Is terbutaline worth using to stop preterm labor?

Alexander Kofinas M.D.

Terbutaline is one of the worst medications ever used in patients with preterm labor. All the studies over the last 20 years have failed to prove any significant effects in stopping labor or prolonging pregnancy. In contrast, many studies have clearly demonstrated that terbutaline is dangerous for the mother and the unborn and continuous use of it in oral and ...

Are pregnancies conceived by assisted reproductive technologies (ART) high-risk pregnancies by default?

Alexander Kofinas M.D.

The answer is resoundingly yes. Many years ago we realized that such pregnancies suffer from serious placental pathologies that can cause all kinds of pregnancy complications. Because of this understanding, we have developed, in conjunction with the KOFINAS FERTILITY INSTITUTE, management protocols that have increased the success rates of these pregnancies and the quality of the fetuses. Despite the fact ...

I lost two babies because of cervical incompetence and was told I needed an abdominal cerclage. Is this correct?

Alexander Kofinas M.D.

No, this is not correct. At KOFINAS PERINATAL we have shown that abdominal cerclage belongs in the history books and not in the operating room. The only exception is when the cervix is not accessible for any reason through the vagina and the diagnosis of incompetent cervix is certain. We have treated a large number of patients who were referred ...

What is the cerclage?

Alexander Kofinas M.D.

Cerclage is a procedure in which a suture (stitch) is placed around the cervix in a purse-string fashion with the intention of keeping the cervix closed and thus sustaining the pregnancy. Most Obstetricians today use the Macdonald type of removable suture, and when the pregnancy gets to term they remove the suture to allow for vaginal delivery. A permanent type ...

Are patients with infertility more likely to have pregnancy complications?

Alexander Kofinas M.D.

Patients with a history of infertility (i.e. experience a difficult time conceiving) who choose to conceive with assisted reproductive technologies (ART) do traditionally experience an increased number of complications during pregnancy. Common complications include preterm delivery, fetal growth failure, and fetal losses and increased rates of fetal loss and neonatal death. These are primarily related to placental failure due to ...

What does the term "incompetent cervix" imply?

Alexander Kofinas M.D.

Incompetent cervix is a condition where the cervix shortens and then dilates early in the pregnancy. This leads to either pregnancy loss (spontaneous abortion in the second trimester) or an extremely premature delivery of less than 34 weeks gestation. This loss occurs with no traditional signs or symptoms of premature labor. Patients who suffer from incompetent cervix can still achieve ...

Are patients with infertility more likely to have pregnancy complications?

Alexander Kofinas M.D.

Patients with a history of infertility (i.e. experience a difficult time conceiving) who choose to conceive with assisted reproductive technologies (ART) do traditionally experience an increased number of complications during pregnancy. Common complications include preterm delivery, fetal growth failure, and fetal losses and increased rates of fetal loss and neonatal death. These are primarily related to placental failure due to ...