28,957 results match your criteria Obstetrics and gynecology[Journal]


Etonogestrel Subdermal Implant-Associated Regression of Endometrial Intraepithelial Neoplasia.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics & Gynecology, Tulane University School of Medicine, New Orleans, Louisiana.

Background: Endometrial intraepithelial neoplasia is a precursor lesion to endometrial adenocarcinoma. Total hysterectomy is the preferred management, but systemic or locally acting progestin therapies are acceptable alternatives. The use of the etonogestrel subdermal implant for treatment of endometrial intraepithelial neoplasia has not been studied. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003152DOI Listing
March 2019
5.175 Impact Factor

The Backstory Behind Burnout in Obstetrics and Gynecology.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Dr. Winkel is from the Department of Obstetrics & Gynecology at the New York University School of Medicine, New York, New York; email:

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http://dx.doi.org/10.1097/AOG.0000000000003195DOI Listing

Multimodal Stepwise Approach to Reducing In-Hospital Opioid Use After Cesarean Delivery: A Quality Improvement Initiative.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, Virginia.

Objective: To evaluate the association of a standardized, structured approach to in-hospital postcesarean delivery pain management with maternal opioid use after cesarean delivery.

Methods: We conducted a retrospective cohort study of women who underwent cesarean delivery before and after a quality improvement intervention at a single tertiary care center. A multidisciplinary task force revised electronic order sets for all patients who underwent cesarean delivery with neuraxial anesthesia. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003156DOI Listing

The Unexpected Power of Presence.

Authors:
Bettina Paek

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

EvergreenHealth Medical Center, Maternal Fetal Medicine, Kirkland, Washington.

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http://dx.doi.org/10.1097/AOG.0000000000003168DOI Listing

Wound Complication Rates After Vulvar Excisions for Premalignant Lesions.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Divisions of Gynecologic Oncology and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, and the Alvin J. Siteman Cancer Center, St. Louis, Missouri.

Objective: To assess the rate of wound complications and evaluate the effectiveness of antibiotic prophylaxis in vulvar wide local excision procedures.

Methods: We performed a single-institution, retrospective cohort study of women undergoing vulvar surgery for premalignant lesions between January 2007 and January 2017. The primary outcome was a composite wound complication rate that included breakdown or infection within 8 weeks postoperatively. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003185DOI Listing

Perioperative Antibiotic Use and Associated Infectious Outcomes at the Time of Myomectomy.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

Objective: To report the frequency of perioperative antibiotic use at time of myomectomy and associated risk of infectious outcomes.

Methods: We conducted a retrospective cohort study including all women who underwent any route of myomectomy from 2009 to 2016 at two academic hospitals in Boston, Massachusetts. Cases involving chromopertubation or conversion to hysterectomy were excluded from further analysis. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003160DOI Listing

Like Mother, Like Daughter.

Authors:
Megan E Bunnell

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

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http://dx.doi.org/10.1097/AOG.0000000000003169DOI Listing

Educating Obstetrics and Gynecology Residents on Transgender Patients: A Survey of Program Directors.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Departments of Obstetrics and Gynecology and Epidemiology, University of Washington, Seattle, Washington.

Objective: To describe education on transgender health provided by obstetrics and gynecology residency programs and to identify the facilitators and barriers to providing this training.

Methods: We conducted a cross-sectional survey to evaluate transgender health education in residency among a representative sample of 100 of the 236 obstetrics and gynecology residency programs listed in the 2015 Electronic Residency Application Service catalogue. We compared programs that did and did not offer transgender education on demographics, presence and type of transgender education offered, and reasons for and barriers to offering transgender health education using χ or Fisher's exact testing. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003173DOI Listing
March 2019
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Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Departments of Obstetrics and Gynecology and Radiology, Abington Hospital, Jefferson Health, Abington, and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

Background: Uterine myomas encountered at cesarean delivery increase the complexity and risk of the procedure. Preoperative planning of such deliveries may help optimize patient outcomes. The application of three-dimensional printing technology is rapidly expanding in many surgical specialties. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003107DOI Listing

Race, Research, and Women's Health: Best Practice Guidelines for Investigators.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Warren Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, and the Providence Community Health Centers, Providence, Rhode Island.

