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Encyclopedia of Health and Medicine

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prostate cancer 327<br />

the prospective due date. Weight, blood pressure,<br />

<strong>and</strong> urine sample for glucose <strong>and</strong> protein remain<br />

staples <strong>of</strong> prenatal visits in the second trimester.<br />

Around the 18th week the health-care provider<br />

<strong>of</strong>fers a set <strong>of</strong> screening blood tests, the triple<br />

screen or the quad screen. These tests measure<br />

certain hormones <strong>and</strong> proteins in the woman’s<br />

blood that may suggest neural tube defects such as<br />

SPINA BIFIDA <strong>and</strong> chromosomal disorders such as<br />

DOWN SYNDROME. The results <strong>of</strong> these tests are specific<br />

to the gestational age so the provider will be<br />

as certain as possible about the due date before<br />

conducting them.<br />

It is important for the woman, her partner, <strong>and</strong><br />

the provider to discuss the implications <strong>of</strong> positive<br />

results from screening tests, <strong>and</strong> for the woman<br />

<strong>and</strong> her partner to consider what actions they<br />

might take. The provider typically recommends<br />

amniocentesis to further evaluate positive triple<br />

screen or quad screen results. The provider may<br />

recommend abdominal ultrasound around the<br />

20th week if the due date is questionable or if<br />

there is reason to suspect abnormalities in fetal<br />

development. At the end <strong>of</strong> the second trimester<br />

the provider typically requests a glucose challenge<br />

test to check for GESTATIONAL DIABETES as well as<br />

blood tests to check for anemia.<br />

MATERNAL SCREENING BLOOD TESTS<br />

Triple Screen<br />

ALPHA FETOPROTEIN (AFP)<br />

beta human chorionic gonadotropin (beta-HCG)<br />

unconjugated estriol (uE3)<br />

Quad Screen<br />

AFP<br />

beta-HCG<br />

uE3<br />

pregnancy-associated plasma protein A (PAPP-A)<br />

Prenatal Care: Third Trimester<br />

Routine prenatal care visits shift to every two<br />

weeks between 28 <strong>and</strong> 36 weeks <strong>and</strong> weekly from<br />

36 weeks until delivery. The health-care provider<br />

continues to check weight, urine, <strong>and</strong> blood pressure.<br />

Early in the third trimester the provider discusses<br />

the potential for delivery by CESAREAN<br />

SECTION if the fetus is in a breech position or there<br />

are other circumstances that might increase the<br />

risk to the fetus or the woman with a vaginal<br />

delivery.<br />

At the 34th or 35th week the provider cultures<br />

swabbed samples from the VAGINA <strong>and</strong> rectum for<br />

group B streptococcus (GBS) BACTERIA, which<br />

some women harbor without harm to themselves<br />

but that can cause life-threatening INFECTION in the<br />

newborn. Women who test positive for GBS<br />

receive ANTIBIOTIC MEDICATIONS when they go into<br />

labor. The provider also monitors the status <strong>of</strong><br />

GENITAL HERPEs, when this STD is present, to be<br />

prepared for cesarean section should an outbreak<br />

occur near the anticipated time <strong>of</strong> delivery.<br />

See also CONGENITAL ANOMALY; FAMILY PLANNING;<br />

FETAL ALCOHOL SYNDROME; PREVENTIVE HEALTH CARE<br />

AND IMMUNIZATIONS.<br />

priapism A condition in which a man’s PENIS<br />

remains erect for longer than four hours. Priapism<br />

is involuntary (not a function <strong>of</strong> sexual stimulation),<br />

painful, <strong>and</strong> requires immediate medical<br />

attention to prevent permanent damage to the<br />

penis <strong>and</strong> preserve sexual function. Priapism is<br />

most <strong>of</strong>ten a SIDE EFFECT <strong>of</strong> medication, notably<br />

medications to treat ERECTILE DYSFUNCTION <strong>and</strong> the<br />

antidepressant medication trazodone. It also may<br />

occur as a complication <strong>of</strong> SICKLE CELL DISEASE, GENI-<br />

TAL TRAUMA, <strong>and</strong> PROSTATE CANCER. Treatment may<br />

include evacuation <strong>of</strong> BLOOD from the corpora cavernosa,<br />

the tubular channels within the penis that<br />

fill with blood to establish an erection, via needle<br />

<strong>and</strong> syringe or intravenous catheter. The doctor<br />

may also inject the penis with vasoconstrictor<br />

medications. If medical interventions fail, surgery<br />

may be necessary to implant a shunt that allows<br />

blood to drain from the penis.<br />

See also ANTIDEPRESSANT MEDICATIONS; PARAPHIMO-<br />

SIS; PEYRONIE’S DISEASE.<br />

prostate cancer A malignant (cancerous) tumor<br />

that arises from the gl<strong>and</strong>ular tissue <strong>of</strong> the<br />

PROSTATE GLAND, a walnut-size structure that encircles<br />

a man’s URETHRA at the base <strong>of</strong> the BLADDER.<br />

Prostate cancer is one <strong>of</strong> the HORMONE-DRIVEN CAN-<br />

CERS that appears to have some genetic foundations<br />

as it tends to run in families. Prostate cancer<br />

also strongly correlates to increased age; it is rare<br />

among men under age 50 <strong>and</strong> affects more than<br />

half <strong>of</strong> men over age 70.

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