Women's Health and Education Center (WHEC)


List of Articles

  • Multiple Pregnancies
    Multiple pregnancies are fascinating and challenging situations. It requires early detection and identification of number of pregnancies, early detection of the complications and their proper management. Multiple births are more common nowadays, owing to over-stimulation of ovulation that occurs when ovulation stimulation is done in cases of women with infertility because of ovulatory failure. Moreover, although the dizygotic twinning rate varies widely under different circumstances, the monozygotic twinning rate is "remarkably constant", usually between 3.5 to 4 per 1,000. Premature babies need prolonged and expensive care. Patient education and availability of trained healthcare providers in the area can reduce the mortality and morbidity. There are support groups for the parents of multiple births available at almost all the area hospitals, which deal with high-risk deliveries.

  • Antepartum Fetal Surveillance
    The goal of antepartum fetal surveillance is to prevent fetal death. Several antepartum fetal surveillance techniques or tests are in use. These include fetal movement assessment, non-stress test (NST), contraction stress test (CST), biophysical profile (BPP), and umbilical artery Doppler velocimetry. Antepartum fetal surveillance techniques are now routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions, as well as those in which complications have developed. Identification of suspected fetal compromise provides the opportunity to intervene before progressive metabolic acidosis can lead to fetal death. Identification of suspected fetal compromise provides the opportunity to intervene before progressive metabolic acidosis can lead to fetal death. In both animals and humans, fetal heart rate pattern, level of activity, and degree of muscular tone are sensitive to hypoxemia and academia. Recent, normal antepartum fetal test results should not preclude the use of intrapartum fetal monitoring.

  • Shoulder Dystocia
    Shoulder dystocia is most often defined as a delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders. It is most often an unpredictable and unpreventable obstetric emergency. Failure of the shoulders to deliver spontaneously places both the pregnant woman and fetus at risk for injury. Shoulder dystocia is caused by the impaction of the anterior fetal shoulder behind the maternal pubis symphysis. It also can occur from impaction of the posterior fetal shoulder on the sacral promontory. Several maneuvers to release impacted shoulders have been developed, and they are described below. The purpose of this chapter is to provide clinicians with information regarding management of deliveries at risk for or complicated by shoulder dystocia.

  • Preterm Labor Management
    Preterm labor is the leading cause of neonatal mortality in the United States and accounts for about 11.5% of all live births. It is responsible for three quarters of neonatal mortality and one half of long-term neurologic impairments in children. Despite the numerous management methods proposed, the incidence of preterm birth has changed little over the past 40 years. Uncertainty persists about the best strategies for managing preterm labor. The purpose of this document is to discuss the various methods proposed to manage preterm labor and the evidence for their roles in clinical practice. The information is designed to aid practitioners in making decisions about appropriate obstetrical care. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice.

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