Women's Health and Education Center (WHEC)


List of Articles

  • Thromboembolism in Pregnancy
    The risk of symptomatic venous thrombosis during pregnancy is between 0.5 and 3.0 per 1,000 women. Pulmonary embolism (PE) is a leading cause of maternal deaths in the United States. During pregnancy women have a five-fold increased risk of venous thromboembolism (VTE), compared to non-pregnant women. The prevalence and severity of this condition warrants consideration of anticoagulant therapy in pregnancy for women at risk for VTE. The purpose of this document is to review the current literature on the prevention and management of thromboembolism in obstetric patients. It offers evidence-based recommendations to address the most clinically relevant issues in the management of these patients.

  • Gestational Trophoblastic Disease: A Comprehensive Review
    Gestational Trophoblastic disease comprises a spectrum of interrelated conditions originating from the placenta. Approximately 20% of patients will develop malignant sequelae requiring administration of chemotherapy after evacuation of hydatidiform moles. Most patients with post-molar gestational trophoblastic disease will have non-metastatic molar proliferation or invasive moles, but gestational choriocarcinomas and metastatic disease can develop in this setting. The purpose of this document is to address current evidence regarding the diagnosis, staging, and management of gestational trophoblastic disease. Other terms often used to refer to these conditions include gestational trophoblastic neoplasia and gestational trophoblastic tumor. At present, with sensitive quantitative assays for beta-hCG and current approaches to chemotherapy, most women with malignant gestational trophoblastic disease can be cured and their reproductive function preserved. Histologically distinct disease entities encompassed by this general terminology include complete and partial hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors.

  • Placental Abnormalities & Major Obstetric Hemorrhage
    Bleeding in the second half of pregnancy and in labor due to placental abnormalities include placenta previa, abruptio placentae, placenta accreta and vasa previa. Third-trimester bleeding complicates about 3.8% of all pregnancies. The purpose of this document is to present evidence-based approach to the management of placental abnormalities and major obstetric hemorrhage. Attention to improving the hospital systems is necessary for the care of women at risk for major obstetric hemorrhage. It is important in the effort to decrease maternal mortality from hemorrhage. Multidisciplinary team implementation systemic changes are also discussed. It is the responsibility of the physician to decide without delay whether the cause is benign or potentially life-threatening to the mother, fetus, or both. The potential harm from either procrastination or unnecessary intervention may be extreme.

  • Placenta Accreta
    An abnormally adherent placenta, although an uncommon condition, assumes considerable significance clinically because of morbidity and at times mortality from severe hemorrhage, uterine perforation, and infection. The incidence of placenta accreta, increta and percreta has increased because of the increased cesarean delivery rate. This document reflects emerging clinical and scientific advances on this subject. If the diagnosis or a strong suspicion is formed before delivery, the patient should be counseled about the likelihood of hysterectomy and blood transfusion.

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