Genetic evaluation and counseling of couples with recurrent miscarriage: recommendations of the National Society of Genetic Counselors.

The objective of this document is to provide recommendations for genetic evaluation and counseling of couples with recurrent miscarriage (RM). The recommendations are the opinions of the multidisciplinary Inherited Pregnancy Loss Working Group (IPLWG), with expertise in genetic counseling, medical genetics, maternal fetal medicine, internal medicine, infectious disease, cytogenetics, and coagulation disorders. The IPLWG defines RM as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (<24 weeks gestation).

Active management of the third stage of labor among American Indian women.

Objective: This study's objective was to judge whether active management of the third stage of labor is as effective in reducing maternal blood loss among rural American Indian women as in randomized trials.

Methods: We collected retrospective data on a cohort of largely multiparous American Indian women having singleton vaginal births at a rural hospital in 2000-2001, comparing measures of blood loss among women receiving active (n=62) versus routine (n=113) management of the third stage of labor. Outcomes included both objective (postpartum hemoglobin decline) and subjective (estimated blood loss) measures of maternal blood loss.