Medicine has a complex history of mishandling the concept of race. This is a crucial time for the field of obstetrics and gynecology to address racial and ethnic disparities. In this commentary, we address misconceptions about race, show how race can be misused in research and clinical care, and suggest new standards to guide authors as they conduct research on disparities and race. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003157DOI Listing

Neonatal and Maternal Morbidity Among Low-Risk Nulliparous Women at 39-41 Weeks of Gestation.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas; and the Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.

Objective: To use a large national database to compare composite maternal or neonatal morbidity among low-risk, full-term women.

Methods: This cohort study, using the U.S. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003064DOI Listing
March 2019
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Change in Second-Trimester Abortion After Implementation of a Restrictive State Law.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama; Ibis Reproductive Health, Oakland, California; Population Research Center, University of Texas at Austin, Austin, Texas; and Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.

Objective: To assess whether indicators of limited access to services explained changes in rates of second-trimester abortion after implementation of a restrictive abortion law in Texas.

Methods: We used cross-sectional vital statistics data on abortions performed in Texas before (November 1, 2011-October 31, 2012) and after (November 1, 2013-October 31, 2014) implementation of Texas' abortion law. We conducted monthly mystery client calls for information about abortion facility closures and appointment wait times to calculate distance from women's county of residence to the nearest open Texas facility, the number of open abortion facilities in women's region of residence (facility network size), and days until the next consultation visit. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003183DOI Listing

Preventing Surgical Site Infection: Approaching Zero Tolerance.

Authors:
David E Soper

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Dr. Soper is from the Department of Obstetrics and Gynecology at the Medical University of South Carolina, Charleston, South Carolina; email:

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http://dx.doi.org/10.1097/AOG.0000000000003194DOI Listing

Furosemide Use and Time to Confirmation of Ureteral Patency During Intraoperative Cystoscopy: A Randomized Controlled Trial.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Morsani College of Medicine, and the Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.

Objective: To investigate the effect of intravenous administration of furosemide on the time to confirmation for ureteral patency during intraoperative cystoscopy.

Methods: In a double-blind randomized controlled trial, intravenous administration of furosemide 10 mg was compared with placebo (normal saline) to investigate the effect of furosemide on the time to confirmation for ureteral patency during intraoperative cystoscopy. The primary outcome was time to confirmation of ureteral patency. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003155DOI Listing

Comparing Force of Stream With a Standard Fill Voiding Trial After Surgical Repair of Apical Prolapse: A Randomized Controlled Trial.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Urogynecology, Northwell System, Great Neck, the Biostatistics Unit, Feinstein Institute for Medical Research at Northwell System, Manhasset, and the Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

Objective: To estimate whether the urinary force of stream method is noninferior to a standard fill voiding trial for rate of catheterization within 6 weeks after apical prolapse surgery in those discharged without a catheter.

Methods: A noninferiority randomized controlled trial was conducted in postoperative women comparing force of stream with standard fill voiding trials after vaginal, abdominal, or laparoscopic-robotic apical pelvic organ prolapse (POP) surgery. Before discharge, women in both groups were backfilled with 300 mL normal saline. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003159DOI Listing

An Alternate Approach to Using Candy Cane Stirrups in Vaginal Surgery.

Authors:
Eddie H M Sze

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Urogynecology, Department of Obstetrics & Gynecology, State University of New York, Upstate Medical University, Syracuse, New York.

Background: Candy cane stirrups are widely used for vaginal surgery because they provide sufficient operating space. When placed in the standard perpendicular alignment, however, these stirrups cause excessive flexion, abduction, and external rotation of the thigh, which may injure the femoral, lateral femoral cutaneous, sciatic, and common peroneal nerves.

Technique: We corrected this deficiency by positioning the stirrups parallel to the operating table, just above and tilting slightly toward its lower break. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003184DOI Listing

Safety Assessment of a Large-Scale Improvement Collaborative to Reduce Nulliparous Cesarean Delivery Rates.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

California Maternal Quality Care Collaborative, Stanford University School of Medicine, Stanford, California.

Objective: To evaluate maternal and neonatal safety measures in a large-scale quality improvement program associated with reductions in nulliparous, term, singleton, vertex cesarean delivery rates.

Methods: This is a cross-sectional study of the 2015-2017 California Maternal Quality Care Collaborative (CMQCC) statewide collaborative to support vaginal birth and reduce primary cesarean delivery. Hospitals with nulliparous, term, singleton, vertex cesarean delivery rates greater than 23. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003109DOI Listing
March 2019
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Incorporating Precesarean Vaginal Preparation Into Standard of Care for Obstetrics.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, and the Department of Microbiology and Immunology, Graduate School of Arts and Sciences, Columbia University, New York, New York.

