America’s Best Obstetricians and Gynecologists

Simply put, Obstetrician/Gynecologists that have accumulated a certain amount of points qualified for the list. This does not mean that OB/Gyn’s that did not accumulate enough points are not good doctors; they merely did not qualify for this list because of the points needed for qualification.

Similar studies have been done with other professions using a survey system. This type of study would ask fellow professionals who they would recommend. We found this method to be more of a popularity contest. For instance, professionals who work in a large office have much more of a chance of being mentioned, as opposed to a professional who has a small private practice. In addition, many professionals have a financial arrangement for back-and-forth referrals. For these reasons, we developed the point value system.

Since this is a subjective call, there is no study that is 100% accurate. As with any profession, there will be some degree of variance in opinion. If you survey 100 patients from a particular physician on their satisfaction, you will undoubtedly hear that some are very satisfied, some moderately satisfied and some dissatisfied. This is really quite normal.

We feel that a point value system takes out the personal and emotional factor and deals with factual criteria. We have made certain assumptions. For example, we feel that more years in practice is better than less years in practice; more education is better than less education, being board certified is better than not being certified, etc.

The Top Obstetrician/Gynecologist list that we have compiled is current as of a certain date and other OB/Gyn’s may have qualified since that date. Nonetheless, we feel that the list of Top Obstetrician/Gynecologists is a good starting point for you to find a qualified health care specialist.

No fees, donations, sponsorships or advertising are accepted from any individuals, professionals, corporations or associations. This policy is strictly adhered to, ensuring an unbiased selection.

There are three stages of pregnancy, referred to as trimesters. Since there is forty weeks of pregnancy they are divided into three equal parts.

First Trimester
The first 14 weeks of pregnancy are referred to as the first trimester. The first signs of the pregnancy may be nausea, tenderness and increased size in the breasts,  and color of the areola.

Second Trimester
The second trimester is filled with tremendous growth and development. You should start to feel better and have more energy.

Third Trimester
During the final trimester you will probably gain 9 to 13 pounds. You will probably feel more tired and need to rest more frequently.

Infertility in women is primarily caused by ovulation disorders. Without ovulation, eggs are not available for fertilization. Ovulation problems are signaled by irregular, or lack of, menstrual periods. Ovulation problems can be caused by stress, diet and even intense athletic training. Other problems that can lead to female infertility include blockage of the fallopian tubes, resulting in the inability of eggs to pass through into the uterus. These blockages can result from an Ectopic pregnancy, Endometriosis or Pelvic Inflammatory Disease.

There are many different type of tests to determine whether the fertility problem is with the male or the female. The first step with the male is to check the sperm quality and count. With the female the first test determines if she is ovulating each month. This can be done by charting changes in body temperature throughout the day. There are even FDA- approved home ovulation test kits.

Depending on the results of the initial testing, your doctor may then proceed with further testing to determine the cause of the infertility. The results of the tests will help the doctor recommend the proper treatment. Eighty to ninety percent of infertility cases can be treated with drugs or surgery.

At the same time of surgery, the ovaries and cervix are sometimes removed for medical reasons related to the individual. In addition to the cessation of menstrual bleeding, removal of the ovaries results in decreased production of sex hormones, vaginal dryness, pain or discomfort during sexual intercourse, and hot flashes.

Gonorrhea
Gonorrhea is cured by antibiotics. If this disease goes untreated the infection can cause infertility in women and sometimes in men. Gonorrhea spreads to the reproductive organs in a woman and can cause PID, pelvic inflammatory disease.

When men contract Gonorrhea it can cause a burning sensation when urinating and a yellow discharge from the penis. Often women have no sign of infection but some experience a yellow discharge, low abdominal pain and irregular menstrual bleeding.

Chlamydia
Chlamydia is a common infection, particularly among young sexually active people. Most people do not show any symptoms, but if any do exist they are similar to those of Gonorrhea. This STD is cured by antibiotics but if it goes untreated it can cause infertility in women and even men. Untreated, Chlamydia is the most common cause of infection, spreading to the reproductive organs in women.

Syphilis
Syphilis may produce a painless sore on the mouth or genitals. The sore usually disappears completely in two to three weeks. Approximately two to four months after contracting this disease there may be symptoms that include a generalized skin rash, patchy loss of hair or moist lumps around the genitals and anus. These may disappear and reappear over the next few years. If this STD goes untreated it can develop conditions in the brain, heart and spinal cord. Syphilis can be cured with antibiotics.

