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Cesarean Section: 6 Ways To Prevent Complications

Although I’ve been a proponent for the prevention of medical errors for years and wrote a book to address those issues, I think my obstetrician-gynecologist (OB/GYN) colleagues are finally catching on.

Dr. Patrick Duff of the University of Florida’s OB/GYN department wrote an article in the December issue of the journal Obstetrics & Gynecology that caught my attention. In his article, “A Simple Checklist for Preventing Major Complications Associated with Cesarean Delivery,” Duff outlines steps that OB/GYNs should take in order to reduce complications during and after a cesarean section. Duff patterns his list after Dr. Atul Gawande’s book, “The Checklist Manifesto: How to Get it Right,” which has set the standard regarding reducing complications after surgery. According to Duff, the following steps should be taken in order to reduce complications after a cesarean section:

1. Clip hair at the surgical site just before making the incision to reduce wound infections. Duff states that there is a greater chance of promoting infections when the hair is shaved the night before the procedure. He also recommends clipping hair as opposed to shaving which reduces the rate of would infections.

2. Cleanse skin with chlorhexidine solution rather than iodine because medical studies have demonstrated a reduction in infections using chlorhexidine solution.

3. Give broad spectrum antibiotics before the surgical incision as opposed to after the newborn’s umbilical cord is clamped. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Vaginal Steam Baths: A Medical Opinion

A spa in California is offering vaginal steam baths, in which spa-goers squat or sit on open stools over a tub of hot steam, as a cure-all for menstrual, digestion, and mood disorders:

The V-Steam: Inspired by an ancient ritual practiced for many years in Korea. The steam from the herbal tea rises and absorbs into your skin & orifice. This steaming treatment stimulates the production of hormones to maintain uterine health, aids regular menstrual cycles, helps correct digestive disorders while soothing the nervous system. The natural antibiotic and anti-fungal properties are said to help maintain internal health as well as keeping your skin looking young. (30 min: $50. Series of 6: $180.)

It’s a douche, folks. A $50 douche made with mugwort and 13 other herbs and having a fancy Korean name: Chai-Yok. True, the water gets up there as steam, and if you don’t squat just right over the steam bath, I imagine it may not get up there at all. But in the end, it’s a douche.

We docs strongly advise against douching since we know that women who do it have higher rates of vaginal and pelvic infections. Not to mention that the vaginal mucosa is highly-absorptive surface, meaning anything you put in there is likely to end up in the rest of your body. And so I ask: What herbs are they using, at what doses, and what side effects might they have? Not to mention what might be growing in those wooden tubs they have you squatting over? Read more »

*This blog post was originally published at tbtam*

Pregnant Teacher Stops A School Fight But Loses Her Baby

When a pregnant woman goes to work and ends up with a dead baby, something is terribly wrong.

Lissedia Batista was a 27-year-old Spanish teacher who taught at Exploration Academy in the Bronx and was sixteen weeks pregnant. Given today’s economy, I’m certain that Batista was grateful to have a job with the New York City Board of Education. As a native New Yorker, I am keenly aware of how competitive it is to land such a position. Working for the Board of Education traditionally meant job security — a pension and a strong union that took care of its members. 

Like many young teachers, Batista had compassion. She attempted to stop a fight between two male students, was pushed out of the way, and subsequently fell to the floor. She was taken by ambulance to the hospital, but unfortunately experienced a miscarriage. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Going Against Medicine: Courageous Or Foolish?

Every once I awhile a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title: “Mom Defies Doctor, Has Baby Her Way.” The article describes a story where a mother was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and “defied” her doctor’s order for the procedure. “You’re being irresponsible,” the patient was told.

The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that “it’s reasonable to consider allowing women who’ve had two C-sections to try to have a vaginal delivery.” Of course, there’s risks with proceeding with a vaginal delivery and risks of another C-section.

What’s always interesting to me are the comments following the article. I applaud the physicians who are fighting back the anti-physician sentiment and those who are pushing (no pun intended) the only home birth agenda.

In the article, this person is being held up as a hero — as someone who defied the paternalistic medical establishment and did it her way. Good for her — or is it? What if that 0.4-0.9 percent possibility of severe complication occurred and there was a problem with mom and/or the baby? What would happen then? Read more »

*This blog post was originally published at Doctor Anonymous*

Snoring During Pregnancy: A Risk For Gestational Diabetes?

A recent medical study reported a fairly unique finding:  Pregnant women who snore frequently are at an increased risk for developing gestational diabetes.

The Associated Professional Sleep Societies (TAPSS) reported that 24 percent of habitual snorers had an official diagnosis of gestational diabetes as opposed to 17 percent of nonsnorers. As gestational diabetes affects 4 to 6 percent of all pregnant women, this study is significant according to Louise O’Brien, Ph.D. who is associated with the department of neurology at the University of Michigan in Ann Arbor.

Snoring is nothing new among women but it becomes more pronounced with the onset of menopause or weight gain. Approximately one-third of all women in the U.S. are obese and at risk for snoring and sleep apnea. Being overweight can cause bulky throat tissue which then physically blocks air flow.

Up until the publication of the University of Michigan study, the health risks associated with snoring included greater than ten seconds of interruptions of breathing, frequent waking from sleep, potential strain on the heart which then results in hypertension, increased risk of heart attacks, and stroke. Now the tide has changed. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

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