Postoperative infections remain a serious concern after cesarean delivery, the most common major surgical procedure in the United States. Multiple strategies have been proposed to combat this problem, including the addition of azithromycin to the standard preoperative antibiotic prophylaxis. However, as obstetricians, we have failed to uniformly adopt precesarean vaginal preparation despite convincing evidence from randomized controlled trials that this technique reduces postoperative rates of endometritis by more than 50%. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003153DOI Listing
March 2019
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U.S. Food and Drug Administration-Approved Poly (ADP-Ribose) Polymerase Inhibitor Maintenance Therapy for Recurrent Ovarian Cancer: A Cost-Effectiveness Analysis.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Surgery, Department of Gynecologic Oncology and Reproductive Medicine, the University of Texas MD Anderson Cancer Center, Houston, Texas; and the Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina.

Objective: We sought to determine whether use of a poly (ADP-ribose) polymerase inhibitor is cost effective for maintenance treatment of platinum-sensitive recurrent ovarian cancer.

Methods: A decision analysis model compared four maintenance strategies: 1) observation, 2) BRCA germline mutation testing and selective treatment of carriers (gBRCA only), 3) BRCA germline and tumor homologous recombination deficiency testing and selective treatment of either BRCA carriers or those with tumor HRD (gBRCA and HRD only), and 4) treat all with niraparib to progression (treat all). Costs were estimated in 2016 U. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003171DOI Listing

Connect the Dots-April 2019.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

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http://dx.doi.org/10.1097/AOG.0000000000003198DOI Listing

Importance of Estimated Blood Loss in Resource Utilization and Complications of Hysterectomy for Benign Indications.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Departments of Obstetrics and Gynecology, Emergency Medicine, and Surgery, University of Michigan, the University of Michigan Institute for Healthcare Policy and Innovation, and the University of Michigan Medical School, Ann Arbor, Michigan.

Objective: To identify the variation in estimated blood loss at the time of hysterectomy for benign indications and to analyze how blood loss is associated with measures of resource utilization and complications.

Methods: We conducted a retrospective cohort study and analyzed hysterectomy for benign indications at hospitals in the Michigan Surgical Quality Collaborative between January 1, 2013, and May 30, 2015. A sensitivity analysis was performed to identify how estimated blood loss was associated with measures of utilization (transfusion, readmission, reoperation, and length of stay) and postoperative complications. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003182DOI Listing

Shared Decision-Making Framework for Pelvic Examinations in Asymptomatic, Nonpregnant Patients.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, the MacLean Center for Clinical Medical Ethics, and the Department of Family Medicine, the University of Chicago, and the Department of Obstetrics and Gynecology, the University of Illinois at Chicago, Chicago, Illinois.

Controversy exists regarding whether to perform pelvic examinations for asymptomatic, nonpregnant patients. However, several professional organizations support the notion that health care providers should no longer recommend that asymptomatic patients receive a yearly pelvic examination. At minimum, health care providers must respect patients' autonomy in decision making around this examination and initiate a joint discussion about whether to proceed with a pelvic examination. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003166DOI Listing

Fewer Cesarean Deliveries and Better Neonatal Outcomes: Having Our Cake and Eating It Too.

Authors:
Dwight J Rouse

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Dr. Rouse is Associate Editor (Obstetrics) for Obstetrics & Gynecology; email:

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http://dx.doi.org/10.1097/AOG.0000000000003193DOI Listing

What Is New in Cesarean Delivery?: Best Articles From the Past Year.

Authors:
Wendy F Hansen

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Dr. Hansen is from the Department of Obstetrics and Gynecology at the University of Kentucky College of Medicine, Lexington, Kentucky; email:

This month we focus on current research in cesarean delivery. Dr. Hansen discusses eight recent publications, which are concluded with a "bottom-line" that is the take-home message. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003197DOI Listing
March 2019
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Hysterectomy Practice Patterns in the Postmorcellation Era.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.

Objective: To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003181DOI Listing

Validation of a Model Predicting De Novo Stress Urinary Incontinence in Women Undergoing Pelvic Organ Prolapse Surgery.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina; and the Department of Gynecology, Martini Hospital, Groningen, and Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Objective: To validate a previously developed prediction model for de novo stress urinary incontinence (SUI) after undergoing vaginal surgery for pelvic organ prolapse (POP).

