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Hormone Levels and PCOSRemember that PCOS cannot be diagnosed by symptoms alone. PCOS is a very complicated endocrine disorder.
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Beautiful Pathology: Benign and Malignant Ovarian DiseaseThese beautiful and often other-worldly photographs by pathologist Ed Uthman, MD, show both benign and malignant ovarian pathology.
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New Tech ToysOBGYN.net Conference CoverageFrom AIUM 44th Conference held in San Francisco, California - April, 2000
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Multiple Pregnancy: Epidemiology, Gestation & Perinatal Outcome. Second EditionOver the past two decades, an epidemic of multiple pregnancies has taken place in the developed world due to the widespread use of assisted reproductive technology. The general public has come to accept the phenomenon of higher order multiple as being a normal occurrence, expecting a good outcome for both the fetuses and the mother.
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Commentary: Understanding Midwife CredentialsCNMs, CMs, CPMs . . . Elaine Germano of the American College of Nurse-Midwives explains the credentials and how they may affect collaboration efforts.
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Genital Wart Management: A Partnership Between Physician and PatientWith its implications of sexual transmission and potential cervical cancer, a diagnosis of genital warts can be emotionally distressing to patients. Because no single treatment serves every patient, the best approach to selecting a therapeutic option considers the extent of the disease, wart location, and the patient's individual needs.
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Recent advances in hysteroscopic and laparoscopic techniques and applicationsFrom the 34th Annual Meeting - Chicago, Illinois - November 2005
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Gyne EndoscopyOBGYN.net Conference CoverageFrom the 5th Meeting of the European Society of Gynecologic Endoscopy- Stockholm, Sweden - June, 1999
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Hospital CuttingsWelcome to this, my first column for OBGYN.net. My hope is that my monthly articles will entertain, question and stimulate you in all areas of OBGYN. I am a general obstetrician and gynecologist working in North London, United Kingdom with particular interests in endoscopic surgery and urogynaecology. I am also an award winning medical journalist. Over the coming months I hope to share my experiences and thoughts with you, challenge our beliefs and contribute to the ongoing debate that shapes improvements in clinical care. I welcome your feedback.
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Intrauterine Growth Restriction: Recognizing the Risk FactorsAbout 40 years ago, doctors recognized for the first time that the restriction of fetal growth was a phenomenon that not only affected animals, but also human beings.
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Born Too Soon Cervical Ultrasonography to Predict Preterm Delivery is UnprovenWomen's health care has engendered innovations with enormous impact on the practice of medicine and on modern life in general--such innovations as hand-washing, the Papanicolaou smear, and oral contraceptives.
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Torch Infections and Prenatal Ultrasound FindingsTORCH INFECTIONS AND PRENATAL ULTRASOUND FINDINGS Eran Casiff M.D. Department of Obstetrics and Gynecology Kaplan Medical Center Rehovot 76100, Israel Limitations • Most infected fetuses are sonographically normal • Ultrasound findings may change with time • no correlation with infant outcome Cerebral Ventriculomegaly • Measured at the posterior aspect of the choroid plexus • Almost always symmetric • 5% of cases can be attributed to fetal infection Intracranial Calcifications • Intrauterine infection • Periventricular hyperechoic foci - the hallmark • May be located in the thalami and basal ganglia • Small with no acoustic shadowing • Most frequently seen with CMV and Toxoplasmosis Hydranencephaly • Most severe manifestation of the destructive process • Cerebral hemispheres replaced by fluid, brain stem preserved, falx present, absent or deviated, posterior fossa structures can be identified • Reported in Herpes simplex, Toxoplasmosis and CMV Microcephaly • Often associated with other CNS anomalies • Diagnosed as three SD below the mean for gestational age • Abnormal HC/AC and HC/FL ratios • Isolated microcephaly documented in CMV, Rubella and Herpes simplex Cardiac Abnormalities • Cardiomegaly, mostly in CMV • Cardiothoracic ratio • VSD, ASD, Pulmonic stenosis and coarctation of the aorta in Rubella Hepatosplenomegaly • Documented in all TORCH infection • Often a transient finding • Normograms are available Intra-abdominal Calcifications • Typical appearance: echogenic foci with acoustic shadowing • Peritoneum, intestinal lumen, organ parenchyma, biliary tree and vascular structures • Echogenic bowel in CMV and Toxoplasmosis Hydrops, Placenta and Amniotic Fluid • Hydrops reported in most TORCH but may be transient • Placentomegaly is usually associated with intrauterine infection, but small placentae have also been reported • Hydramnios and oligohydramnios have been reported with similar frequency Fetal Growth Restriction • Estimated weight below the 10th percentile • Common feature with CMV, Rubella, Herpes simplex and Varicella • Usually not seen with Toxoplasmosis and Syphilis TOXOPLASMOSIS • Ventriculomegaly is the most frequently documented finding Intracranial calcifications, placentomegaly, liver calcifications and ascites Hyperechoic bowel have been reported Microcephaly never been reported in utero SYPHILIS • Hepatomegaly and