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Postpartum Office Visit

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821. Amniotic Fluid Embolism (Overview)

Amniotic Fluid Embolism (Overview) Amniotic Fluid Embolism: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjUzMDY4LW92ZXJ2aWV3 processing > Amniotic Fluid Embolism Updated (...) , during labor, and the day after delivery. Six of the 9 women with AFE died, and all 9 required blood transfusions for disseminated intravascular coagulation (DIC). Seven women had no evidence of mast cell degranulation (ie, either urinary histamine or serum tryptase). Compared with postpartum control patients, complement levels in the AFE group were severely depressed. C3 in the AFE group was 44 compared with 117.2 in the postpartum group. C4 was 10.7 in the AFE group versus 29.4 in the postpartum

2014 eMedicine.com

822. Amenorrhea, Primary (Overview)

Amenorrhea, Primary (Overview) Amenorrhea: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjUyOTI4LW92ZXJ2aWV3 processing > Amenorrhea Updated: Jan 08, 2019 Author: Kenneth M (...) the point at which oligomenorrhea becomes amenorrhea. Some authors suggest the absence of menses for 6 months constitutes amenorrhea, but the basis for this recommendation is unclear. For a post-menarchal girl or a reproductive-aged woman to experience a menstrual cycle interval of more than 90 days is statistically unusual. Practically speaking, this should be an indication for an evaluation to seek the cause. Next: Pathophysiology The menstrual cycle is an orderly progression of coordinated hormonal

2014 eMedicine.com

823. Platelet Disorders (Follow-up)

Platelet Disorders (Follow-up) Platelet Disorders: Overview of Platelet Disorders, Pathophysiology of Platelet Disorders, Autoimmune Thrombocytopenias Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) . In a prospective observational cohort study of 32 women with von Willebrand disease and 40 women without von Willebrand disease, vWF levels peaked at 250% of baseline at 4 hours postpartum in the von Willebrand disease group and at 12 hours postpartum in the women without von Willebrand disease and then decreased rapidly, reaching baseline at 3 weeks in both groups. Fifteen of the women with von Willebrand disease received treatment with desmopressin or vWF concentrate before or after delivery. Except

2014 eMedicine.com

824. PET Scanning in Autism Spectrum Disorders (Follow-up)

PET Scanning in Autism Spectrum Disorders (Follow-up) PET Scanning in Autism Spectrum Disorders: Overview, Evaluation of Autism Spectrum Disorders, Screening for PET Scanning Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) retardation, and approximately one third of people have seizure disorders. Asperger disorder [ ] refers to autism without mental retardation (ie, high-functioning autism). Complications in the prenatal, perinatal, and postnatal periods have been described in some cases of autism and other pervasive developmental disorders. [ , , ] Exposure to toxins, poisons, residues, and other contaminants is one of the mechanisms hypothesized to cause autism and related conditions. Although evidence exists that toxic

2014 eMedicine.com

825. Autistic Spectrum Disorders (Overview)

Autistic Spectrum Disorders (Overview) Autism Spectrum Disorder: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTEyNzgxLW92ZXJ2aWV3 processing > Autism Spectrum (...) . Through special education, children may learn to suppress the movements, although these may subsequently be exhibited at times of particular stress or excitement. Causes Although the etiology of autism is unknown, hypotheses include genetic abnormalities, obstetric complications, exposure to toxic agents, and prenatal, perinatal, and postnatal infections. [ , , , ] Maternal rubella is associated with significantly higher rates of autism and other conditions in children. Additionally, is associated

2014 eMedicine.com

826. Assisted Reproduction Technology (Overview)

Assisted Reproduction Technology (Overview) Assisted Reproduction Technology: Overview, Cause of Infertility, Diagnostic Tests Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjYzOTA3LW92ZXJ2aWV3 processing (...) ), looking at the interaction of cervical mucous and sperm at a specified time after intercourse during the perio-ovulatory phase of the cycle. A lack of consensus exists regarding the accuracy, precision, and use of the PCT in the modern infertility evaluation, and it is now rarely used in practice. Uterine disease testing Similar to tubal disease, obtaining a history from the patient is the most important diagnostic tool. A history of repetitive abortions, uterine surgery, postpartum uterine infections

2014 eMedicine.com

827. Absence Seizures (Overview)

Absence Seizures (Overview) Absence Seizures: Overview, Etiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2FydGljbGUvMTE4Mzg1OC1vdmVydmlldw== processing > Absence Seizures Updated: Sep 25, 2018 Author (...) epilepsy are girls. [ , ] Absence epilepsy with myoclonus has a male predominance. [ ] Age of onset The generalized idiopathic epilepsies have age-related onset. Onset of absence seizures in children with symptomatic generalized epilepsies depends on the underlying disorder. While many of these disorders may have their onset at an early (prenatal, perinatal, or postnatal) age, absence seizures do not appear until later in childhood. An example is the . The cause may be a genetic disorder or a perinatal