Methods: Model performance was determined using a cohort of women who participated in two, 14-center randomized trials in the Netherlands that evaluated whether postoperative SUI 1 year after surgery was reduced with or without concomitant midurethral sling at the time of surgery for symptomatic women who had at least stage 2 POP. Age, number of previous vaginal births, urine leakage associated with urgency, history of diabetes, body mass index, preoperative stress test result, and placement of a midurethral sling were used to calculate the predicted probability of an individual developing de novo SUI. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003158DOI Listing

Postpartum Contraception Usage Among Somali Women in Olmsted County, Minnesota.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology and the Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.

Objective: To compare postpartum contraception use between Somali and non-Somali women.

Methods: A retrospective cohort study was performed using the Rochester Epidemiology Project. All Somali women aged 18 and older with live singleton births in Olmsted County, Minnesota, in 2009-2015 (n=317) were included, and a group of age-matched non-Somali women (n=317) were identified. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003154DOI Listing

An Integrated, Trauma-Informed Care Model for Female Survivors of Sexual Violence: The Engage, Motivate, Protect, Organize, Self-Worth, Educate, Respect (EMPOWER) Clinic.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Departments of Obstetrics & Gynecology and Psychiatry, NYU School of Medicine, the New York Harbor Veterans Administration Healthcare System, NYU School of Medicine, and New York University, New York, New York.

This article describes the Engage, Motivate, Protect, Organize, self-Worth, Educate, Respect (EMPOWER) Clinic for Survivors of Sex Trafficking and Sexual Violence located at Gouverneur Health in New York, New York, as a model for integrated gynecologic and psychiatric care of survivors of sexual and gender-based violence. Although patients with a history of sexual trauma often have critical health needs that persist long after the traumatic event, most existing services for survivors of sexual violence focus solely on the provision of acute care immediately after the violence has occurred. There are very few clinics in the United States dedicated to managing the significant long-term medical consequences and sequelae of sexual violence in a trauma-informed setting. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003186DOI Listing

Hypertensive Postpartum Admissions Among Women Without a History of Hypertension or Preeclampsia.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York; and the Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.

Objective: To analyze risk factors, temporality, and outcomes for women readmitted postpartum for a hypertensive indication who did not have a hypertensive diagnosis during their delivery hospitalization.

Methods: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for 2010-2014 was used to evaluate risk for postpartum readmission for preeclampsia and hypertension within 60 days of discharge from a delivery hospitalization among women without these diagnoses during delivery in this cohort study. Obstetric, medical, demographic, and hospital factors associated with postpartum readmission were analyzed. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003099DOI Listing

Influence of Genetic Variants on Steady-State Etonogestrel Concentrations Among Contraceptive Implant Users.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Division of Family Planning, Department of Obstetrics and Gynecology, and the Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Objective: To identify genetic variants that influence steady-state etonogestrel concentrations among contraceptive implant users.

Methods: We enrolled healthy, reproductive-age women in our pharmacogenomic study using etonogestrel implants for 12-36 months without concomitant use of hepatic enzyme inducers or inhibitors. We collected participant characteristics, measured serum etonogestrel concentrations, and genotyped each participant for 120 single nucleotide variants in 14 genes encoding proteins involved in steroid hormone (ie, estrogens, progestins) metabolism, regulation, or function. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003189DOI Listing
March 2019
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A Nudge Toward Universal Aspirin for Preeclampsia Prevention.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, Providence, Rhode Island.

The July 2018 American College of Obstetricians and Gynecologists' guidelines for aspirin prophylaxis for preeclampsia prevention represent a departure from prior, more stringent guidelines and extend eligibility for aspirin prophylaxis to a large proportion of pregnant women in the United States. However, these latest guidelines are predicated on a complex, risk-factor-based screening algorithm and ignore the reality that, outside of the setting of clinical research, effective implementation of risk-factor-based approaches consistently falls short. Herein we argue for transitioning to universal aspirin prophylaxis for preeclampsia prevention using the concept of libertarian paternalism, knowing that altering the choice architecture from an "opt-in" to an "opt-out" system will greatly increase the number of patients who receive the advantage of this inexpensive, safe, and beneficial preventative intervention. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003167DOI Listing

Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates.