Placentomegaly are the most frequent sonographic manifestations • Ascites, Hydrops and Hydramnios are less commonly reported • Resolution of sonographic signs have been reported with maternal antibiotic therapy RUBELLA • Incidence less than 1:100,000 live birth • Prenatal diagnosis by sonographic findings have never been reported • Potential detected abnormalities include: cardiac anomalies, microcephaly, hepatosplenomegaly, FGR, microphtalmia and cataract CMV • The most common congenital infection affecting 1% of all live births • 10% of infected neonates demonstrate clinical manifestations that potentially could be identified by prenatal sonography • Ventriculomegaly, FGR, Intracranial calcifications and oligohydramnios are the most frequently reported findings HERPES SIMPLEX • HSV are usually acquired at birth Intrauterine infections resulting in clinical signs has been reported in 100 cases worldwide • Hydranencephaly is the only sonographic sign reported antenatally • Microcephaly, interracial calcifications and FGR are potentially detectable VARICELLA ZOSTER • The most common finding is Hydramnios • Also reported: liver calcifications, hepatomegaly, hydrops, limb deformities, ventriculomegaly and FGR SUMMARY • Sonography is not a sensitive test for fetal infection • Normal fetal anatomy survey cannot predict a favorable outcome • Multiple organ systems are affected in 50% of cases THANK YOU
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History of UltrasoundMy ultrasound training began when I was starting the second year of a neurology residency at the Bowman Gray School of Medicine of Wake Forest University in Winston-Salem, North Carolina. I had just finished a year of general medical internship which was a requirement for neurology residents.
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Ectopic Pregnancy: OverviewThe word "ectopic" means "out of place." An ectopic pregnancy is a pregnancy that is not growing in the usual location (the uterine cavity). Ectopic pregnancies can occur in a number of abnormal locations, each with different characteristic growth patterns and treatment options.
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Defining Infertility, Part 1I was recently asked by WebMD to comment on a newly published study that highlights a possible link between epilepsy, its treatment, and infertility, but a finding in the study has broader implications for all patients trying to conceive. First, a little about the study, and afterwards I will show how it applies to everyone trying to build a family.
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Overactive Bladder Screening and TreatmentThe symptoms of overactive bladder – urinary frequency, urgency, and urge incontinence – affect an estimated 1 in 11 adults of all ages in the United States.
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Fewer Risks, New Hope: The Reality of Blastocyst TransfersThe first thing that usually comes to mind when people hear the term, "infertility treatment," is the risk of multiple births. This worry has been fueled by the recent highly publicized multiple births in Iowa and Texas.
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Tips for Residency InterviewsIn a recent study published in the American Journal of Obstetrics and Gynecology, Dr Strand and colleagues found that behavioral interviewing techniques may be useful in predicting success of a candidate in residency. Here, Dr Strand shares some tips for graduating medical students who are preparing for residency interviews.
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Scientific Review of: The Control of LaborLabor at term is regarded as a release of the myometrium from the inhibitory effects of pregnancy (phase 0) which are mediated by a variety of suppressors that maintain uterine quiescence.
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Office HysteroscopyThe first use of hysteroscopy as a diagnostic tool occurred in 1869 by Pantaleoni who used a tube with an external light source to detect “vegetations in the uterine cavity.”[1] Since that time, improvements in optics, light sources and video cameras have made office hysteroscopy an invaluable tool in the diagnosis of abnormal uterine bleeding. Additionally, the office hysteroscope has the potential for use in treatment of certain disorders of the uterine cavity.
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Genital Wart Management: A Partnership Between Physician and PatientWith its implications of sexual transmission and potential cervical cancer, a diagnosis of genital warts can be emotionally distressing to patients. Because no single treatment serves every patient, the best approach to selecting a therapeutic option considers the extent of the disease, wart location, and the patient's individual needs.
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Anatomy of the Autonomic Innervation of the Pelvic Organs Some considerations for pelvic surgeonsThe innervation of the pelvic structures has an important role in the surgical knowledge, especially when the surgeon is dealing with radical surgery for cancer and with extensive surgical procedures for deep infiltrating endometriosis.
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Laparoscopic treatment of endometriosis in patients with failed in vitro fertilization cyclesEndometriosis is one of the most common gynecologic disorders and is significantly more prevalent in the setting of infertility. The prevalence of endometriosis in infertile women ranges from 25% to 50% compared to 5% in fertile women. Successful laparoscopic management of all stages of endometriosis was reported as early as 1986. This has revolutionized the management of endometriosis. The benefits of surgical therapy for infertility associated with endometriosis have been well documented.