2014 eMedicine.com

828. Abnormal Neonatal EEG (Overview)

Abnormal Neonatal EEG (Overview) Abnormal Neonatal EEG: Neonatal EEG, The Normal Neonatal EEG, The Abnormal Neonatal EEG Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEzOTY5Mi1vdmVydmlldw== processing (...) it difficult to interpret EEG results, which can discourage the use of EEG testing. Given the close relationships between certain morphological aspects of the developing brain and EEG results, gestational age can be reliably estimated (to ±1 wk) by EEG criteria. In fact, CNS development of the immature brain proceeds at about the same rate during fetal development as in the postnatal environment. The physiological substrate for these early EEG patterns is unknown, but is probably derived from cortical

2014 eMedicine.com

829. Neuroimaging in Epilepsy Surgery (Follow-up)

Neuroimaging in Epilepsy Surgery (Follow-up) Neuroimaging in Epilepsy: Overview, Epilepsy Protocol MRI, Evaluation of a First Seizure Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE1NTI5NS1vdmVydmlldw (...) into the following 3 categories based on the stage the MCD occurred: Cortical dysplasia - Neuronal and glial proliferation or apoptosis < 10 wk Heterotopias - Abnormal neuronal migration 10-20 wk Polymicrogyria - Abnormal late cortical migration and organization >20 wk Some degree of cortical organization also occurs postnatally. [ ] Previous Next: MRI of Malformations of Cortical Development Malformations due to abnormal neuronal and glial proliferation or apoptosis Microlissencephaly and microcephaly

2014 eMedicine.com

830. Neuroleptic Malignant Syndrome (Follow-up)

Neuroleptic Malignant Syndrome (Follow-up) Neuroleptic Malignant Syndrome Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) malignant syndrome. Am J Psychiatry . 1997 Aug. 154(8):1156-8. . Alexander PJ, Thomas RM, Das A. Is risk of neuroleptic malignant syndrome increased in the postpartum period?. J Clin Psychiatry . 1998 May. 59(5):254-5. . Otani K, Horiuchi M, Kondo T, Kaneko S, Fukushima Y. Is the predisposition to neuroleptic malignant syndrome genetically transmitted?. Br J Psychiatry . 1991 Jun. 158:850-3. . Rosebush PI, Stewart TD, Gelenberg AJ. Twenty neuroleptic rechallenges after neuroleptic malignant syndrome

2014 eMedicine.com

831. Myasthenia Gravis (Follow-up)

in their myasthenic symptoms, 28% improved, and 41% deteriorated during pregnancy.{Plauche WC. Myasthenia gravis in mother and their new-borns. Clin Obstet Gynecol 1991;34:82-99}. Of the pregnant myasthenic mothers, 30% had exacerbation of the disease in the post-partum period. In general, pyridostigmine and, if needed, prednisone are used, whereas other immunomodulating agents are avoided if possible beause of teratogenic concerns. Current information indicates that azathioprine and cyclosporine are relatively (...) Myasthenia Gravis (Follow-up) Myasthenia Gravis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of neonatal myasthenia gravis Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

832. Lung Cancer, Non-Small Cell (Follow-up)

Lung Cancer, Non-Small Cell (Follow-up) Non-Small Cell Lung Cancer Treatment & Management: Approach Considerations, Surgical Treatment, Radiation Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) . [ ] Although surgical sampling of mediastinal (level 2) lymph nodes was most lacking, evaluation of level 1 lymph nodes was also suboptimal. Further studies are indicated to assess surgical practices in order to achieve minimum standards for accurate staging, prognostication, and eligibility for clinical trials. An understanding of post-surgical quality of life can help surgeons provide lung cancer patients with important information regarding postoperative outcomes. A study that measured health-related

2014 eMedicine.com

833. Menkes Disease (Follow-up)

Menkes Disease (Follow-up) Menkes Disease Treatment & Management: Approach Considerations, Medical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE4MDQ2MC10cmVhdG1lbnQ= processing > Menkes Disease Treatment (...) References Tumer Z, Moller LB. Menkes disease. Eur J Hum Genet . 2010 May. 18(5):511-8. . . Hardman B, Michalczyk A, Greenough M, et al. Hormonal regulation of the Menkes and Wilson copper-transporting ATPases in human placental Jeg-3 cells. Biochem J . 2007 Mar 1. 402(2):241-50. . Niciu MJ, Ma XM, El Meskini R, et al. Developmental changes in the expression of ATP7A during a critical period in postnatal neurodevelopment. Neuroscience . 2006. 139(3):947-64. . Schlief ML, West T, Craig AM, et al. Role

