Four Tips for Using A Quantitative HCG Test

Published on :

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?

Published on :

  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

Published on :

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?)

Published on :

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 […]

Williams Obstetrics and Male Chauvinism

Published on :

As a collector of old Ob/Gyn textbooks, I am absolutely amazed at some of the male chauvinistic gems they contain. Here’s a good one from 1934 (Thorek’s Surgical Errors and Safeguards): He was discussing vaginal repairs, of course. The same author was wise enough to point out a couple of paragraphs later that “Many useless surgeries […]

Child Mortality

Published on :

Ever heard of the Child Mortality Rate? It’s the number of children, per 1000, who die before the age of 5.  This includes Neonatal Mortality and Infant Mortality, but it doesn’t include Fetal Mortality and therefore doesn’t include Perinatal Mortality. Confused? Here’s a refresher (each rate is reported per 1,000): Fetal Mortality: Fetal deaths which […]

Four Tips for Performing a Hysterosalpingogram (HSG)

Published on :

Hysterosalpingogram (HSG) is performed less commonly in modern gynecology than in the past, but it is still a valuable tool for some patients. A well performed HSG should be relatively painless and its results need to be correctly interpreted in context of what is already known about the patient. Here are four tips for performing […]