Adult Services, Cardiovascular, Case Study, Obstetrics, Pulmonology

Using ECMO for amniotic fluid embolism contributes to survival in dangerous case

The patient A 41-year-old pregnant patient at 38 weeks’ gestation was admitted for elective cesarean section. Her medical history included three pregnancies, two live births, two prior cesarean sections, anterior placenta with polyhydramnios (amniotic fluid index 35), pituitary macroadenoma, gastroesophageal reflux disease (GERD), and headaches. Echocardiogram in 2019 demonstrated an ejection fraction (EF) of 56%….

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Adult Services, Obstetrics

Certified nurse midwife services now available at Norton Hospital in downtown Louisville

Midwife services are now available at Norton Hospital, as Norton OB/GYN Associates in downtown Louisville introduces a new midwife program. This significant addition to the practice expands existing comprehensive prenatal care services. Previously, midwifery services were available only at a Norton Women’s & Children’s Hospital location in St. Matthews. A certified nurse midwife is a…

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Adult Services, Gynecology, Obstetrics, Pediatric Services

Chronic pelvic pain’s persistence poses challenges for patients and health care providers

Chronic pelvic pain (CPP) is a complex and often debilitating condition that affects a significant portion of the female population. It is commonly defined as pain perceived to originate from the pelvic region that has been present for longer than six months. This differs from acute pelvic pain, which usually has a clearly identifiable cause…

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Adult Services, Obstetrics

Helping patients talk about their menopause symptoms

Women in their 40s and 50s who are starting to experience symptoms of menopause and perimenopause frequently don’t know what to expect, and they are often reticent about bringing up symptoms during visits with their primary care providers. By asking questions and explaining symptoms, providers can normalize symptoms of menopause and perimenopause and put patients…

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Adult Services, Diabetes, Obstetrics

Gestational diabetes diagnosis criteria and management

When considering gestational diabetes diagnosis criteria, carbohydrate intolerance with onset or recognition during pregnancy after 20 weeks is foremost. Gestational diabetes accounts for about 6 in 7 cases of diabetes in pregnancy. Risk factors are similar to nongestational diabetes: obesity, advanced maternal age, hypertension, family history of diabetes, nonwhite ethnicity and prior macrosomic infant. Diagnosing…

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Adult Services, Maternal Fetal Medicine, Obstetrics, Pediatric Services

Rescue cerclage success: Advanced cervical dilatation with bulging bag of water

The patient A routine ultrasound at 20 weeks’ and four days’ gestation showed cervical insufficiency. A pelvic exam by the patient’s primary obstetrician revealed her cervix was 3 centimeters dilated, with a bulging bag of water beyond her cervix. The patient was admitted to Norton Women’s & Children’s Hospital, and a referral was sent to…

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Adult Services, Obstetrics

First-line evaluation and treatment of urogynecologic conditions

Many of our patients at Norton Urogynecology Center are middle-aged with female anatomy, who present with symptoms affecting their quality of life. They may have issues related to incontinence, pelvic organ prolapse, pelvic pain, urinary tract infections or painful sex. Fortunately, these conditions can be managed successfully. We see many patients with urinary function issues…

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Adult Services, Obstetrics

Botox for overactive bladder

[vc_row][vc_column][vc_column_text]Up to 50% of patients with female urinary organs have some issue with bladder control, which can begin as early as their 20s. Those who have had multiple pregnancies or are overweight are at higher risk. Overactive bladder consists of at least two of the following: an urgent need to urinate right away; urinating at…

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Adult Services, Obstetrics

Anticholinergic alternatives for overactive bladder

Medications are the second-line therapy for overactive bladder, after physical therapy and lifestyle changes. Overactive bladder causes bothersome sudden urges and often is accompanied by urinary incontinence. This can really be disruptive to a patient’s quality of life. Anticholinergics such as oxybutynin are the oldest of these medications and the most studied. These drugs are…

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Adult Services, Obstetrics

Advanced stress incontinence treatments

For patients who want to be completely rid of stress incontinence, midurethral sling surgery remains our mainstay treatment. The data show a high success rate, great durability and a low risk profile. With this procedure, a sling is placed underneath the urethra so when the patient coughs or strains in a way that normally results…

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Adult Services, Obstetrics

Alaina C. Sewell, APRN, joins Norton Community Medical Associates – Endocrinology

Alaina C. Sewell, APRN, has joined Norton Community Medical Associates – Endocrinology and is seeing patients at the practice’s Springhurst location. Alaina most recently worked as a nurse practitioner providing family care. She also has worked at Norton Immediate Care Centers; in the Norton Clinical Command Center, in the area of employee health during the…

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Adult Services, Obstetrics

Pelvic health physical therapy can be a first step before urogynecology referral

Pelvic health physical therapy can alleviate pain and improve the strength and function of pelvic floor muscles — enhancing quality of life, hygiene, safety and independence. Sometimes therapy is all that’s needed to address pelvic-health-related conditions such as bladder or bowel control, stool or urine leakage, pelvic pain or pain during intercourse. Physical therapy can…

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