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Methods to reduce pain with insertion of intrauterine contraception | Cochrane

Fear of pain with insertion of intrauterine contraception (IUC) may cause women to avoid using this very effective method of birth control. IUC includes devices with copper and with the hormone levonorgestrel. Researchers have studied many ways of reducing pain with IUC insertion. These include drugs that lessen uterine cramps, soften and open the cervix (uterus opening), or numb the cervix.  
cochrane.org
about 5 years ago
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49

Fallopian Tube Disorders: Overview, Salpingitis, Salpingitis Isthmica Nodosa

The human oviduct, also known as the fallopian tube, is an essential component of the normal reproductive process. The tube, which connects the peritoneal space to the endometrial cavity, captures the egg after ovulation and transports the sperm from the uterus to the fertilization site in the ampulla (the middle portion of the tube).  
emedicine.medscape.com
about 5 years ago
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Molecular mechanisms within fetal lungs initiate labor

Researchers have identified two proteins in a fetus' lungs responsible for initiating the labor process, providing potential new targets for preventing preterm birth. They discovered that the proteins SRC-1 and SRC-2 activate genes inside the fetus' lungs near full term, leading to an inflammatory response in the mother's uterus that initiates labor.  
sciencedaily.com
about 5 years ago
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Antibiotic prophylaxis during the second and third trimester in pregnancy to reduce adverse pregnancy outcomes and morbidity | Cochrane

Antibiotics are administered to pregnant women during the second and third trimester of pregnancy (before labour) to prevent bacteria in the vagina and cervix affecting the pregnancy. Infection by some infectious organisms in a woman’s genital tract can cause health problems for the mother and her baby, and has been associated with preterm births. This review of eight randomised trials involved approximately 4300 women in their second or third trimester. We found that antibiotics did not reduce the risk of preterm prelabour rupture of the membranes (one trial, low quality of evidence), or the risk of preterm birth (six trials, high quality of evidence). Preterm delivery was reduced in pregnant women who had a previous preterm birth and an imbalance of bacteria in the vagina (bacterial vaginosis) during the current pregnancy. There was no reduction in preterm delivery in pregnant women with previous preterm birth without a bacterial imbalance during the current pregnancy (two trials). Postpartum endometritis, or infection of the uterus following birth, was reduced overall (three trials, moderate quality of evidence), as well as in a trial of high-risk women who had a previous preterm birth (one trial, moderate quality of evidence). No reduction in neonatal illness was observed. Outcomes of interest were available in trials with high losses to follow-up. We could not estimate the side effects of antibiotics since side effects were rare; however, antibiotics may still have serious side effects on women and their babies.  
cochrane.org
about 5 years ago
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Tranexamic acid for preventing bleeding after delivery | Cochrane

Postpartum haemorrhage is a common and an occasionally life-threatening complication of labour. The majority of women receive drugs that directly stimulate the uterus (prophylactic uterotonics) during childbirth to prevent haemorrhages resulting from failure of the uterine muscle to contract normally (uterine atony).  
cochrane.org
over 5 years ago
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Methods for assessing pre-induction cervical ripening, the ability of the cervix to open in response to spontaneous uterine contractions | Cochrane

In this review, researchers from The Cochrane Collaboration examined a comparison between the Bishop score and any other method for checking pre-induction cervical ripening in women admitted for induction of labour. The Bishop score is the traditional method of determining the readiness of the cervix to open (dilate) before labour induction. It also assesses the position, softening and shortening of the cervix, and the location of the presenting part of the baby. After searching for relevant trials up to 31 March 2015, we included two randomised controlled trials that recruited 234 pregnant women.  
cochrane.org
over 5 years ago
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Normal Labor and Delivery: Practice Essentials, Definition, Stages of Labor and Epidemiology

Labor is a physiologic process during which the fetus, membranes, umbilical cord, and placenta are expelled from the uterus. Stages of labor Obstetricians have divided labor into 3 stages that delineate milestones in a continuous process.  
emedicine.medscape.com
over 5 years ago
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125

