MCH Frequently Asked Questions
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Links to C FAQs
- Calcium in Postpartum Hemorrhage
- Calcium, prevention of preeclampsia
- Cancer: [Also see more info on the Women's Health Cancer page]
- Breast cancer:
- Cancer, Breast
- Nurse based breast cancer screening
- Reconsidering use of mammography? [2/02]
- Silicone implants and breast cancer risk. [10/01]
- Cervical cancer screening:
- Cervical Cancer Screening in Low Resource Settings
- Cervical Cancer Screening: Managment of CIN 2
- Colposcopy certification for non-OB/GYN
- Bethesda System 2001 final report, discussion. [4/02]
- Bethesda System 2001 - terminology. [4/02]
- New screening technologies: Should we be using them? Two answers, [9/01 and 4/02]
- Nurse Based Cervical Cancer Screening
- Pap smears: evidence to supports one interval versus another. [9/01]
- Pap smears: proper interval. [9/01]
- Evidence-based screening guidelines: 20 latest. [8/03]
- Cervical cancer- other:
- DES exposure
- Following patients with cervical cancer. [2/02]
- Colon cancer screening:
- Colon cancer screening: latest evidence. [8/01]
- Endometrial cancer:
- Following patients with endometrial cancer. [2/02]
- Ovarian cancer:
- Following patients with ovarian cancer. [2/02]
- Outpatient methods and cost effectiveness
- Candidiasis, recurrent vulvovaginal
- Cervical priming in non-pregnant patients, misoprostol
- Cesarean delivery:
- Chaperone policy
- Chickenpox in pregnancy. Continuing education module in this site's Perinatology Corner section.
- Child sexual assault: training resources available. [12/01]
- Chlamydia:
- Latest screening recommendations. [12/01]
- Screen all women? [12/01]
- Chlamydia re-testing in pregnancy.
- Chlamydia with IUD in place.
- Cholestasis in pregnancy, AI/AN
- Clerkships
- Clinic staffing ratios
- Colposcopy certification for non-OB/GYN
- Consent for Minor's Reproductive Services
- Cord Blood Stem Cell Storage
- Credentials and Privileges
- Credentials: How many deliveries are OK?
- Cystic fibrosis. [12/01]
C FAQs
Q. What are the alternatives to manage CIN 2 in young women?
A. Managed with LEEP in the past, this can be managed less invasively in a compliant patient . (WORD 79 k)
Q. Is there a role for calcium in the management of postpartum hemorrhage?
A. Yes, consider calcium therapy to reverse any magnesium before invasive action . (WORD 66 k)
Q. What is known about nurse based breast and cervical cancer screening in AI/AN(s)?
A. Here are several articles that discuss this method to increase screening in AI/AN(s). (WORD 49k)
Q. What are the risks of the breast cancer with silicone breast implants? [10/01]
A. Download the Q&A document on this topic from our sister site, Women's Health: MS Word (.DOC), 68k | Acrobat Reader (.PDF) 84K
Q. Is there data to support combined visual inspection of the cervix with acetic acid wash (VIA) in low resource settings?
A. Yes, there is a significant body of literature to support VIA (WORD 41k)
Q. How many colposcopies does a non-OB/GYN provider need to maintain their "certification”?
A. There is no "certification" for colposcopy, but here are some helpful accreditation guidelines. (WORD 37k)
Q. Where can I find more discussion about the final Bethesda System 2001? [4/02]
A. Try this page and/or the many other options that NCI offers.
Q. What is the final Bethesda System 2001 terminology? [4/02]
A. Here is the Bethesda System 2001 final terminology.
Q. Should we switch to the new cervical cancer screening technologies? Two answers:
A. Dr. Alan Waxman on liquid-based technologies. Downloadable file: MS Word (.DOC) 28K | Acrobat Reader (.PDF) 8K. [4/02]
Q. What is the evidence that supports one pap smear interval versus another - for instance, every year versus every 3 years? [9/01]
A. The Agency for Healthcare Quality and Research provides this evidence-based background: On-line.
Q. What is the proper pap smear interval? [9/01]
A. One I.H.S. Area wrestled with that question and came up with this answer for their Area:
Q. How should I follow patients with cervical cancer? [2/02]
A. Here is how one service unit approached that problem. Downloadable file: MS Word (DOC) 28K | Acrobat Reader (PDF) 12K.
