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Women's Health and Education Center (WHEC)

Obstetrics

List of Articles

  • Exercise During Pregnancy and Postpartum Period
    The aim of this review is to highlight exercise guidelines in pregnancy in concise format for obstetricians and gynecologists and other healthcare providers who provide prenatal and postpartum care. These recommendations provide evidence that increasing weekly physical-activity expenditure while incorporating vigorous exercise provides optimal health outcomes for pregnant women and their fetuses, and also suggest light strength training during the second and third trimesters does not negatively affect newborn body size and overall health. Women of childbearing age are at increased risk of gestational diabetes mellitus (GDM), which has been linked strongly to obesity. Weight gain during pregnancy can be excessive, and some women tend to retain that weight after delivery. Gaining excessive weight during pregnancy can result in obesity-associated comorbidities, which are a major health concern in the United States.

  • Recurrent Pregnancy Loss
    Recurrent pregnancy loss (RPL) is a frustrating problem for both the patients and physicians. Pregnancy is a complicated process involving many intricate interactions between the fetus and the maternal environment. Pregnancy loss can result from any number of genetic, anatomic, endocrine, immune, or thrombotic disorders, as well as from unknown causes. The purpose of this document is to outline the causes of recurrent pregnancy loss and their potential therapies, where applicable. Traditionally RPL refers to the loss of three or more consecutive pregnancies; however, many clinicians will begin the evaluation of RPL after two losses, because the risk of a third loss after two miscarriages is approximately 30%, whereas the risk after three losses is about 33%. This approach may be especially useful in older women. It is important to remember that couples who are being evaluated for RPL have high levels of depression and stress. Some studies have indicated that psychological support may decrease the rates of unexplained miscarriage. Finally, patients should be reassured that even without treatment, successful pregnancy occurs in the majority of cases. This review can serve as a useful resource when counseling patients regarding treatment options.

  • Healthy Mother Healthy Infant Through Nutrition
    Maternal nutritional status not only influences fetal development and overall health but also significantly affects long-term risk for chronic childhood and adult diseases. Many pregnant and lactating women may not achieve optimum levels of important nutrients, as evidenced by the proportion of women throughout the US population and in the world, whose nutritional levels do not meet documented standards for many vitamins, minerals, and other essential nutrients. Women's Health and Education Center (WHEC) places emphasis on specific nutrients essential for optimal fetal development, notably folic acid, calcium, vitamin D, and omega-3 fatty acids; these are often consumed at levels below the recommended requirements. Maternal/infant morbidity and mortality are age-old and worldwide problems. There are many factors that influence the ultimate outcome of pregnancy, including the absence or presence of access to prenatal care, maternal stress (physical and psychological), comorbid diseases, and maternal nutrition -- both before and during pregnancy. Good nutrition is much more than just the food we eat.

  • Intrapartum Electronic Fetal Heart Rate Monitoring
    The purpose of this document is to: 1) review nomenclature for fetal heart rate assessment, 2) review the data on the efficacy of electronic fetal monitoring (EFM), and 3) delineate the strengths and shortcomings of EFM. It also compares international three-tier systems for fetal heart rate tracing, including the National Institute of Child Health and Human Development (NICHD), Society of Obstetricians and Gynecologists of Canada (SOGC) and the Royal College of Obstetricians and Gynecologists (RCOG, United Kingdom). The collaboration of practitioners in defining the interpretation and implementing is critical for improved care for women and children. Realizing that this information deserves wide dissemination, Women's Health and Education Center (WHEC) encourages its translations and adaptations.

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