Babies After 35

12/14/2025

OP UpToDate:✂️Episiotomy is the surgical enlargement of the posterior aspect of the va**na by an incision to the perineum during the last part of the second stage of labor. The purpose is to widen the birth outlet and facilitate va**nal delivery.✂️Routine episiotomy is associated with higher rates of severe perineal trauma and wound complications compared with restricted use of episiotomy. The decision to perform episiotomy is made on a case-by-case, or restricted, basis rather than performing the procedure routinely.✂️Situations in which episiotomy can be helpful include the need for expedited va**nal delivery, operative va**nal delivery, and shoulder dystocia. ✂️When an episiotomy is to be performed, a mediolateral or lateral episiotomy will not increase the risk of a**l sphincter laceration (ie, third- or fourth-degree obstetric injury) as median (midline) episiotomy does. ✂️Once the decision is made to perform an episiotomy, patient consent is obtained, adequate anesthesia is provided, and the fetal scalp is protected by the clinician prior to incision. Documentation of the indication for episiotomy and type performed should be in the delivery record. ✂️Common complications of episiotomy include extension of the incision into the perineum or a**l sphincter complex, infection, postpartum pain, and dyspareunia. ✂️Episiotomy use at the time of the first va**nal delivery appears to increase the risk of a severe obstetric laceration in a subsequent va**nal delivery.

12/12/2025

Abdominal pregnancy is a rare form of ectopic pregnancy in which the pregnancy implants within the peritoneal cavity, exclusive of the fallopian tubes, ovaries, broad ligament, and cervix. It is further classified as early (≤20 weeks of gestation) or advanced (>20 weeks of gestation). Abdominal pregnancy is associated with high maternal and fetal morbidity (eg, maternal hemorrhage, fistula formation, fetal malformation) and mortality. However, some abdominal pregnancies may continue to a viable gestation and successful pregnancy outcomes have been reported. Patients with hemorrhage and existing or impending hemodynamic instability or with embryonic/fetal demise require surgical removal of the pregnancy. Hemodynamically stable patients may choose expectant management or termination; the decision is generally determined by gestational age, but other factors (eg, patient preference, experience of the physician caring for the patient, presence of a fetal anomaly or severe oligohydramnios, access to a tertiary care hospital) also guide management decisions. The optimal management of the placenta is unclear and various methods (eg, removal of the placenta at the time of surgery, leaving the placenta in situ, pre- or postoperative methotrexate, selective embolization of the placental bed) may be used.

12/10/2025

OP @ alleightaylor

12/07/2025

12/07/2025

12/06/2025

Pregnancy is so frickin’ cool!

Physiologic changes related to pregnancy result in a weight gain of approximately 25 lb (11 kg). Gestational weight gain is the weight gained during pregnancy, which is rarely measurable with precision. The starting weight is often considered the weight documented at the first prenatal visit, but a self-reported or documented periconceptional weight may be used, especially if prenatal care is initiated after the first trimester. The ending weight is often considered the weight recorded at the last prenatal office visit, which is typically within a few days of birth in late pregnancy but may be two to four weeks before a preterm birth. Weighing the patient on the labor and delivery unit may be an option when an accurate rate is clinically important.

IOM recommendations for weight gain in pregnancy:
●Singleton pregnancy
•BMI

12/06/2025

Preeclampsia is a pregnancy specific hypertensive disease with multi-system involvement. It usually occurs after 20 weeks of gestation.

Preeclampsia without severe features: •Hypertension and proteinuria or in absence of proteinuria, new-onset hypertension with the new onset of any of the following:
•Thrombocytopenia: Platelets 1.1 mg/dl or doubling of serum creatinine in the absence of other renal disease
•Impaired liver function: Elevated blood concentrations of liver transaminases to twice normal concentration
•Pulmonary edema
•Neuro: Unexplained new-onset headache unresponsive to medication (without an alternative diagnosis) or visual symptoms

The following are not diagnostic criteria for the diagnosis of preeclampsia or preeclampsia with severe features •Clinically evident edema
•Rapid weight gain
•Massive proteinuria
•Fetal growth restriction
•Uric acid elevation

Outpatient management appropriate for the following:
•Gestational hypertension without severe features or Preeclampsia without severe features

Outpatient management assessments: •Fetal growth assessment every 3-4 weeks
•Amniotic fluid assessment weekly •Antenatal testing 1-2 times per week •Weekly maternal labs
•Weekly clinic visits

Inpatient management appropriate for the following:
•Severe preeclampsia or Poor adherence to monitoring recommendations

Candidates for expectant management:
•Gestational hypertension or preeclampsia without severe features •Reassuring antenatal testing
•Intact membranes
•No va**nal bleeding
•No evidence of active preterm labor •Delivery at 37 weeks if no severe features. Delivery at 34 weeks if severe features.

12/05/2025

OP jennyfrancis23 and resultswithbump…

The suit is cute, but not the content. It’s really disappointing to see people sensationalize information to get views, which this video accomplished. People deserve accurate info with context and clarity, not info that serves to promote confusion and fear.

From UpToDate:

Re**us abdominis diastasis (RAD) is an anatomic term describing a condition in which an abnormal distance separates the two re**us muscles. There is controversy regarding what constitutes a normal inter-re**us distance. A separation of more than 2 cm typically considered to be abnormal.

Pregnancy increases the risk of developing re**us abdominis diastasis; however, not all develop diastasis during the course of pregnancy, and among those who do, RAD is associated with conditions that are related to the weakening of other tissues (eg, heavy lifting). The amount of separation can increase, decrease, or stay the same in the postpartum period. While pre-emptive exercise may prevent diastasis, whether postpartum exercise can resolve is less certain.

**usmuscles

12/05/2025

OP

12/03/2025

What are your Gs and Ps?

G: number of pregnancies

P numbers:
Full term births
Preterm births
Pregnancy losses
Living children born after 20 weeks

I am a G3P0122.

12/03/2025

Their primary sources of income include: •Online Schools and Courses: FBS runs online schools that train “radical birth keepers” and “authentic midwives” to support women during unassisted births. These programs are expensive; one year-long “midwifery school” charged $12,000, while a three-month course was priced at $6,000. •Video Guides: They sell instructional materials, most notably “The Complete Guide to Freebirth,” a video course co-created by founders Emilee Saldaya and Yolande Norris-Clark, available for download from their website. •Membership Community: The organization operates a paid membership group called “The Lighthouse” which provides pregnant women with access to monthly workshops, an online community, and exclusive access/pricing for in-person events and retreats. An annual membership has been noted to cost around $499. The business is highly adept at monetizing its ideology, leveraging a large social media following across platforms like podcasts, Instagram, and YouTube to attract customers. Reports suggest FBS has generated over $13 million in revenue since 2018.

12/01/2025

Go to my link in bio-Linktree-Google drive of resources to access this paper.