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

University of California, Irvine, School of Medicine, Irvine, and the Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California.

Objective: To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates.

Methods: This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5-7 months after implementation of a universal delayed cord-clamping protocol (October-December 2015 and October-December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003172DOI Listing
March 2019
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ACOG Committee Opinion No. 772: Immunization Implementation Strategies for Obstetrician-Gynecologists.

Authors:

Obstet Gynecol 2019 Mar;133(3):e254-e259

Immunization against vaccine-preventable diseases is an essential component of women's primary and preventive health care. Many studies have shown that a recommendation from an obstetrician-gynecologist or other health care provider for a vaccine is one of the strongest influences on patient acceptance. Obstetrician-gynecologists and other health care providers should develop a standard process for assessing and documenting the vaccination status of patients and for recommending and administering vaccines. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003130DOI Listing

ACOG Committee Opinion No. 771: Umbilical Cord Blood Banking.

Authors:

Obstet Gynecol 2019 Mar;133(3):e249-e253

Since the first successful umbilical cord blood transplant in 1988, it has been estimated that more than 35,000 transplants have been performed in children and adults for the correction of inborn errors of metabolism, hematopoietic malignancies, and genetic disorders of the blood and immune system. Two types of banks have emerged for the collection and storage of umbilical cord blood: 1) public banks and 2) private banks. The benefits and limitations of public versus private umbilical cord blood banking should be reviewed with the patient because they serve different purposes. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003128DOI Listing

ACOG Committee Opinion No. 770: Uterine Morcellation for Presumed Leiomyomas.

Authors:

Obstet Gynecol 2019 Mar;133(3):e238-e248

Morcellation is a surgical technique used to reduce the size of the uterus or myomas by creating smaller pieces to allow the tissue to be removed through small incisions or with laparoscopic instruments. Open (uncontained) morcellation of the uterus and myomas has been scrutinized because of the possible spread of an unsuspected leiomyosarcoma while using a power morcellator during a hysterectomy or myomectomy for presumed symptomatic uterine leiomyomas. Before considering open morcellation of the uterus, a woman should be evaluated to determine if she is at increased risk of malignancy of the uterine corpus. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003126DOI Listing
March 2019
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ACOG Committee Opinion No. 769: Reprocessed Single-Use Devices.

Authors:

Obstet Gynecol 2019 Mar;133(3):e235-e237

The reprocessing and reuse of single-use instruments has become increasingly common. Although there are limited data on reprocessed single-use devices, existing studies have found a significant rate of physical defects, performance issues, or improper decontamination. There are currently no data in the medical literature of studies evaluating the cost-effectiveness of reprocessed single-use devices in gynecologic surgery. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003124DOI Listing

ACOG Committee Opinion No. 768: Genetic Syndromes and Gynecologic Implications in Adolescents.

Authors:

Obstet Gynecol 2019 Mar;133(3):e226-e234

As adolescents with a genetic syndrome transition to adult medical care, they may be referred to obstetrician-gynecologists for routine preventive or contraceptive services, screening, or counseling for sexually transmitted infection, or for menstrual management. Although some genetic syndromes have no physical or intellectual impairment, others have significant ones; therefore, education and gynecologic care should be based on a patient's intellectual and physical capabilities. It is important to remember that adolescents with or without a genetic syndrome are sexual beings. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003122DOI Listing

ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia.

Authors:

Obstet Gynecol 2019 Mar;133(3):e208-e225

Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003132DOI Listing
March 2019
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ACOG Practice Bulletin No. 207: Thrombocytopenia in Pregnancy.

Authors:

Obstet Gynecol 2019 Mar;133(3):e181-e193

Obstetricians frequently diagnose thrombocytopenia in pregnant women because platelet counts are included with automated complete blood cell counts obtained during routine prenatal screening (). Although most U.S. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003100DOI Listing
March 2019
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Clinical Updates in Women's Health Care Summary: Evaluation and Management of Lipid Disorders: Primary and Preventive Care Review.

Obstet Gynecol 2019 Mar;133(3):609

Cardiovascular disease (CVD) remains the leading cause of mortality for women, and only a small percentage of women have optimally managed risk factors. One of the strongest risk factors for CVD is an increased lipid level. Many women seek primary care from obstetrician-gynecologists who often identify and provide initial management of dyslipidemia in these women. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003139DOI Listing

ACOG Committee Opinion No. 772 Summary: Immunization Implementation Strategies for Obstetrician-Gynecologists.

