71 research outputs found
Preventive Antepartum Care
As the role of the obstetrician-gynecologist evolves to include primary care, the obstetrician must assume greater
responsibility for providing prenatal preventive care, particularly regarding the STORCH5 pathogens
Prevention of Infection in Pregnancy
We believe the prevention of infection-related adverse pregnancy outcome is the most important focus for obstetricians today. An emphasis upon immunization of susceptible women, prevention of transmissible disease by modification of patient behavior, and identification and treatment of silent infections should become standards of practice. This will require educational initiatives for physicians and their patients as well as continued clinical trials to determine costs and effectiveness
Ethical Dimensions of Human Immunodeficiency Virus Infection During Pregnancy
Physicians encounter complex and sensitive ethical challenges in the medical care of pregnant women with human immunodeficiency virus (HIV) infection. This paper identifies those ethical challenges and provides concrete clinical guidance for how they should be addressed in obstetric care. The paper begins with a brief historical review, to highlight and to call into question the civil rights model of the ethics of HIV infection that has dominated the literature, clinical practice, and public policy. The authors propose an alternative ethical framework. This framework begins by underscoring the public health obligations of both physicians and pregnant women with HIV infection. The framework is based on a clinical ethics that appeals to both beneficence-based and
autonomy-based obligations of the physician to the pregnant woman and the beneficence-based
obligations of both the physician and the pregnant woman to the fetal patient. This framework is
then deployed in a clinical ethical analysis of termination of pregnancy and contraception, partner
notification, disclosure and confidentiality of her serostatus by the patient to the health care team,
disclosure and confidentiality of her serostatus to other health care professionals, prevention of
vertical transmission, and advance directives
Pregnancy Outcome Following Pelvic Infection
To determine whether a previous pelvic infection has an effect on the outcome of a subsequent
pregnancy, we identified women with a diagnosis of pelvic inflammatory disease (PID), amnionitis,
and postpartum or postabortal endometritis-salpingitis by a retrospective chart review of all patients
admitted to the Department of Obstetrics and Gynecology at The New York Hospital-Cornell
Medical Center between 1975 and 1977 and between 1985 and 1988. Antimicrobial regimens
effective against Chlamydia trachomatis were initiated in 1985. Controls were randomly selected
patients presenting during the same time period for routine examinations who had normal Pap
smears and no infections. Both groups were comparable for age, race, gravity, and parity. Differences
were evaluated by chi square analysis, using the Yates correction factor. We identified 183
women with a history of the above infections who subsequently conceived, and 82 controls. There
were no differences in outcome between the two index groups. Term vaginal deliveries occurred in
14.2% of the women with a prior pelvic infection and in 56% of the controls (P < 0.001). Among the
97 women who had had PID, 21 (21.6%) had a spontaneous abortion in the subsequent pregnancy,
as opposed to 6 (7.3%) of the controls (P = 0.013). In addition, eight of the women with PID (but no
controls) went into preterm labor (P = 0.021). An increased incidence of preterm labor (P = 0.001)
was also observed in women with a history of amnionitis. A history of endometritis was not
associated with an increased prevalence of abnormal outcome in subsequent pregnancies. PID and
amnionitis may adversely affect the outcome of subsequent pregnancies
Vulvar Vestibulitis—A Complex Clinical Entity
Objective: This study aims to determine the pathophysiology of vulvar vestibulitis and to evaluate
currently used treatment options
International Group for Research in the Immunopathogenesis of Genital Infections: II. International Symposium on Immunopathogenesis of Pregnancy, December 6–7, 1997
Relation between recurrent vulvovaginal candidiasis, vaginal concentrations of mannose-binding lectin, and a mannose-binding lectin gene polymorphism in latvian women
Funding Information: Financial support: FIGO/Schering Research Foundation Fellowship (O.B.).Vaginal concentrations of mannose-binding lectin (MBL) and possession of a polymorphism in codon 54 of the MBL gene were determined in 42 women with recurrent vulvovaginal candidiasis (RVVC) and 43 control subjects. Reduced vaginal MBL levels and an increased occurrence of the polymorphism were present in women with RVVC.Peer reviewe
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