Page 12 – Womens Health Polylang

A cornerstone of blood glucose management of GDM is Medical Nutrition Therapy (MNT). The goal of MNT is to help the woman achieve normoglycemia without ketosis and optimal nutritional intake for maternal health and fetal growth. An estimated 50-75% of pregnancies complicated by GDM can be successfully managed with MNT alone. It is important to initiate such intervention as soon as possible after diagnosis. Referral to a Registered Dietitian (RD) should be made within 48 hours of diagnosis so that intervention can be initiated within one week after diagnosis.

Drugs in Pregnancy and Lactation

August 6, 2009

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The ideal time to address medication exposure and consider alternative treatment is prior to conception. Many pharmacologic agents have teratogenic potential as well as the potential to induce fetal harm later in gestation with effects that may be lethal or cause long-term handicaps. Many women will present already pregnant, thus providing a narrow window of time in which to evaluate the fetal risks and weigh them against the maternal benefits of continuing the medication. This chapter reviews the risks of commonly used medications during pregnancy, highlights medications with particularly high risk, and reviews the evaluation of fetuses who are exposed.

Walk In Her Shoes

October 14, 2009

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Domestic Violence is characterized as a pattern of coercive behaviors that may include repeated battering & injury, psychological abuse, sexual assault, progressive social isolation, deprivation and intimidation. Someone who is or was involved in an intimate relationship, with the victim, perpetrates these behaviors. This article gives an overview of the dynamics and magnitude of Domestic Violence.

Challenges of Cultural Diversity and Practice of Medicine

December 7, 2009

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Culture is a lens through which people see their world. Every professional encounter with a patient involves three cultures: that of patient, that of healthcare provider and that of environment. The answer to the situation is as simple as the issue is complex. If there were any religion that could cope with modern scientific needs, it would be – an open mind.

Breast Cancer Surgical Treatment Complications & Lymphedema

August 15, 2011

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Complications after any operation can be minimized with thorough preoperative evaluation, meticulous technique, hemostasis, and wound closure. In addition to the standard oncologic evaluation, preoperative evaluation includes assessment of the patient’s overall physiologic condition, with particular emphasis on tolerability of anesthesia, uncontrolled diabetes, hypertension, anemia, coagulopathy, or steroid dependency. The purpose of this document is to review commonly used approaches for the care of the post-mastectomy wound and addresses the complications encountered in these patients. Rehabilitation of the post-mastectomy patients produces problems of varying complexity. Pathophysiology, prevention, and management of lymphedema are also discussed. Mastectomy is a safe operation with low morbidity and mortality. Although the incidence of post-operative complications is low, physicians should be aware of the morbidity unique to mastectomy and axillary node dissection.

Global Efforts to End Obstetric Fistula (Part 1)

February 20, 2013

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Obstetric fistula is a devastating childbirth injury that leaves women incontinent, often stigmatized, and isolated from their communities. It is a stark outcome of socioeconomic and gender inequalities, human rights denial and poor access to reproductive health services, including maternal and newborn care, and an indication of high levels of maternal death and disability. These reviews outline efforts made at the international, regional and national levels, and by the United Nations system, to end obstetric fistula. It offers recommendations to intensify these efforts, within a human rights-based approach, to end obstetric fistula as a key step towards achieving Millennium Development Goal 5, by improving maternal health, strengthening health systems, reducing health inequities, and increasing the levels and predictability of funding. This review addresses magnitude of the problem and efforts at international, national and regional levels. Nongovernmental organizations (NGOs) and faith-based organizations in Africa are comparable to government-run institutions in terms of infrastructure and capacity to deliver obstetric care. Higher rates of obstetrician attendance and cesarean / instrumental delivery occurred at these institutions, potentially indicating better access to lifesaving intrapartum care. Greater recognition and integration of NGOs and faith-based organizations into strategies to improve maternal and neonatal health are essential for reaching international targets.

Zika Virus Infection in Pregnancy

March 16, 2017

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Zika virus infection in humans appears to have changed in character while expanding in geographical range. Zika virus has now been clearly established as the cause of severe fetal malformations, particularly microcephaly. The risk of fetal injury appears to be greater when maternal infection occurs in the first trimester of pregnancy. Zika virus has now been established as the cause of Guillain-Barré syndrome (GBS) in adults. Although most cases of Zika virus infection are transmitted as the result of mosquito bites, patients can acquire the infection through sexual contact. Both male-to-female and female-to-male transmission have been documented. Currently, real-time reverse transcription polymerase chain reaction (rRT-PCR), immunoglobulin M (IgM), and plaque reduction neutralization (PRNT) tests are available to detect Zika infection, although each test has limitations. If a patient has had symptoms of Zika virus infection for less than 5 days, serum and urine should be obtained for rRT-PCR testing. If symptoms have been present for 5 to 14 days, urine should be tested by rRT-PCR because urine samples appear to remain positive for virus longer than serum samples do. Early-stage trials examine whether an experimental vaccine is safe and generates immune responses in vaccinated volunteers. A safe and effective, fully licensed Zika vaccine will likely not be available for several years.

Health Implications of Urinary Incontinence in Women

February 9, 2009

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Understanding the best available evidence for evaluating and treating urinary incontinence in women with a focus on overactive bladder (OAB). Prevalence of incontinence appears to increase gradually during young adult life, has a broad peak around middle age, and then steadily increases in the elderly. After the basic evaluation of urinary incontinence, simple cystometry is appropriate for detecting abnormalities of detrusor compliance and contractibility, measuring postvoid residual volume, and determining capacity. The differential diagnosis including genito-urinary and non-genito-urinary conditions and their various managements are also discussed. Although pharmacologic and non-pharmacologic therapies are effective in reducing urge incontinence, neither is curative in some patients.

Anxiety Disorders

March 19, 2009

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Anxiety disorders are common in women, and cause substantial impairment in all spheres of functioning. Many effective treatment modalities offer hope and help to most sufferers and by asking specific questions to determine whether an anxiety disorder is a possibility, physicians will be able to make the appropriate diagnosis. Women are particularly vulnerable to such disorders, experiencing them twice as frequently as men. Situations related to gender, such as childbirth and domestic violence may increase the frequency of these problems. The purpose of this document is to outline a general framework for healthcare providers to diagnose and treat various types of anxiety disorders in women.

Chronic Hypertension in Pregnancy

June 8, 2009

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This review discusses the effects of chronic hypertension on pregnancy, to clarify the terminology and criteria used to define and diagnose it during pregnancy, and to review the available evidence for treatment options. Chronic hypertension complicates pregnancy and is associated with several adverse outcomes, including premature birth, intrauterine growth restriction (IUGR), fetal demise, placental abruption, and cesarean delivery. An additional diagnostic complication may arise in women with hypertension who begin prenatal care after 20 weeks of gestation.