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WHEC
WOMEN'S HEALTH AND EDUCATION CENTER

Multiple Pregnancies

August 6, 2009

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.

Contraception and New Millennium

September 23, 2009

The new millennium has brought optimism to the field of family planning. Recent research and modification to existing contraceptive products have generated confidence, among both healthcare professionals and the public, in the safety, efficacy, and importance of contraceptives. According to World Health Organization’s (WHO’s) statistics there are an estimated 200 million pregnancies around the world each year, and one third of these, or 75 million, are unwanted. These pregnancies contribute to women’s health problems in two ways. First, unwanted pregnancy can threaten women’s health or well being because she may have existing health problems or lack of support and resources, which she needs to have a healthy pregnancy and raise a healthy child.

Obstetric Anesthesia: Complications and Management

September 30, 2009

During pregnancy, there are major alterations in nearly every maternal organ system. These changes are initiated by hormones secreted by the corpus luteum and placenta. The mechanical effects of the enlarging uterus and compression of surrounding structures play an increasing role in the second and third trimesters. This altered physiologic state had relevant implications for the anesthesiologist caring for the pregnant patient. Any drug that reaches the fetus undergoes metabolism and excretion. Well-conducted obstetric analgesia and anesthesia, in addition to relieving pain and anxiety, may benefit the mother. Placental drug uptake is limited, and there is no evidence to suggest that this organ metabolizes any of the agents commonly used in obstetric anesthesia. The idea that surgical anesthesia, although deemed necessary for the patient, might have detrimental effects on the growth and development of the human fetus has led to a great deal of investigation, both in-vitro and in experimental animals. Because a single exposure to anesthetic agents seems unlikely to result in fetal abnormalities, the selection of agent should be based on specific surgical requirements.

Pathways To Change

October 14, 2009

Refraining and responding to violence against women. Health care Professionals are among the first person to whom a victim of abuse will turn for help. This presents a significant opportunity to offer effective, timely interventions that help victims regain a sense of control over their lives.

Safe Motherhood: A Matter of Human Rights & Social Justice

December 7, 2009

Maternal health is a multifaceted problem with social, psychological and cultural roots. There is no simple or single solution to the problem; rather women’s healthcare must be addressed at multiple levels and in multiple sectors of society to develop effective projects and programs. Aim to ensure equal access to affordable and quality healthcare.

Breast Cancer: Radiotherapy and Adjuvant Systemic Modalities

January 6, 2012

Radiation therapy (RT) plays an important role in management of breast cancer. In all situations, RT must be delivered in a manner that will appropriately treat the target tissues and minimize risks to adjacent normal tissues. For patients desirous of breast-conserving therapy (BCT), lumpectomy plus breast RT is typically the preferred approach, because it provides long-term survival rates equivalent to that achieved with mastectomy. This chapter also briefly reviews our current understanding of the role of adjuvant systemic therapy in the management of breast cancer in the modern era.

Global Efforts to End Obstetric Fistula (Part 2)

February 20, 2013

The review outlines efforts made by the United Nations system and its Member States and remaining gaps. Commitments and efforts of Women’s Health and Education Center (WHEC) are also included. 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. Almost all obstetric fistulae occur in resource-poor areas, as a paucity of resources is the root cause. Where there are no suitable facilities for deliveries and obstetric emergencies, obstruction of labor often results in fetal death and obstetric fistula. Treatment in this setting usually focuses on meeting patients’ immediate needs rather than conducting research and refining techniques and long-term management of the patients. Unified, standardized evidence-base for informing clinical practice is lacking.

Ebola Virus Disease and Pregnancy

October 24, 2014

The review provides general background information on Ebola virus disease (EVD) and specifically addresses what is known about EVD in pregnancy and the implications for practicing obstetricians and gynecologists. Limited evidence suggests that pregnant women are at increased risk for severe illness and death when infected with Ebola virus, but there is no evidence to suggest that pregnant women are more susceptible to EVD. It is important that all health care providers are prepared to respond to ensure that Ebola virus transmission is contained. Specifically, U.S. health care providers, including obstetricians and gynecologists, should ask patients about recent travel to affected countries in West Africa, know the signs and symptoms of EVD, and know what to do if they have a patient with compatible illness. For all healthcare providers, infection-control procedures are recommended, including standard, contact, and droplet precautions. Pregnant women with EVD appear to be at an increased risk for spontaneous abortion and pregnancy-associated hemorrhage. Neonates born to mothers with EVD have not survived.

First Trimester Ultrasound Applications

October 30, 2015

For at least 20 years, many researchers have advocated the use of ultrasound in general and transvaginal ultrasound in particular to identify anomalies in the first and early second trimester. Over that period, advances in transducer technology, faster computers, and deepening understanding of developmental anatomy have facilitated such use. Increasing reliance on first-trimester screening brings more and more women with gestations from 11 to 14 weeks to the obstetrician’s office, providing an opportunity to expand the narrow viewing angle of the ultrasound probe from the nuchal area to the entire fetus. As time goes on, we may discover additional compelling reasons to shift the first fetal evaluation from the second-trimester to the first-trimester. In the meantime, we find no reason not to widen the viewing angle of transducer probes to assess fetal anatomy at the first-trimester scan. This document discusses evolving applications of first-trimester ultrasound. Scanning can be performed transvaginally or transabdominally, although the transvaginal route is preferred during the first-trimester, because of high-resolution images it yields. Clear images improve reliability and accuracy. However, at times, a combination of transvaginal and transabdominal scanning may be preferred. Both basic and advanced first-trimester ultrasound applications are discussed in this review.

Urinary Incontinence: Introduction & Behavior Modification

February 9, 2009

There are various types of incontinence and the role of behavior modification. Overactive bladder (OAB) / urge incontinence is a common condition that becomes even more prevalent as people age. It is associated with significant psychological and physical morbidity as well as increased healthcare costs. The prevalence of stress incontinence represents a spectrum, depending on how incontinence is defined. There is racial and ethnic variation in the prevalence of urinary incontinence in women.