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Obstetrics

• Editor's Note
• List of Articles

List of Articles

• Ectopic Pregnancy
  Ectopic pregnancy is a condition in which an early embryo (fertilized egg) implants outside the normal site for implantation (uterus). The purpose of the document is to diagnose early, and to understand conservative medical and surgical treatments that are now widely available for ectopic pregnancies. Methotrexate, a folinic acid antagonist, has been used to treat patients with small unruptured tubal pregnancies. Evidence, including risks benefits, about methotrexate as an alternative treatment for selected ectopic pregnancy is also discussed. Early detection may make it possible for some patients to receive medical therapy instead of surgery.
  
  
• Female Genital Cutting: Impact on Maternal and Neonatal Outcomes
  Female genital cutting (FGC) is the collective name given to traditional practices that involve partial or total cutting away of the female external genitalia whether for cultural or other non-therapeutic reasons. These beliefs and practices can damage the health of both mother and child in various ways. FGC, for instance, leads to scarification and later complications in childbirth. Female genital cutting/mutilation has no known health benefits. On the contrary, it is known to be harmful to girls and women in many ways. First and foremost, it is painful and traumatic. The removal of or damage to healthy, normal genital tissue interferes with the natural functioning of the body and causes several immediate and long-term health consequences. Babies born to women who have undergone female genital mutilation suffer a higher rate of neonatal death compared with babies born to women who have not undergone the procedure. Girls have the right to grow to womanhood without harm to their bodies. We know what has to be done to abandon this harmful practice, strong support from governments encouraging communities and individuals to make the healthiest choices possible for girls will save lives and greatly benefit families and communities.
  
  
• Neural Tube Defects Screening
  Neural tube defects (NTDs) are congenital structural abnormalities of the brain and vertebral column that occur either as an isolated malformation, along with other malformations, or as a part of genetic syndrome. The purpose of this document is to review prenatal screening, diagnosis that are widely available and prenatal therapy is being investigated. Neural tube defects (NTDs) are among the few birth defects for which primary prevention is possible. Yet identification of selected anomalies, such as ventriculomegaly and spina bifida, remains a challenge in many cases. Anencephaly accounts for one half of all cases of NTDs and is incompatible with life; with treatment, 80-90% of infants with spina bifida survive with varying degrees of disability. In this chapter, the sonographic investigation, screening for NTDs and role of folic acid are also reviewed.
  
  
• Premature Rupture of Membranes: Diagnosis and Management
  Premature rupture of the fetal membranes (PROM) is one of the most common and controversial problems facing the obstetric clinician. The fetal membranes and the amniotic fluid that they encase have functions that are critical for normal fetal protection, growth, and development. The purpose of this document is to review the current understanding of premature rupture of membranes (PROM) and to provide management guidelines that have been validated by appropriately conducted outcome-based research. There is some controversy over the optimal approaches to clinical assessment and treatment of women with term and preterm PROM. Management hinges on knowledge of gestational age and evaluation of the relative risks of preterm birth versus infection, abruptio placentae, and cord accident that could occur with expectant management. The risk factors, diagnosis, and management of PROM are discussed here. Additional guidelines on the basis of consensus and expert opinion also are included.
  
  

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