a unique physical therapy program to strengthen the female pelvic musculature through exercise, biofeedback, and pelvic muscle electrical stimulation. Downloadable files: a) Biofeedback - MS Word (.DOC) 28K | Acrobat Reader (.PDF) 12K, b) Electrical muscle stimulation - MS Word (.DOC) 28K | Acrobat Reader (.PDF) 12K, c) Product list - MS Word (.DOC) 36K | Acrobat Reader (.PDF) 20K. Many more links on pelvic relaxation, pain and related issues, downloadable file: MS Excel (.XLS) 20K | Acrobat Reader (.PDF) 8K.
Q. How can my department tell if we providing effective urinary incontinence procedures?
A. Two good benchmark times to re-evaluate are at 1 and 5 years post operatively. (WORD 42k)
Q. What patient education material can I offer my patients about common uterine conditions? [8/01]
A. The A.H.R.Q. offers some pertinent information for patients.
Q. What is the latest evidence on management of uterine fibroids? [8/01]
A. The AHRQ offers this information on the management of uterine fibroids: On-line summary | Downloadable files - MS Word (.DOC) 64K, Acrobat Reader (.PDF) 36K.
Q. How does birth interval affect the repeat cesarean vs vaginal delivery decision?
A. Intervals < 18-24 months slightly increase risk, but it is something the patient can control. (WORD 45k)
Q. What should I do about a patient at 4-6 weeks gestation with a varicella like rash?
A. Rapid treatment may ameilorate maternal symptoms, but have little benefit for the fetus. (WORD 35k)
Q. What is the significance of a ultrasound (US) 'soft marker' for Down Syndrome?
A.2nd trimester US markers for Down syndrome are varied in their significance. See details (WORD 51k)
Q. Should a urine test be performed on every pregnant patient each prenatal visit?
A.No, routine urine testing in pregnancy is very insensitive and non-specific. See details (WORD 94k)
Q. Can we use a protein to creatinine ratio instead of a 24 urine protein in preeclampsia?
A. P:C is a standard metric for chronic renal disease. Here are the details in the OB setting (WORD 396k)
Q. When should we change the estimated date of delivery (EDD) based on ultrasound?
A. There are various criteria, but once you determine an EDD, stick with it. See these helpful tips (WORD 48k)
Q. Is cord blood stem cell storage a viable option in Indian Country ?
A. Cord blood stem cell storage can offer patients both advantages and disadvantages. (WORD 109k)