Heidi Anne Duerr, MPH

Rates of asthma continue to rise in the general population, which translates to increased rates among women who are pregnant. When this happens, asthma not only affects the mother but the fetus as well. However, the specific effects are unclear. With that in mind, Dr Vanessa Murphy, postdoctoral research fellow school of medicine and public health at the University of Newcastle in Australia, and colleagues conducted a meta-analysis to determine if maternal asthma is associated with adverse perinatal outcomes.

Are younger women with breast cancer more likely to develop another primary cancer later in life as compared to their older counterparts? According to some experts, younger women may have more unfavorable tumor characteristics. Others hypothesize this increase is observed because younger women can be observed for longer periods. To better understand this phenomenon, Dr Lene Mellemkjaer, senior researcher at the Institute of Cancer Epidemiology of the Danish Cancer Society in Copenhagen, Denmark, and colleagues conducted a study of 304,703 women who received a diagnosis of breast cancer between 1943 and 2006 according to registries in Denmark, Norway, and Finland.

Advances in the treatment for breast cancer have allowed for better outcomes and decreased mortality rates. Tamoxifen, the oldest and most frequently prescribed selective estrogen receptor modulator approved by the US Food and Drug Administration, has shown great efficacy, and studies of tamoxifen treatment lasting 5 years now have follow-up efficacy data that go past one decade. To better understand the evidence, the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) conducted a meta-analysis of 20 trials to ascertain the protective effects of tamoxifen in reducing recurrence and death ratios.

The ebb and flow of reproductive hormones can have effects outside the reproductive process. Indeed, research has shown that the neuroactive properties of reproductive steroids can affect neuronal excitability and therefore may be associated with seizures. To better understand this phenomenon, Dr Andrew G. Herzog, professor of neurology at Harvard Medical School and director of the neuroendocrine unit at Beth Israel Deaconess Medical Center, Boston, and colleagues looked at seizure experience in anovulatory versus ovulatory cycles.

With the rate of diabetes and prediabetes/glucose intolerance increasing, it is imperative for clinicians to help reduce the risk of their patients developing full-blown diabetes as well as to help patients manage the illness.

Data increasingly point to the benefits of breastfeeding, both for the infant and for the mother. Now, a new study points to the relationship between postpartum depression and negative early breastfeeding experiences, just as the Centers for Disease Control and Prevention sheds light on the lack of breastfeeding support for women in hospitals.

With increasing rates of women at high risk for stroke due to obesity, congenital heart disease, and autoimmune disorders, there is a growing concern about stroke during pregnancy. In fact, the World Health Organization (WHO) has chosen stroke during pregnancy and the postpartum period as an area of special interest; WHO is considering labeling stroke as a life-threatening obstetric complication and as a condition that may make unintended pregnancy an unacceptable health risk.

Breast cancer mortality appears to be decreasing not only in the United States but internationally as well. While mammography and screening supporters point to its efficacy as the main reason for this decrease, there is no definitive answer. With that in mind, Dr Philippe Autier, research director at the International Prevention Research Institute in Lyon, France, and colleagues sought to compare the trends in breast cancer mortality and the relative screening policies among 3 pairs of neighboring European countries.

The increasing epidemic of obesity affects all areas of obstetrics. Obesity is associated with medical, surgical, and obstetrical complications and higher rates of induction dysfunctional labor patterns. Since one-third of all reproductive-aged women are obese and almost 10% are extremely obese, this represents a significant problem for obstetricians. Thus, researchers from the division of maternal fetal medicine in the department of obstetrics and gynecology at University of Cincinnati College of Medicine in Ohio conducted a study to better understand the association between failed induction and obesity as well as to determine if the link is correlated with increasing class of obesity.

The use of chemotherapy for the treatment of breast cancer can result in transient or permanent amenorrhea, and research indicates that each month of chemotherapy translates into 1.5 year of lost reproductive life. This is especially significant for women younger than 40 years, which accounts for 6% of the population diagnosed with breast cancer.

Recent studies have indicated that β-adrenergic signaling is involved in the regulation of immune responses to breast tumor cells, and data from in vivo studies show an association between β-adrenergic signaling with increased nodal involvement and development of metastasis but no effect on primary tumor growth. Based on this evidence, Dr Thomas I. Barron, from the department of pharmacology and therapeutics at Trinity Centre for Health Sciences, in Dublin, Ireland, and colleagues chose to explore the relationship between beta blocker use and breast tumor characteristics as well as breast cancer morbidity.

Approximately 10% of maternal deaths in the United States are attributed to obstetric hemorrhage, with peripartum hysterectomy for placenta accreta associated with substantial morbidity. To help reduce this morbidity, Dr Jason Wright, assistant professor of obstetrics and gynecology in the College of Physicians and Surgeons, Columbia University, New York, and researchers explored the risk factors associated with large-volume blood loss in patients with placenta accreta who undergo hysterectomy in order to help develop referral recommendations to tertiary facilities with expertise in this condition.

The wide availability of over-the-counter (OTC) and prescription medications has translated into increased quality of life for many people, but at what cost? During pregnancy, for example, caution and concern is warranted as there is insufficient information about the true risks to the fetus. As a result, some women unintentionally take medications that could potentially harm their fetus, while others experience increased anxiety about relatively safe and effective (and crucial) medications, which may lead to lack of adherence and troublesome outcomes for mother and fetus.