Q. What is the latest evidence on colon cancer screening? [8/01]
A. A.H.R.Q. offers the latest evidence on colon cancer screening: Summary | Technical review
Q. How should I follow patients with endometrial cancer? [2/02]
A. Here is how one service unit approached that problem. Downloadable file: MS Word (.DOC) 28K | Acrobat Reader (PDF) 8K.
Q. How should I follow patients with ovarian cancer? [2/02]
A. Here is how one service unit approached that problem. Downloadable file: MS Word (DOC) 28K | Acrobat Reader (PDF) 12K.
Q. What are some methods of cervical ripening and Induction of Labor?
A. The AFP presents a review of the topic.
Q. What is the cost effectiveness for the use of cytotec or any other induction agents?
A. Misoprostol is more cost-effective than the comparable commercial agents. (WORD 35k)
Q. What kind of surgical availability is necessary for vaginal birth after cesarean (V.B.A.C.)?
A. V.B.A.C. should be attempted in institutions equipped to respond with physicians immediately available to provide emergency delivery. (WORD 64 k)
Q. What are some of the issues involving rapid cesarean delivery + local anesthesia?
A. It can be quite uncomfortable despite local infiltration (WORD 66k). Think about the surgical approach too. (WORD 66k)
Q. Do all hospitals need cesarean delivery capacity?
A. Here is an example in which careful triage leads to excellent outcomes. (WORD 42k)
Q. What resources are available for child sexual assault training?
A. A provider at an I/T/U site asked the above question. I posed it to members of the MCH listserv and found that there are several resources available. Downloadable file: MS Word (DOC) 32K | Acrobat Reader (PDF) 12K.
Q. What are the latest recommendations on chlamydia screening?
A. Here are the National Guideline Clearinghouse's latest recommendations.
Q. Should all women be screened for chlamydia?
A. U.S.P.S.T.F. strongly recommends ('A' recommendation) routine screening for:
- All sexually active women ages 25 and younger.
- Other asymptomatic women at increased risk for infection.
Q. Are there medical student rotations available?
A. Yes, Medical Students seeking a medical rotation/clerkship in an IHS facility should contact the appropriate person on the Medical Student Clerkship Contacts List. There are several medical student rotation benefits and requirements.
Q. How many colposcopies does a non-OB/GYN provider need to maintain their "certification”?
A. There is no "certification" for colposcopy, but here are some helpful accreditation guidelines. (WORD 37k)
Q. Should I offer DNA screening for cystic fibrosis in preconception and prenatal care? (Note: 5 answers below.) [12/01]
A. A.C.O.G. recommends that Ob-Gyns make screening for cystic fibrosis available to all couples seeking care.
Q. Should we do a test of cure for Chlamydia in pregnancy? If so, when?
A. Yes, you should do a test of cure in pregnancy. See the details below (WORD 70k)
Q. If a patient has an IUD and develops a Chlamydia infection, should you remove the IUD?
A. The safest approach is to remove the IUD, but you can keep the IUD in certain cases. (WORD 50k)
Q. Is an abnormal Pap smear an effect of DES exposure?
A. There is an increase risk of HGSIL in DES exposed daughters. See details (WORD 41k)
Q. How do I manage patients with recurrent vulvovaginal candidiasis?
A. First make sure of the correct diagnosis, then try these strategies (WORD 88k)
Q. Is cholestasis in pregnancy significant in American Indians and Alaska Natives?
A. Yes, cholestasis can be associated with infant mortality and maternal discomfort. See details (WORD 97k)
Q. Ever had problems with a stenotic cervix? e. g., for an IUD placement or EmBx?
A. Cervical priming with misoprostol can be helpful in non-pregnant women. See Details (WORD 142k)
Q. How do I get clinical privileges in _______ (deliveries, ultrasound, colposcopy, etc…)
A. It requires documentation of training, experience, and current competence. See details (WORD 50k)
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