Gastrulation Lecture

Following the implantation of the blastocyst into the endometrium of uterus, the embryo begins another important embryological process called gastrulation. Gastrulation is the formation of the three distinct germ layers - the ectoderm, the mesoderm and the endoderm. The ectoderm is the outermost layer of the developing embryo and it consists of cells that eventually give rise to the integumentary system (the outer skin, nails and hair) as well as the nervous system (central and peripheral system). The mesoderm is the middle layer of the developing embryo and it consists of cells that eventually give rise to the musculoskeletal system (bone, cartilage, skeletal muscle, cardiac muscle, smooth muscle), cardiovascular system (the heart and blood vessels), excretory system (kidneys) and reproductive system (gonads). The endoderm is the innermost layer of the developing embryo and it gives rise to the epithelial layer of the digestive tract, lungs, pancreas, bladder, liver as well as the thyroid gland, parathyroid gland and thymus.  
aklectures.com
over 5 years ago
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Preparing the cervix with different ripening agents before operative hysteroscopy | Cochrane

Are cervical ripening agents effective for dilating the cervix before operative hysteroscopy and do they reduce the risk of complications during the surgery?  
cochrane.org
over 5 years ago
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Doppler ultrasound of fetal blood vessels in normal pregnancies | Cochrane

One of the main aims of routine antenatal care is to identify babies who are not thriving in the womb. It is possible that medical interventions might improve outcomes for these babies, if they can be identified. Doppler ultrasound uses sound waves to detect the movement of blood in vessels. It is used in pregnancy to study blood circulation in the baby, uterus and placenta. Using it in high-risk pregnancies, where there is concern about the baby's condition, shows benefits. However, its value as a screening tool in all pregnancies needs to be assessed as there is a possibility of unnecessary interventions and adverse effects. The review of trials of routine Doppler ultrasound of the baby’s vessels in pregnancy identified five studies involving more than 14,000 women and babies. The studies were not of high quality and were all undertaken in the 1990s. There were no improvements identified for either the baby or the mother, though more data would be needed to prove whether it is effective or not for improving outcomes.  
cochrane.org
over 5 years ago
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UOTW #41 – Ultrasound of the Week

A 24 y/o female presents with c/o vaginal spotting and severe abdominal pain. LMP 2 months ago. BP 82/40. You lie the patient supine and are unable to visualize the uterus, but obtain this clip instead. What’s your next step?  
ultrasoundoftheweek.com
over 5 years ago
Www.bmj
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Clinical applications of preimplantation genetic testing

Genetic diagnostic technologies are rapidly changing the way medicine is practiced. Preimplantation genetic testing is a well established application of genetic testing within the context of in vitro fertilization cycles. It involves obtaining a cell(s) from a developing embryo in culture, which is then subjected to genetic diagnostic analysis; the resulting information is used to guide which embryos are transferred into the uterus. The potential applications and use of this technology have increased in recent years. Experts agree that preimplantation genetic diagnosis is clinically appropriate for many known genetic disorders. However, some applications of such testing, such as preimplantation genetic screening for aneuploidy, remain controversial. Clinical data suggest that preimplantation genetic screening may be useful, but further studies are needed to quantify the size of the effect and who would benefit most.  
bmj.com
over 5 years ago
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Ob/Gyn - Ca Endometrium

The online lecture series for medical students. On demand streaming video lectures. www.mdcrack.tv Owner: MD CRACK  
YouTube
almost 6 years ago
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Uterus

Uterus by Dr. Fabian  
YouTube
almost 6 years ago
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Confidence Building During Medical Training