Obtaining reliable hemostasis is crucial as part of laparoscopically assisted vaginal hysterectomies, and over the past 20 years, various methods to do so have been advocated. For instance, in 1989, Harry Reich recommended using sutures to control the uterine vessels, as monopolar, bipolar, and laser instruments available at that time were inherently risky to use along the pelvic sidewall.

Currently in the United States, early pregnancy failure (EPF) appears to be predominantly treated by expectant management and operating room–based uterine evacuation, even though research data have demonstrated that misoprostol and office uterine evacuation can safely evacuate a uterus in the context of induced abortion. In addition, research data indicate that women accept and actually prefer treatment with office uterine evacuation or misoprostol after EPF. So why aren’t these procedures being performed more regularly?

The 400-meter timed walk can provide insights into an older person’s cardiorespiratory fitness; the resulting data from these walks are useful in predicting total mortality, cardiovascular disease, mobility limitation, and disability. But do leisure time activities and weight/body composition changes affect walk time? Dr Kelley K. Pettee Gabriel from the division of epidemiology, human genetics, and environmental sciences at the University of Texas Health Science Center, Austin, and colleagues believe a better understanding of this relationship will help clarify the best use of the 400-meter walk in middle-aged women.

Shoulder dystocia can result in maternal and neonatal injuries, including brachial plexus palsies, fractures of the clavicle and humerus, and hypoxic-ischemic encephalopathy in babies as well as postpartum hemorrhage and fourth-degree lacerations in mothers. Although its incidence remains relatively low (reported between 0.6% and 1.4%), it continues to be a clinical challenge for birth attendants and is among the 4 largest causes of monetary awards in obstetric tort cases. Recognizing this problem, Dr Matthew K. Hoffman and colleagues sought to determine the efficacy of various obstetric maneuvers used to resolve shoulder dystocia and their impact on neonatal injury.

Research has emerged validating and confirming the recommendations of the American Congress of Obstetricians and Gynecologists, the American Cancer Society, and the American Society for Colposcopy and Cervical Pathology to screen women for cervical cancer every 3 years if they have a negative human papillomavirus (HPV) test and a normal Pap test. However, the researchers also found that Pap testing was important among women who tested positive for HPV since it helped identify women who developed cancer or precancer.

Although uncommon, insulation failure (IF) during minimally invasive surgical procedures can cause electrosurgical injuries that can lead to significant complications. For instance, the resulting burns of these injuries involve a high risk of tissue necrosis and abscess formation that can lead to the perforation of internal organs, such as the bowel, which in turn can result in bacterial contamination of the abdominal cavity.

A prospective case-control study from Sweden has found long-term benefits of regular mammography screening, including a positive impact on reducing mortality.

Researchers from the University of British Columbia, Canada, and Newcastle University, United Kingdom, have good news for women with multiple sclerosis (MS): they can have healthy babies and pregnancies like their non-MS maternal counterparts.

Urge urinary incontinence (UUI) can be a troublesome symptom following surgery for stress incontinence and may be most likely to occur in women with a history of preoperative UUI. Meanwhile, the number of these procedures has grown, mostly due to the availability of the less invasive midurethral sling procedure

Breast cancer causes more than 40,000 deaths annually and is only second to lung cancer in cause of cancer deaths in women in the United States. Since early identification is key to prompt treatment and the best prognosis, it is crucial to identify women at risk.

Every year, resident programs spend financial and human resources to sort out the various candidates applying for a spot in their program in hopes of securing the most ideal candidates. In 2009 there were 1796 applicants for the 1185 residency positions in the specialty of obstetrics and gynecology.

Although ultrasounds are relatively safe and have become integral tools in medicine, the underlying thermal and mechanical mechanisms have the potential for causing negative biological effects. To protect patients, the National Electrical Manufacturers Association developed standards requiring the on-screen display of thermal indexes (TI) and mechanical indexes (MI) on machines capable of producing MIs or TIs greater than 1.

Twin-twin transfusion syndrome (TTTS) affects approximately 10% of twins that share the same placenta. The preferential shunting of blood from one twin to the other twin causes such hemodynamic alternations as twin oligohydramnios, recipient twin polyhydramnios, recipient twin polyhydramnios, and characteristic anatomical and arterial/venous flow abnormalities.

More than half of the 600,000 hysterectomies performed in the 1900s involved bilateral salpingo-oophorectomy, and it has been estimated that many of those were performed solely to reduce the risk for ovarian cancer. While there has been increased knowledge in the risk in women with familial history, a knowledge gap still exists for other women, which could lead them down the path of potentially unnecessary surgery

Clinicians and researchers have seen an increase in the prevalence of gastroschisis, with the greatest risk seen in women who are younger than 20 years. That, coupled with an evident increase in developing countries, has led researchers to believe that gastroschisis is associated with environmental factors (with or without underlying genetic susceptibility).

There is no denying that we live in a fast-paced, communications-driven world. Email is increasingly being used for business and personal communications, but how has this impacted communications between patients and their doctors?

Varying risks and benefits are associated with cesarean deliveries as compared to vaginal deliveries, including the impact on the mother’s health and the infant’s health. Ultimately, the goal is to deliver the baby the safest way possible for both mother and baby, but does the mode of delivery significantly impact the health-related quality of life in the immediate postpartum period through the first year after childbirth?