Subchorionic Hematomas, Lakes, and all that Jazz…

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Two things drive me crazy, and a third vexes my soul: Over-diagnosis of subchorionic hematoma; Inappropriate counseling and recommendations regarding subchorionic hematoma; And inappropriate management of placental lakes. Not a week goes by that I don’t see a patient who has presented to an emergency department somewhere, diagnosed with a (questionable) subchorionic hematoma or placental […]

Ten Things I’ve Learned About Maternal Mortality

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I’ve attended two conferences in the last 3 weeks that largely revolved around maternal mortality in the United States. About 700 women each year die in the United States during or around the time they give birth. For those of who practice Obstetrics, we believe that even one is too many. I’ve been reading and […]

Four Tips for Removing a Nexplanon

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Nexplanon removal should be a relatively straightforward and easy procedure. However, there are a few things you can do to make the job even easier. Number four is my favorite. Here are four tips for removing a Nexplanon. 1. Pick the right spot. Move the device by pushing on the distal end to see where […]

The Serena Syndrome

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(Note: I have no personal knowledge of Serena Williams’ pregnancy or the care she received. This article is based on publicly available information only and many details are surmised.) Serena Williams recently had a baby. Apparently, she almost died. Here’s how Serena herself described what happened: I almost died after giving birth to my daughter, […]

Four Tips for Using A Quantitative HCG Test

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Pregnancy tests come in three varieties: a urine qualitative test (it’s either positive or negative), a serum qualitative test (again, either positive or negative), and a serum quantitative test (with a specific numeric result). I see far too many serum quantitative hCGs ordered in clinical practice (by OBs, ER docs, etc.) and this implies that […]

Have We ARRIVEd at 39 Weeks?

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  Confused by the ARRIVE Trial presented this past week at SMFM? Don’t be. It’s unclear what impact this trial will ultimately have on recommendations from ACOG or the Society of Maternal-Fetal Medicine, but it is clear that it adds little to the present debate. I have written about this debate already in a three part […]

Birth Control and Weight Gain

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I spend a considerable amount of my day trying to convince women that whatever their current complaint might be is not related to their birth control. For many reproductive-age women, the only medication they use is birth control. So, it’s unfortunately natural that whenever they have a problem they tend to blame it on birth […]

The Medical Hype Cycle (The Herrell Curve?)

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When a breakthrough innovation, new test, or new treatment is discovered in medicine, its adoption often follows a typical pattern. This pattern is demonstrated graphically on the illustration below. I have adapted this concept from the Hype Cycle used to describe new technologies in business but with some important modifications. A new discovery is made […]