My fellow medical students, interns, residents and attendings: I am not a medical student but an emeritus professor of Obstetrics and Gynecology at the University of Miami Miller School of Medicine, and also a voluntary faculty member at the Florida International University Herbert Wertheim College of Medicine. I have a great deal of contact with medical students and residents. During training (as student or resident), gaining confidence in one's own abilities is a very important part of becoming a practitioner. This aspect of training does not always receive the necessary attention and emphasis. Below I describe one of the events of confidence building that has had an important and lasting influence on my career as an academic physician. I graduated from medical school in Belgium many years ago. I came to the US to do my internship in a small hospital in up state NY. I was as green as any intern could be, as medical school in Belgium at that time had very little hands on practice, as opposed to the US medical graduates. I had a lot of "book knowledge" but very little practical confidence in myself. The US graduates were way ahead of me. My fellow interns, residents and attendings were really understanding and did their best to build my confidence and never made me feel inferior. One such confidence-building episodes I remember vividly. Sometime in the middle part of the one-year internship, I was on call in the emergency room and was called to see a woman who was obviously in active labor. She was in her thirties and had already delivered several babies before. The problem was that she had had no prenatal care at all and there was no record of her in the hospital. I began by asking her some standard questions, like when her last menstrual period had been and when she thought her due date was. I did not get far with my questioning as she had one contraction after another and she was not interested in answering. Soon the bag of waters broke and she said that she had to push. The only obvious action for me at that point was to get ready for a delivery in the emergency room. There was no time to transport the woman to the labor and delivery room. There was an emergency delivery “pack” in the ER, which the nurses opened for me while I quickly washed my hands and put on gloves. Soon after, a healthy, screaming, but rather small baby was delivered and handed to the pediatric resident who had been called. At that point it became obvious that there was one more baby inside the uterus. Realizing that I was dealing with a twin pregnancy, I panicked, as in my limited experience during my obstetrical rotation some months earlier I had never performed or even seen a twin delivery. I asked the nurses to summon the chief resident, who promptly arrived to my great relief. I immediately started peeling off my gloves to make room for the resident to take my place and deliver this twin baby. However, after verifying that this baby was also a "vertex" without any obvious problem, he calmly stood by, and over my objections, bluntly told me “you can do it”, even though I kept telling him that this was a first for me. I delivered this healthy, screaming twin baby in front of a large number of nurses and doctors crowding the room, only to realize that this was not the end of it and that indeed there was a third baby. Now I was really ready to step aside and let the chief resident take over. However he remained calm and again, stood by and assured me that I could handle this situation. I am not even sure how many triplets he had delivered himself as they are not too common. Baby number three appeared quickly and also was healthy and vigorous. What a boost to my self-confidence that was! I only delivered one other set of triplets later in my career and that was by C-Section. All three babies came head first. If one of them had been a breech the situation might have been quite different. What I will never forget is the implied lesson in confidence building the chief resident gave me. I have always remembered that. In fact I have put this approach in practice numerous times when the roles were reversed later in my career as teacher. Often in a somewhat difficult situation at the bedside or in the operating room, a student or more junior doctor would refer to me to take over and finish a procedure he or she did not feel qualified to do. Many times I would reassure and encourage that person to continue while I talked him or her through it. Many of these junior doctors have told me afterwards how they appreciated this confidence building. Of course one has to be careful to balance this approach with patient safety and I have never delegated responsibility in critical situations and have often taken over when a junior doctor was having trouble. Those interested, can read more about my experiences in the US and a number of other countries, in a free e book, entitled "Crosscultural Doctoring. On and Off the Beaten Path" can be downloaded at this link. Enjoy!  
DR William LeMaire
over 6 years ago
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Ob/Gyn - Ca Endometrium

The online lecture series for medical students. On demand streaming video lectures. www.mdcrack.tv Owner: MD CRACK  
YouTube
over 6 years ago
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Uterus

Uterus by Dr. Fabian  
YouTube
over 6 years ago
Www.bmj
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US agency warns against morcellation in hysterectomies and myomectomies

The US Food and Drug Administration (FDA) issued a safety communication on 17 April urging doctors not to use laparoscopic power morcellation for hysterectomies or removal of uterine fibroids over concerns that the technique may spread uterine sarcomas beyond the uterus.1  
bmj.com
over 6 years ago
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Normal Uterine Contractions During Delivery with Fetal Monitoring Strip

Labor and Delivery - Normal Uterine Contractions with Fetal Monitoring Strip. Depicts a relaxed uterus and dilated cervix followed by a contracted uterus. The third image shows a relaxed uterus. The fourth image shows the uterus contracting, and squeezing the baby toward the birth canal. The fifth and sixth illustrations picture a fetal monitor and its printout, graph with contractions and recovery periods.  
Nucleus Medical Media
over 6 years ago