American Journal of Obstetrics & Gynecology is the world's leading Obstetrics and Gynecology Medical Journal and Website. It presents the latest diagnostic procedures, leading-edge research, and expert commentary in maternal-fetal medicine, reproductive endocrinology and infertility, and gynecologic oncology as well as general obstetrics and gynecology.
Regular training in the management of intrapartum emergencies has been demonstrated to yield measurable benefits in terms of maternal and perinatal outcomes. Thanks to technologic advances,computerized full-body mannequins have been created and made available for high-fidelity simulation in obstetrics. The technical skills subjected to training are conventionally represented by classical manual maneuvers, which are recommended in the case of instrumental vaginal delivery, shoulder dystocia, or postpartum hemorrhage.
Medication-Assisted Treatment is recommended for individuals with an opioid use disorder including pregnant women. Medication-Assisted Treatment during pregnancy provides benefits to the mother and fetus including better pregnancy outcomes, reduced illicit drug use and improved prenatal care. An alternative approach, medically supervised withdrawal (detoxification), has, in recent reports, demonstrated a low risk of fetal death, low rates of relapse and Neonatal Abstinence Syndrome. The rates of relapse and Neonatal Abstinence Syndrome are questioned by many who view medically supervised withdrawal as unacceptable based on the concern for the potential adverse consequences of relapse to mother and baby.
Pudendal neuralgia is a painful neuropathic condition involving the pudendal nerve dermatome. Tarlov cysts have been reported in the literature as another potential cause of chronic lumbosacral and pelvic pain. Notably, they are often located in the distribution of the pudendal nerve origin at the S2, S3, and S4 sacral nerve roots and it has been postulated that they may cause similar symptoms to pudendal neuralgia. Literature has been inconsistent on the clinical relevance of the cysts and if they are responsible for symptoms.
Pelvic floor myofascial pain, which is predominantly identified in the muscles of the levator ani and obturator internus, has been observed in women with chronic pelvic pain and other pelvic floor disorder symptoms, and is hypothesized to contribute to their symptoms.
Hysterectomy is one of the most common surgeries performed worldwide. Identification of modifiable risk factors for complications or re-admissions could lead to targeted interventions to improve patient care and reduce healthcare costs. Pre-operative anemia has been identified as a risk factor for adverse post-operative outcomes following non-cardiac surgery. However, studies have not focused on young and healthy surgical populations, such as women undergoing gynecologic surgery for benign indications.
Doppler ultrasound measurements of the peak systolic velocity of the middle cerebral artery can be used to non-invasively diagnose fetal anemia but are less precise following fetal blood transfusion and in late gestation. We have previously demonstrated the feasibility of estimating fetal hematocrit in vitro using MRI relaxation times. Here we report the use of MRI as a non-invasive tool to accurately detect fetal anemia in vivo.