Heidi Anne Duerr, MPH

Research has shown that the soluble fms-like tyrosine kinase (sFlt-1)/placental growth factor (PlGF) ratio can be used to assess and identify women who develop preeclampsia.

As the use of assisted reproductive technologies has increased, so, too, has the concern over its effects on the female reproductive system. Specifically, the increased gonadotrophin levels in ovarian cancer pathogenesis coupled with the multiple ovarian punctures and repeated ovarian stimulation associated with in vitro fertilization have raised concerns that IVF may increase the risk of ovarian malignancies.

A 35 year old patient presents with a high grade squamous intraepithelial lesion (HGSIL) Pap smear. There is an unsatisfactory colposcopy; the transformation zone was not sampled. The biopsy shows slight atypia. What’s your next move?

What do you do when a patient has a recurrent yeast infection? This conundrum recently became a discussion on the OBGYN.net forum.

The American College of Obstetricians and Gynecologists released a new committee opinion urging clinicians to treat all patients presenting with vulvar intraepithelial neoplasia (VIN). The opinion is a result of an increasing incidence of VIN, particularly among US women in their 40s. The full opinion was published in the November issue of Obstetrics & Gynecology.

Over the years, researchers and clinicians have made great strides in reducing the number of maternal deaths associated with cardiac disease, infection, and hemorrhage.

Following caesarean section for abruption, a patient continues bleeding and is taken back to the operating room. There, a D & C is performed, and a Bakri balloon is inserted and inflated. The patient continues to deteriorate and shows signs of continued bleeding. After a third surgery, in which a hematoma was evacuated from under the fascia, the Bakri is released. After removal, there is no significant vaginal bleeding.

Oral and topical pre-exposure prophylaxes are successful in preventing the transmission of human immunodeficiency virus via sexual intercourse, according to a presentation at the 13th European AIDS Conference of the European AIDS Clinical Society (EACS). Established in 1991, the EACS is a leading scientific society composed of clinicians that aims to educate, train and compose guidelines for those clinicians in Europe treating patients with HIV and AIDS.

Now open for public comment, the US Preventive Task Force (USPTF) has drafted a recommendation statement that updates their 2003 recommendations for screening for cervical cancer. Based on research examining benefits and risks associated with screening across various groups of women, the new draft recommendations note which women most benefit from cervical cancer screening.

A patient with group B strep presents requesting induction at 38 weeks. Three of her previous pregnancies resulted in precipitous delivery at or before 38 weeks. The patient expresses fears of possible intrapartum GBS fetal infection and other anxieties.

Despite the positive effects of hormone replacement therapy for treating menopause-related issues, HRT’s association with negative adverse outcomes has cast a dark shadow on it. Now, new research out of Europe shows that HRT also increases severe asthma attacks in patients.

Women with breast cancer have a new ally in their fight, as researchers now believe zoledronic acid will help prevent bone loss associated with adjuvant aromatase inhibitor therapy. The latest results from the Z-FAST trial were published in Cancer by Dr Adam M. Brufsky, professor of medicine at the University of Pittsburgh School of Medicine and associate director of clinical investigation for the University of Pittsburgh Cancer Institute, and colleagues.

By some estimates, as many as 80% of women will have fibroids at some point in their lives. And, although many women are asymptomatic, their presence can cause extreme pain in some women and also may be a factor in infertility issues, with submucosal, intramural and subserosal fibroids (in a decreasing order of importance) impacting infertility. Moreover, some research has linked the presence of uterine fibroids with recurrent miscarriage in women, but the data thus far had been inconclusive.

According to some estimates, menstrual migraine effect about 60% to 70% of women. Since hormone levels might impact these migraines, Dr Vincent De Leo from the department of obstetrics and gynecology at the University of Siena in Italy, and colleagues sought to examine the impact of two different oral contraception regimens on the migraines.

Reassuring news for clinicians treating pregnant patients with cancer: chemotherapy does not appear to cause developmental problems in offspring. Dr Frederic Amant, assistant professor, staff gynecologic oncologist, and head of the scientific section of gynecologic oncology at Katholieke Universiteit in Leuven, Belgium, presented these findings at the 2011 European Multidisciplinary Cancer Congress.

Based on the protective effects of intrauterine devices against endometrial cancer, researchers hypothesized that IUDs may also have a protective effect against cervical cancer. However, results from epidemiological and clinical studies to date have been inconclusive.

