November 22nd 2024
Review some of the top stories from the Contemporary OB/GYN website over the last week, and catch up on anything you may have missed.
Patient, Provider, and Caregiver Connection™: Exploring Unmet Needs In Postpartum Depression – Making the Case for Early Detection and Novel Treatments
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Identifying Health Care Inequities in Screening, Diagnosis, and Trial Access for Breast Cancer Care: Taking Action With Evidence-Based Solutions
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16th Annual International Symposium on Ovarian Cancer and Other Gynecologic Malignancies™
May 3, 2025
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Addressing Healthcare Inequities: Tailoring Cancer Screening Plans to Address Inequities in Care
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Clinical Consultations™: Guiding Patients with Genital Psoriasis Toward Relief Through a Multidisciplinary Approach
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Burst CME™: Optimizing Migraine Management – Addressing Unmet Needs, Individualizing Care for Diverse Populations, and Utilizing CGRP Targeted Agents
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Burst CME™: Optimizing the Use of CGRP Targeted Agents for the Treatment of Migraine
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Burst CME™: Setting the Stage – Individualizing Migraine Care for Diverse Populations Across Care Settings
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Burst CME™: The Patient Journey – Unmet Needs From Diagnosis Through Management of Migraine
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‘REEL’ Time Patient Counseling™: Fostering Effective Conversations in Practice to Create a Visible Impact for Patients Living with Genital Psoriasis
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Pre eclampsia, sometimes called toxemia, is a unique and often dangerous condition that only occurs during pregnancy. Most experts define PRE ECLAMPSIA as an elevation in blood pressure in a pregnant woman of 140/90, with protein in the urine, or swelling (edema) of the feet, hands, and/or face. The condition occurs more commonly during first pregnancies, with twins or triplets, in very young or older women, and when a woman has had pre eclampsia with previous pregnancies.
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A guide to Women's Health on the Internet Part 2. Gynaecology and Reproductive Medicine
July 1st 2011The problems relating to searching the Internet for medical information are well known; too many sites are identified and there is no easy way to filter out the good from the bad. Consequently, if search engines are not the best place to start your exploration of the Web for information relating to gynaecology and reproductive medicine, where is? In my opinion the best place to start is at the OBGYN.net site .
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Endometrial Ablation and Hysteroscopic Surgery
June 30th 2011Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.
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Gasless Gynecologic Laparoscopy
June 30th 2011After more than 50 years, pneumoperitoneum with carbon dioxide remains the standard for creating a working space for laparoscopic surgery. Although the physiologic problems resulting from CO2 pneumoperitoneum have been well documented, they are becoming more of a concern as older, more debilitated women are undergoing longer, more extensive laparoscopic procedures
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Laparoscopy, looking inside the abdomen through a tube placed through a small incision, is a procedure commonly used by gynecologists to diagnose and treat a number of medical conditions. Since the early 1900's when rudimentary laparoscopes were used to visualize, but not treat, abdominal diseases, advancements in this technique have led to the ability to perform complex surgical procedures through a few small incisions, rather than the larger incisions used in the past.
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Diagnostic Laparoscopy in Gynaecological Problems: A Retrospective Study
June 28th 2011Objective: To study the findings obtained by diagnostic laparoscopy in gynaecological problems in order to re-assess the role of laparoscopy in the diagnosis of gynaecological problems during the study period.
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Tubal Ectopic Pregnancy: Laparoscopy vs. Laparotomy
June 28th 2011Objectives: To compare the efficiency of laparoscopic treatment versus conventional abdominal surgery in the treatment of ectopic pregnancy (EP) and to review the clinical presentation, evaluate methods of diagnosis, and identifying the risk factors.
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Extraperitoneal Endometriosis, Catamenial Pneumothoracies, And Review of the Literature
June 28th 2011Objective: To present a case of catamenial pneumothorax and diaphragmatic endometriosis that was managed thoracoscopically. A review of the literature is also presented. A 28-year-old woman initially presented with bloody stools and chronic constipation. During a review of systems, the patient described monthly chest pain associated with her menses. The initial workup included a pre-operative chest x-ray that revealed a right pneumothorax and colonoscopy that revealed biopsy-proven endometriosis of the sigmoid colon.
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Endometriosis is still poorly understood despite a high and still increasing publication rate of over 500 articles a year, i.e. 455 426, 448, 504 and 534 in the last 5 years respectively. It is considered to be one of the most important causes of pelvic pain and of infertility. The exact prevalence is not known since a laparoscopy is required to make the diagnosis and since the recognition varies with the training and the interest of the laparoscopist. Moreover the pathophysiology is poorly understood, which makes it difficult to formulate and test simple hypotheses.
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Dermatoses of Pregnancy at a Glance
June 23rd 2011During pregnancy, every mother-to-be undergoes radical psychological and physiological changes (endocrinologic, immunologic, metabolic, or vascular) whose influence may trigger various skin manifestations, even during the very first weeks of gestation.
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An ectopic pregnancy is a pregnancy implanted in an abnormal location (outside of the uterus). During the past 40 years its incidence has been steadily increasing concomitant with increased STD rates and associated salpingitis (inflammation of the Fallopian tubes). Such abnormalities of the tubes prevent normal transport of the fertilized egg to the uterus.