Herpes
Genital Herpes causes a painful outbreak of blisters on the external genitals or on the cervix. During outbreaks the Herpes virus can be transmitted to someone else. The outbreaks usually consist of clusters of blisters which become ulcers. Theses blisters generally heal within seven to fourteen days. Many people infected with the Herpes virus never develop any symptoms and are unaware that they have this infection. There is not a cure for Herpes but there are antiviral drugs that suppress the number of outbreaks.

Genital Warts
There are many strains of genital warts that affect specific parts of the human body. Some people can carry the virus and never have any obvious signs of warts. Genital warts may not appear for months and even years after the infection has occurred. Warts are very common and can be removed by freezing or applying a special lotion.

Hepatitis B
Hepatitis B is a virus that affects the liver. People who are infected with Hepatitis B may have no symptoms. Other afflicted people can experience fever, nausea, dark urine and jaundice. Once recovered, most affected people develop antibodies to the virus and cannot spread the virus to others. Some others retain the virus and become carriers that could infect other people. A vaccine to prevent Hepatitis B is available but is not effective for Hepatitis B carriers.

HIV (Human Immunodeficiency Virus)
This virus is spread by blood to blood contact. Once infected, the victim remains infected for life. This virus affects the human immune system. People who have contracted this disease may not have any symptoms for many years. Over time, the immune system becomes ineffective and serious infections and cancers can develop. When this happens it is known as AIDS (acquired immune deficiency syndrome). HIV is diagnosed by a blood test.

The urinary system is composed of the kidneys, ureters, bladder, and urethra. All play a role in removing waste from the body. The kidneys filter waste from the blood. Tubes called ureters carry urine from the kidneys to the bladder, where it is stored until it exits the body through the urethra. All of these parts of the urinary system can become infected, but most infections involve the lower tract—the urethra and the bladder.

Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi, but it does contain fluids, salts, and waste products. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria, Escherichia coli (E. coli).

In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. An infection limited to the urethra is called urethritis. If bacteria move to the bladder and multiply, a bladder infection called Cystitis results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called Pyelonephritis.

UTIs are rarely serious when they occur in otherwise healthy adults. However, they have the potential to cause permanent kidney damage or life-threatening infection if they are not treated promptly, especially in people who have medical conditions that may complicate the infection.

Some people are more prone to getting a UTI than others. Any abnormality of the urinary tract that obstructs the flow of urine—a kidney stone, for example—sets the stage for an infection. An enlarged prostate gland also can slow the flow of urine, raising the risk of infection. People with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection. Women are more likely to have UTI than men. Many women suffer from frequent UTIs. Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another.

You may have a UTI if you have any of the following symptoms:

		Pain or burning when urinating
		The urge to urinate frequently while passing only small quantities of urine
		Tenderness or a feeling of heaviness in the lower abdomen
		Cloudy or foul-smelling urine
		Pain on one side of the back or under the rib cage
		Fever and chills
		Nausea and vomiting

Oral antibiotics can treat most UTIs successfully. The length of treatment may depend on the location of the infection, your sex and age, and whether you have complicating conditions such as pregnancy, diabetes, or prostate problems.

Abnormal cervical cell changes are often the result of high-risk sexual behaviors years earlier. These behaviors include having unprotected sex, having multiple sex partners, or having a partner who has had multiple partners. These behaviors increase your risk of infections and sexually transmitted diseases. The most common cause of cervical cancer is infection with a high-risk type of the human papillomavirus (HPV). A past HPV infection in you or your partner can cause abnormal cervical cell changes later since the virus may remain in the body for life. Low-risk types of HPV cause genital warts, but other types may not cause any symptoms so you may not know you have had it.

Smoking or having an impaired immune system may also increase your risk for cervical cell changes. The use of birth control pills for more than 5 years may be a risk factor related to infection with HPV.

So, the best ways to prevent cervical cancer is to:

		Delay first intercourse
		Have fewer sexual partners
		Don’t smoke

Some of the risk factors for cancer can be avoided, but many cannot. For example, although you can choose to quit smoking, you cannot choose which genes you have inherited from your parents. Both smoking and inheriting specific genes could be considered risk factors for certain kinds of cancer, but only smoking can be avoided. Prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chance of developing cancer decreases.