2014 eMedicine.com

834. Menorrhagia (Follow-up)

Menorrhagia (Follow-up) Menorrhagia Treatment & Management: Medical Care, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjU1NTQwLXRyZWF0bWVudA== processing > Menorrhagia Treatment & Management (...) are ongoing. Heated free fluid [ ] HydroThermAblator (HTA) is an office procedure in which normal saline is infused into the uterus via the hysteroscope. The solution is heated to 194°F (90°C) for 10 minutes under direct visualization. This procedure requires only local anesthesia. HTA may be used in patients with irregularly shaped endometrial cavities and/or fibroids. Vaginal and skin burns are the most reported complications. Cryoablation [ ] Cryoablation is the use of liquid nitrogen to freeze

2014 eMedicine.com

835. Hypertension (Follow-up)

healthcare visit if they are obese, are taking medications known to increase BP, have renal disease, or a history of aortic arch obstruction or coarctation, or diabetes. Trained clinicians in the office setting should make a hypertension diagnosis children or adolescents in the presence of auscultatory-confirmed BP readings at or over the 95th percentile for age and height at three separate visits. Perform ambulatory BP monitoring (ABPM) to confirm hypertension in children and adolescents with elevated (...) Hypertension (Follow-up) Hypertension Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjQxMzgxLXRyZWF0bWVudA

2014 eMedicine.com

836. Hypertension and Pregnancy (Follow-up)

Therapy Treatment of Acute Hypertension in Pregnancy Acute severe hypertension in pregnancy is a medical emergency requiring treatment to lower blood pressures within 30 minutes of confirmation to reduce risk of maternal stroke. According to the February 2015 ACOG Committee Opinion #623 “Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Post-Partum Period,” first line options for treatment include oral immediate-release nifedipine, IV labetalol, and IV hydralazine (...) Hypertension and Pregnancy (Follow-up) Hypertension and Pregnancy: Overview, Chronic Hypertension, Differential Diagnosis Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjYxNDM1LW92ZXJ2aWV3 processing

2014 eMedicine.com

837. Hypermagnesemia (Follow-up)

Hypermagnesemia (Follow-up) Hypermagnesemia: Overview, Renal Failure, Other Causes Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjQ2NDg5LW92ZXJ2aWV3 processing > Hypermagnesemia Updated: Sep 06, 2017 Author (...) D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev . 2010 Nov 10. 345(8963):CD000025. . Naeimi A, Rieu M, Le Guen F, Marpeau L. [Preeclampsia and benefit from magnesium sulfate. About 105 cases]. Gynecol Obstet Fertil . 2014 May. 42 (5):322-4. . Al-Shoha M, Klair JS, Girotra M, Garcia-Saenz-de-Sicilia M. Magnesium Toxicity-Induced Ileus in a Postpartum Patient Treated for Preeclampsia With Magnesium Sulphate. ACG Case Rep J . 2015 Jul. 2 (4

2014 eMedicine.com

838. Cystic Hygroma

Cystic Hygroma Cystic Hygroma Imaging: Overview, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDAyNzU3LW92ZXJ2aWV3 processing > Cystic Hygroma Imaging Updated: Dec 10, 2015 (...) shows posterior cystic hygroma (same patient as in previous image). The discovery of a cystic hygroma has a variable effect and prognosis, depending on whether it is found in the prenatal or postnatal period. This article focuses on fetal cystic hygromas, that is, cystic hygromas that are discovered prenatally. [ ] Preferred examination Ultrasonography (US) is the modality of choice for diagnosing fetal cystic hygromas. [ ] US is readily available and noninvasive, and it is used extensively

2014 eMedicine Radiology

839. Cecal Volvulus

Cecal Volvulus Cecal Volvulus Imaging: Overview, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzY0OTY3LW92ZXJ2aWV3 processing > Cecal Volvulus Imaging Updated: Jan 12, 2016 (...) of the differential diagnosis. Other conditions to be considered are a distended stomach from high gastrointestinal obstruction or gastroparesis, other forms of large bowel obstruction, and a giant sigmoid diverticulum. An attempt should always be made to reduce the volvulus with barium enema examination, unless contraindications are present. Reduction with barium enema examination is particularly successful in the rare cecal volvulus that occurs in the postpartum patient. The volvulus may reduce during

2014 eMedicine Radiology

840. Gastroschisis

Gastroschisis Gastroschisis Imaging: Overview, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDAzODAwLW92ZXJ2aWV3 processing > Gastroschisis Imaging Updated: Nov 28, 2016 Author (...) . Intrauterine growth restriction (IUGR) occurs in 38-77% of fetuses and is usually secondary to nutrient loss through exposed bowel. Approximately 48% of infants with gastroschisis are small for their gestational age. [ ] A bowel diameter greater than 17 mm usually represents significant bowel dilatation, and diameters greater than 11 mm are usually associated with a greater number of postnatal bowel complications. Sonographic findings of bowel abnormalities are associated with difficult abdominal wall

2014 eMedicine Radiology

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