Authors:

Obstet Gynecol 2019 Mar;133(3):607-608

Immunization against vaccine-preventable diseases is an essential component of women's primary and preventive health care. Many studies have shown that a recommendation from an obstetrician-gynecologist or other health care provider for a vaccine is one of the strongest influences on patient acceptance. Obstetrician-gynecologists and other health care providers should develop a standard process for assessing and documenting the vaccination status of patients and for recommending and administering vaccines. Read More

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March 2019
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ACOG Committee Opinion No. 771 Summary: Umbilical Cord Blood Banking.

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Obstet Gynecol 2019 Mar;133(3):604-606

Since the first successful umbilical cord blood transplant in 1988, it has been estimated that more than 35,000 transplants have been performed in children and adults for the correction of inborn errors of metabolism, hematopoietic malignancies, and genetic disorders of the blood and immune system. Two types of banks have emerged for the collection and storage of umbilical cord blood: 1) public banks and 2) private banks. The benefits and limitations of public versus private umbilical cord blood banking should be reviewed with the patient because they serve different purposes. Read More

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ACOG Committee Opinion No. 770 Summary: Uterine Morcellation for Presumed Leiomyomas.

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Obstet Gynecol 2019 Mar;133(3):604-605

Morcellation is a surgical technique used to reduce the size of the uterus or myomas by creating smaller pieces to allow the tissue to be removed through small incisions or with laparoscopic instruments. Open (uncontained) morcellation of the uterus and myomas has been scrutinized because of the possible spread of an unsuspected leiomyosarcoma while using a power morcellator during a hysterectomy or myomectomy for presumed symptomatic uterine leiomyomas. Before considering open morcellation of the uterus, a woman should be evaluated to determine if she is at increased risk of malignancy of the uterine corpus. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003127DOI Listing
March 2019
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ACOG Committee Opinion No. 769 Summary: Reprocessed Single-Use Devices.

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Obstet Gynecol 2019 Mar;133(3):600-601

The reprocessing and reuse of single-use instruments has become increasingly common. Although there are limited data on reprocessed single-use devices, existing studies have found a significant rate of physical defects, performance issues, or improper decontamination. There are currently no data in the medical literature of studies evaluating the cost-effectiveness of reprocessed single-use devices in gynecologic surgery. Read More

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ACOG Committee Opinion No. 768 Summary: Genetic Syndromes and Gynecologic Implications in Adolescents.

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Obstet Gynecol 2019 Mar;133(3):598-599

As adolescents with a genetic syndrome transition to adult medical care, they may be referred to obstetrician-gynecologists for routine preventive or contraceptive services, screening, or counseling for sexually transmitted infection, or for menstrual management. Although some genetic syndromes have no physical or intellectual impairment, others have significant ones; therefore, education and gynecologic care should be based on a patient's intellectual and physical capabilities. It is important to remember that adolescents with or without a genetic syndrome are sexual beings. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003123DOI Listing
March 2019
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ACOG Practice Bulletin No. 209 Summary: Obstetric Analgesia and Anesthesia.

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Obstet Gynecol 2019 Mar;133(3):595-597

Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003133DOI Listing
March 2019
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ACOG Practice Bulletin No. 208 Summary: Benefits and Risks of Sterilization.

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Obstet Gynecol 2019 Mar;133(3):592-594

Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide (1). Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually (2-4). For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. Read More

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March 2019
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ACOG Practice Bulletin No. 207 Summary: Thrombocytopenia in Pregnancy.

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Obstet Gynecol 2019 Mar;133(3):589-591

Obstetricians frequently diagnose thrombocytopenia in pregnant women because platelet counts are included with automated complete blood cell counts obtained during routine prenatal screening (1). Although most U.S. Read More

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ACOG Publications: March 2019.

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Obstet Gynecol 2019 Mar;133(3):587-588

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Obstet Gynecol 2019 Mar;133(3):585-586

University of California, San Francisco, San Francisco, California Northwestern Medical Group, Chicago, Illinois University of South Carolina, Greenville, South Carolina University of California, San Francisco, School of Medicine, San Francisco, California Weill Cornell Medicine, New York, New York University of North Carolina, Chapel Hill, North Carolina.

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