Although many risk factors can be avoided, it is important to keep in mind that avoiding risk factors does not guarantee that you will not get cancer. Also, most people with a particular risk factor for cancer do not actually get the disease. Some people are more sensitive than others are to factors that can cause cancer.

The ovaries are a pair of female reproductive organs which are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries have two functions: they produce eggs and female hormones.

Each month, during the menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a fallopian tube to the uterus. The ovaries are the main source of female hormones. These hormones control the development of female body characteristics, such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.

Cancer occurs when cells become abnormal and keep dividing and forming more cells without control. Like every other organ in the body, the ovaries are made up of many types of cells. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy. If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth, or tumor, can be benign or malignant.

Malignant tumors are cancerous. Cancer cells can invade and damage tissues and organs near the tumor. Cancer cells can also break away from a malignant tumor in the ovary and spread to other organs in the abdomen and form new tumors. Ovarian cancer spreads most often to the colon, the stomach, and the diaphragm. The cancer cells can also enter the lymphatic system or the bloodstream and spread to other parts of the body. The spread of cancer is called metastasis.There are several types of ovarian cancer; most ovarian cancers are epithelial carcinomas, which begin in the lining of the ovary. Other types of ovarian cancer are rare.

The cause of ovarian cancer is unknown. In 10 to 20 percent of women with ovarian cancer, a family history of the disease is found. Other risk factors for developing ovarian cancer include infertility and long-term ovulation that is not interrupted by pregnancy or suppressed with hormonal birth control methods. Older women are at highest risk: More than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age, and approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age.

Ovarian cancer does not cause many symptoms in its early stages—which is why 75 to 80 percent of cases are not diagnosed until the cancer has reached an advanced stage. The most common symptoms that cause women to seek evaluation include ongoing abdominal discomfort, cramping pain, intestinal gas, or a change in bowel or bladder habits.

Surgery is the preferred treatment and is frequently necessary for diagnosis. Surgery performed by a specialist in Gynecologic Oncology results in a higher rate of cure. Chemotherapy is used as after surgery to treat any residual disease. Chemotherapy can also be used to treat women who have a recurrence. Radiation therapy is rarely used in ovarian cancer in the United States.

Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made. The outcome is often poor. The five-year survival rate for all stages is only 35 percent to 38 percent. If, however, diagnosis is made early in the disease, five-year survival rates can reach 90 percent to 98 percent

Ovarian Cysts

An ovarian cyst is a round, thin-walled, clear fluid-filled sac that develops in the ovary as part of normal egg development. When on the ovary’s surface, an ovarian cyst looks something like a skin blister. A normal ovarian cyst can grow as large as 1.5 inches as it prepares to release an egg into the abdomen.

When an ovarian cyst does not release its egg, it continues to grow, becoming larger than normal—known as a Functional Ovarian Cyst. These may also form after an egg is released. In this case, the ovarian cyst reseals itself and swells with fluid, which is called a Luteal Cyst. Functional ovarian cysts are the most common type of ovarian growth in women of childbearing age.

Like most types of ovarian cysts, functional cysts usually don’t cause symptoms and are first noticed during a general pelvic exam. However, a larger ovarian cyst can twist, rupture, or bleed and be very painful. If your health professional has found that you have a functional ovarian cyst, you have no reason to worry about it being cancerous—functional cysts do not lead to cancer. Most functional ovarian cysts are harmless and disappear on their own within a few months.

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:

Wait and See

You can wait and be re-examined in one to three months if you are in your reproductive years, you have no symptoms and an ultrasound shows you have a simple, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size. Watchful waiting, including regular monitoring with ultrasound, is also a common treatment option recommended for postmenopausal women if a cyst is filled with fluid and less than 2 inches in diameter.

Birth control pills

Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer—the risk decreases over time as  you take birth control pills.

Surgery

Your doctor may suggest removal of a cyst if it is large, doesn’t look like a functional cyst, is growing or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed. Some cysts can be removed without removing the ovary in a procedure known as a Cystectomy. Your doctor may also suggest removal of the one affected ovary and leaving the other intact in a procedure known as Oophorectomy. Both procedures may allow you to maintain your fertility if you’re still in your childbearing years.