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Nonsurgical Management of Uterine Fibroids
June 22nd 2011Fibroids are the most common benign tumors of the uterus. These noncancerous growths are present in 20-40% of women over the age of 35. In some women, the fibroids can become enlarged and cause symptoms of excessive bleeding and pain. While the classic treatment of symptomatic fibroids has been surgical removal of the fibroids (myomectomy) or the uterus (hysterectomy) recent advances now afford a nonsurgical treatment.
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Ovarian Cysts and Endometriosis
June 22nd 2011Ovarian cysts are enlargements of the ovary that appear to be filled with fluid. They can be a simple fluid filled bleb or contain complex internal structures. The term cyst is used to differentiate them from solid enlargements. Simple cysts have no internal structures and are less worrisome than those with complex structures or solid components. A sonogram or ultrasound test can determine if a cyst is simple or complex.
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A significant number of women experience infertility due to surgically correctable causes. Most cases are a result of endometriosis and/or adhesions (scar tissue) from previous surgery or pelvic infection. Endometriosis and adhesions cause distortion and blockage of the fallopian tubes, thus causing infertility. Infertility surgery tries to unblock, release and restore normal anatomy of the fallopian tube.
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Around 153 million women around the world have chosen to be sterilized for contraceptive purposes, of these 138 million are in the developing countries. 1 Approximately fifty percent of all female sterilization is performed during the puerperal period or a cesarean section, and the other fifty percent is called “interval sterilization” when there has been no pregnancy for the previous six weeks.
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Currently there are two ways to treat endometriosis – hormonal therapy and surgery. Depending on the patient’s expectations and the extent of the disease, we may prescribe hormonal therapy, surgery, a combination of surgery and hormonal therapy, or occasionally a just “wait and see” approach.
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The most important question to ask is whether or not the fibroids need to be treated at all. The vast majority of fibroids grow as a woman gets older, and tend to shrink after menopause. Obviously, fibroids that are causing significant symptoms need treatment. While it is often easier to treat smaller fibroids than larger ones, many of the small fibroids never will need to be treated. So just because we can treat fibroids while they are small, it doesn't follow that we should treat them. The location of the fibroids plays a strong influence on how to approach them. A gynecologist experienced in the treatment of fibroids can help you determine if they need to be treated.
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Fibroids are non-cancerous (benign) growths of the muscle wall of the uterus. They are probably responsible for more unnecessary gynecologic surgery than any other condition. It is a staggering number, but about 600,000 American women have a hysterectomy every year. And about 30% of those hysterectomies, 180,000 in all, are performed because of fibroids. For many years these growths have been surgically removed, often because of fear of the problems they might cause in the future. And, those problems are often overstated. While approximately 30% of all women will have fibroids during their lifetimes, the vast majority of these women will never have symptoms and will never require treatment. And, for the rare patient that does have problems, there are a number of sound and effective options available. Hysterectomy should be the solution of last resort.
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Throughout history, menstruation has been associated with myth and superstition. Menstrual blood was felt to cure leprosy, warts, birthmarks, gout, worms and epilepsy. It has been used to ward off demons and evil spirits. Menstruating women have been separated from their tribes in order to prevent a bad influence on the crops or the hunt. As recently as 1930, the cause of abnormal menstrual bleeding was felt to be an undue exposure to cold or wet just prior to the beginning of the period.
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Abnormal PAP Smears, HPV, Cervical Dysplasia and Cancer
June 21st 2011The terminology used to describe pap smear results has changed over the past few years, leading to confusion about what the results of your pap smear actually mean. Originally, pap smears were divided into 5 "classes" based on what the cells looked like to the pathologist. Class I was normal, while class II cells appeared a little irregular to the pathologist, usually representing bacterial infection. Class III and IV pap smears suggested that dysplastic cells were present, and further testing needed to be done. Class V usually meant cancer.
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Endometrial Ablation and Hysteroscopic Surgery
June 21st 2011Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.
Read More
Laparoscopy, looking inside the abdomen through a tube placed through a small incision, is a procedure commonly used by gynecologists to diagnose and treat a number of medical conditions. Since the early 1900's when rudimentary laparoscopes were used to visualize, but not treat, abdominal diseases, advancements in this technique have led to the ability to perform complex surgical procedures through a few small incisions, rather than the larger incisions used in the past.
Read More
Uterine fibroids ( "fibroid tumors";" leiomyoma"; "myomas") are benign, (non-cancerous) growths present in about 30% of women over the age of 30. They are usually detected on pelvic examination, which may reveal the uterus to be enlarged and/or irregular in configuration. The vast majority of cases are absolutely silent and cause no symptoms. The size of a single fibroid may be smaller than a pea, or larger than a melon. In a given patient, there may be a single fibroid, or multiple fibroids of varying size. In the latter situation, the summation of the fibroids of varying sizes will lead to an aggregate size increase.
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"Abnormal Uterine Bleeding" or "AUB" is a relatively common condition. Normal menstrual flow produces less than 3 ounces of blood, in a maximum of 7 days. AUB patterns are characterized by flows that are heavier, and/or more prolonged or more frequent than a 21-28 day interval. AUB can cause anemia, embarrassment, or marked inconvenience. It has been said by many so afflicted women-" I have to plan my life around my period".
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Hysteroscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (hysteroscope) through the cervix into the uterus. The hysteroscope allows the surgeon to visualize the inside of the uterine cavity on a video monitor. The uterine cavity is then inspected for any abnormality. The surgeon examines the shape of the uterus, the lining of the uterus and looks for any evidence of intrauterine pathology (fibroids or polyps). The surgeon also attempts to visualize the openings to the fallopian tubes (tubal ostia).
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