Obstetrics And Gynecology Quotes

In 2001, the American Journal of Obstetrics and Gynecology declared the G spot a “modern gynecologic myth,

I spend almost two weeks with Dewhurst's Text book of Obstetrics and Gynecology (eight edition) and looking at videos available on the Internet before deciding that these materials needed to be supplemented with practical experience. It was like reading a book on karate - useful to a point, but not sufficient for combat preparation.

The earliest and most dramatic changes in maternal physiology are cardiovascular. These changes improve fetal oxygenation and nutrition.

Dyspnea during pregnancy may be “physiologic” but still requires evaluation insofar as it may represent respiratory or cardiac illness.

Women who gain more weight than the recommended range during the pregnancy tend to be heavier at 3 years postpartum than women who gained weight within recommended range during pregnancy, and this applies to both obese and nonobese patients.

Women with PCOS typically have signs of hyperandrogenism, the most frequent of which are hirsutism and acne. Hirsutism is

uterus is palpable just at the pubic symphysis at 8 weeks. At 12 weeks, the uterus becomes an abdominal organ, and at 16 weeks, it is usually at the midpoint between the pubic symphysis and the umbilicus. Between 18 and 34 weeks’ gestation, the uterus size or fundal height is measured in centimeters from the pubic symphysis to the upper edge of the uterine corpus, and the measurement correlates well with the gestational age in weeks (Fig. 6–1). The uterus is palpable at 20 weeks at the umbilicus. After 36 weeks, the fundal height may

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In obstetrics and gynecology, the term abortionist is still a dirty word.

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After completing medical school and serving my residency in obstetrics and gynecology, I felt knowledgeable enough to be a parent. Between

For some time, an arbitrary line in the sand was drawn at the end of the first trimester as the demarcation marking the beginning of "life". Of course, advances in medical technology continued to force those who stood on that line to retreat further and further toward the beginning of gestation. For instance, it has been established that a fetus has brain waves which can be measured by EEG only 40 days after conception, and merely 18 days after conception, the fetus has a measurable heart beat. In fact, they were getting so close to the beginning of gestation, i.e., conception, that the PC pro-abortion genderists then had to adopt the more ephemeral "viability" position. Of course, according to their definition of "viability", comatose patients would not be considered human being because, in some ways, a fetus is actually more "viable" than someone who is comatose. As obstetrical and gynecological medicine continued its inevitable advance, revealing more and more about the nature of a human fetus, the pro-abortion forces continued their retreat until now they do not even discuss the fetus at all. As with all politically correct positions, if a fact gets in the way, it is simply changed or ignored. Unfortunately for the pro-abortion genderists, the fetus is a fact, a fact which is itself usually the result of "choices". Furthermore, the simple scientific fact is that at the moment of conception, the embryo is not a part of the mother's body. At that point and forever more it is a genetically distinct being with its own genetic code that is completely and totally different from every other human being who has ever lived or ever will live, including the mother. So here is the first instance of PC genderism crashing into scientific fact. It also seems ironic that while more and more law enforcement agencies in this country are now turning to DNA identification in criminal investigations and our courts are now admitting such identification as evidence in criminal prosecution, the rights of a fetus, which has its own, distinct DNA code at the moment of conception, are still not legally recognized in all cases. Now they are recognized in some cases, for there have been instances of people being prosecuted for two murders when they have killed pregnant women. There are also cases where mothers who have given birth to babies who are addicted to illegal drugs have been prosecuted, but there are no consistent standards or guidelines. It is also a macabre irony that in this country it is illegal to destroy the egg of an American bald eagle, but the government uses our tax dollars to destroy human embryos and fetuses.

Pregnancy is associated with an increase in total body oxygen consumption of approximately 50 mL O2/minute, which is 20% greater than nonpregnant levels.

The primary functional change in the cardiovascular system in pregnancy is a marked increase in cardiac output.

In the first half of pregnancy, cardiac output rises as a result of increased stroke volume and, in the latter half of pregnancy, as a result of increased maternal heart rate, whereas the stroke volume returns to near-normal, nonpregnant levels. These

These changes in stroke volume are due to alterations in circulating blood volume and systemic vascular resistance. Circulating

about one-fifth of the cardiac output goes through the uterus at term increasing the risk from postpartum hemorrhage substantially.

During pregnancy, arterial blood pressure follows a typical pattern. When measured in the sitting or standing position, diastolic blood pressure decreases beginning in the 7th week of gestation and reaches a maximal decline of 10 mm Hg from 24 to 26 weeks. Blood

Physiologic changes in blood pressure in midpregnancy may be misunderstood as hypotension unless allowance for gestational age is made.

The cardiovascular system is in a hyperdynamic state during pregnancy. Normal physical findings on cardiovascular examination include an increased second heart sound split with inspiration, distended neck veins, and low-grade systolic ejection murmurs, which are presumably associated with increased blood flow across the aortic and pulmonic valves.

Serial blood pressure assessment is an essential component of each prenatal care visit.

Measured blood pressure is highest when a pregnant woman is seated, somewhat lower when supine, and lowest while lying on the side.

The period of gestation can be divided into units consisting of 3 calendar months each or 3 trimesters. The first trimester can be subdivided into the embryonic and fetal periods. The embryonic period starts at the time of fertilization (developmental age) or at 2 through 10 weeks’ gestational age. The

Fetal lung maturity is assumed after 39 weeks’ gestation but can be verified at an earlier gestational age by analysis of amniotic fluid by amniocentesis.