New research sheds light on vulvodynia, showing that the disorder is under-diagnosed and inadequately treated. Since the chronic pain associated with vulvodynia can make it difficult to sit or participate in sexual activity, the disorder greatly impacts quality of life for women afflicted with it. The research is published online as part of the American Journal of Obstetrics and Gynecology.

Hormonal changes associated with menopause do not increase a woman’s risk for heart disease and heart disease mortality, according to new research published in BMJ. The work of Dr Dhananjay Vaidya, assistant professor of medicine at John Hopkins School of Medicine, and colleagues contradict the previously hypothesis that heart disease and heart attacks rise dramatically after menopause.

Following two days of hearings, the US Food and Drug Administration has declared that silicone breast implants are safe for use and will remain available. However, the FDA will encourage manufacturers to conduct post-approval studies.

New research shows that the SIRT3 gene may contribute to obesity as well as a variety of chronic diseases including diabetes, heart disease, and high blood pressure. The study was published in the August 18th issue of Molecular Cell.

We invited Dr Amer Karam, assistant clinical professor of obstetrics and gynecology at UCLA's David Geffen School of Medicine, to shed some light on how best to address patients' concerns and confusions. Dr Karam is a surgical oncologist who specializes in the diagnosis and treatment of patients with breast cancer.

More and more, women are empowering themselves in regards to breast cancer awareness, but the information they receive regarding mammography may be misleading, confusing, or even conflict with the American College of Obstetrics and Gynecology recommendations.

Women seeking an abortion may have a difficult time finding a physician who performs the procedure, according to a study published in Obstetrics and Gynecology. In fact, study authors found that the number of obstetricians-gynecologists who offer abortion may be smaller than previously thought.

Prophylactic human papillomavirus vaccines have been shown to be effective in reducing the disease burden of cervical cancer, but the three dose regimen can be expensive and difficult to complete. With that in mind, Dr Aimée R. Kreimer, investigator in the division of cancer epidemiology and genetics at the National Cancer Institute, the National Institute of Health, and colleagues sought to determine if less than three doses of the vaccine would be effective. The results are published in the Journal of the National Cancer Institute.

According to results from a new study, a popular herbal remedy may come to the rescue of women suffering from postmenopausal sleep disturbances. About half of postmenopausal women experience some degree of sleep disturbance, which in turn impacts their quality of life.

Cessation of hormone therapy in menopausal women may result in sleep disturbances, according to a new study in Menopause. Since the hormone therapy has been associated with the alleviation of sleep problems in women experiencing menopausal symptoms, Dr Sarah E Tom, Interdisciplinary Women’s Health Research (IWHR) Scholar at the University of Texas Medical School, and colleagues sought to determine the resulting sleep effects during cessation of hormone therapy.

Since their introduction, cervical cytology screening programs have caused a substantial reduction in cervical cancer rates. However, the low sensitivity of one screen and resulting need for repeated screens during a lifetime to achieve programmatic sensitivity has deemed it inefficient. With that in mind, Dr Philip E Castle, of the American Society for Clinical Pathology in Washington, D.C., and colleagues compared the performance of the cobas human papillomavirus (HPV) test versus liquid-based cytology.

New guidelines from the American College of Obstetricians and Gynecologists contain recommendations to help prevent, manage and treat blood clots in pregnant women. Blood clots are a leading cause of maternal morbidity, with pregnancy associated with a four-fold increase in the risk of thromboembolism. As such, ACOG released “Thromboembolism in Pregnancy” in the September 2011 issue of Obstetrics & Gynecology to guide clinicians in the prevention, management and treatment of blood clots during pregnancy.

Compared to healthy women, the researchers found significantly higher serum mesothelin antigen levels in women with ovarian cancer, benign conditions, and unexplained infertility. Luborsky and colleagues further noted that mesothelin antibodies had a higher affinity in the infertility groups, especially premature ovarian failure and ovulatory dysfunction, than that in the healthy, benign, or ovarian cancer groups. Specifically, they found significantly higher positive sera in women with premature ovarian failure and ovulatory dysfunction as compared to normal sera.

The most lethal reproductive cancer in women, ovarian cancer, is estimated to affect 12.8 per 100,000 women in the United States. As such, researchers continue to look into novel ways to eradicate the disease. Armed with the knowledge that almost all (90%) ovarian cancers can be characterized by their expression of alpha-folate receptor, Dr De-Gang Song, postdoctoral investigator in the Perelman School of Medicine at the University of Pennsylvania, and colleagues attempted to engineer T cells to see if they would help shrink the cancer tumors.