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Saturday, February 15, 2014

5 Pregnancy Recommendations that Have Been Questioned by Choosing Wisely

Guidelines are supposed to be just that: a guide for your gyno to evaluate and determine if this should be applied to you. In a new, fairly sophisticated analysis of practices by high risk specialists some tests have been called into question by an organization called Choosing Wisely. It is an interesting site to review guidelines of many specialties.
Their recommendations are relatively narrow for pregnancy; most of which is very specific for prenatal patients with specific pregnancy concerns. But in summary the 5 are:
  1. In women with histories of miscarrige, small babies, toxemia or abruption you don't need to look for antiphospholipids any longer, it was not likely the cause of the problem.
  2. Twin pregnancies may have a short cervix but do not need to have their cervix sewn shut.
  3. They caution against doing blood testing for chromosome problems in pregnancy unless you are at risk and bid patients to remember it is 99% acurate.
  4. Ultrasound use of blood flow through the placenta can be misleading in cases where nothing is wrong.
  5. Progesterone for women with prior premature baby is good but progestogens for preterm birth prevention has not been shown to help twin pregnancies.

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