Increased morbidity and mortality may be associated with a macrosomic infant or a large for gestational age (LGA) fetus. This is defined as a fetus with an estimated fetal weight at or beyond the 90th percentile at any gestational age. At term, approximately 10% of newborn infants weigh more than 4000 g, and the weight of 1.5% of newborns is in excess of 4500 g. Excessive

Progesterone causes increased central chemoreceptor sensitivity to CO2, which results in increased ventilation and a reduction in arterial pco

Gestational diabetes mellitus (GDM) refers to glucose intolerance identified during pregnancy. In most patients, it subsides postpartum, although glucose intolerance in subsequent years occurs more frequently in this group of patients.

Approximately 7% of pregnancies are complicated by diabetes that either develops during pregnancy (gestational diabetes) or was antecedent to pregnancy (pregestational diabetes mellitus). In

Gestational diabetes refers to any degree of glucose intolerance with variable severity with the onset or first recognition during pregnancy. This

The first stage of labor is evaluated by the rate of change of cervical effacement, cervical dilatation, and descent of the fetal head.

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Hirsutism is however, more than a cosmetic problem because it usually represents a hormonal imbalance, resulting from a subtle excess of androgens that may be of ovarian origin, adrenal origin, or both. The

Diabetes mellitus is a metabolic disorder that can significantly alter the maternal and in utero environment, leading to complications. Optimizing

Women with high-risk factors should undergo screening at the first visit or as soon as possible, while individuals who continue to exhibit low-risk characteristics do not require screening. A

Routine screening at 24–28 weeks is recommended for those not meeting low- or high-risk criteria.

The risk of major congenital anomalies correlates with the initial glycosolated hemoglobin level and the initial mean fasting glucose levels. The

The vast majority of women infected with HPV do not develop CIN or cervical cancer. This suggests that infection with HPV alone is insufficient for the development of CIN or cervical cancer and underscores the importance of other cofactors, such as cigarette smoking or immunosuppression.

Screening for gestational diabetes at 26 to 28 weeks; generally consists of a 50-g oral glucose load and assessment of the serum glucose level after 1 hour.

active phase cannot be reliably defined until 6 cm of dilation.

however, if the progress is prolonged or uterine contractions are inadequate, oxytocin is an option.

Finally, the nonimmune rubella status should alert the practitioner to immunize for rubella during the postpartum time (since the rubella vaccine is live attenuated and is contraindicated during pregnancy).

Cesarean delivery (for labor abnormalities) in the absence of clear cephalopelvic disproportion is generally reserved for arrest of active phase and ROM with adequate uterine contractions for at least 4 hours, or inadequate uterine contractions for at least 6 hours.

Maybe Sloan would agree to a deal. I’d talk to someone about some of my issues if she would agree to go to grief counseling. It wasn’t me giving in to Josh like she wanted, but Sloan knew how much I hated therapists, and she’d always wanted me to see someone. I was debating how to pitch this to her when I glanced into the living room and saw it—a single purple carnation on my coffee table. I looked around the kitchen like I might suddenly find someone in my house. But Stuntman was calm, plopped under my chair. I went in to investigate and saw that the flower sat on top of a binder with the words “just say okay” written on the outside in Josh’s writing. He’d been here? My heart began to pound. I looked again around the living room like I might see him, but it was just the binder. I sat on the sofa, my hands on my knees, staring at the binder for what felt like ages before I drew the courage to pull the book into my lap. I tucked my hair behind my ear and licked my lips, took a breath, and opened it up. The front page read “SoCal Fertility Specialists.” My breath stilled in my lungs. What? He’d had a consultation with Dr. Mason Montgomery from SoCal Fertility. A certified subspecialist in reproductive endocrinology and infertility with the American Board of Obstetrics and Gynecology. He’d talked to them about in vitro and surrogacy, and he’d had fertility testing done. I put a shaky hand to my mouth, and tears began to blur my eyes. I pored over his test results. Josh was a breeding machine. Strong swimmers and an impressive sperm count. He’d circled this and put a winking smiley face next to it and I snorted. He’d outlined the clinic’s high success rates—higher than the national average—and he had gotten signed personal testimonials from previous patients, women like me who used a surrogate. Letter after letter of encouragement, addressed to me. The next page was a complete breakdown on the cost of in vitro and information on Josh’s health insurance and what it covered. His insurance was good. It covered the first round of IVF at 100 percent. He even had a small business plan. He proposed selling doghouses that he would build. The extra income would raise enough money for the second round of in vitro in about three months. The next section was filled with printouts from the Department of International Adoptions. Notes scrawled in Josh’s handwriting said Brazil just opened up. He broke down the process, timeline, and costs right down to travel expenses and court fees. I flipped past a sleeve full of brochures to a page on getting licensed for foster care. He’d already gone through the background check, and he enclosed a form for me, along with a series of available dates for foster care orientation classes and in-home inspections. Was this what he’d been doing? This must have taken him weeks. My chin quivered. Somehow, seeing it all down on paper, knowing we’d be in it together, it didn’t feel so hopeless. It felt like something that we could do. Something that might actually work. Something possible. The last page had an envelope taped to it. I pried it open with trembling hands, my throat getting tight. I know what the journey will look like, Kristen. I’m ready to take this on. I love you and I can’t wait to tell you the best part…Just say okay. I dropped the letter and put my face into my hands and sobbed like I’d never sobbed in my life. He’d done all this for me. Josh looked infertility dead in the eye, and his choice was still me. He never gave up. All this time, no matter how hard I rejected him or how difficult I made it, he never walked away from me. He just changed strategies. And I knew if this one didn’t work he’d try another. And another. And another. He’d never stop trying until I gave in. And Sloan—she knew. She knew this was here, waiting for me. That’s why she’d made me leave. They’d conspired to do this.