Pregnancy and Birth

The view that nuns have a very low risk of cervical cancer is questioned. The historical evidence for this view is reviewed, from the beginning of the eighteenth century to the present. An estimate of the actual mortality rate from cervical cancer suggests that risk of death from this neoplasm among nuns is little different from that among the general female population.

In this column, subject experts have been invited to provide an annotated guide to some of the most useful health sites on the Internet. In this issue Hans van der Slikke, Consultant Obstetrician at Zaandam Hospital, The Netherlands, and Chairman of the International Council of OBGYN.net, provides a guide to some of the best women's health resources now available on the Internet.

Discussion between Mark Perloe, MD, and Bruno Lunefeld, MD, on the risks associated with ovulation induction in breast cancer and ovarian cancer.

Although sperm and embryos (fertilized eggs) have been successfully frozen and subsequently thawed to create healthy children for decades, it is only recently that successful human egg freezing has become a reality.

Susan is a 58-year-old woman who saw her family physician after a few weeks of mild abdominal pain and bloating. The examination of her abdomen was normal, as was a pelvic and rectal exam. Blood tests for infection, liver and gall bladder problems were also normal.

Human Papillomavirus has emerged as a distinct cause of cervical changes in young women. Its prevalence is continuously growing and is considered at epidemic proportions with 20 million Americans already infected and 5.5 million new cases reported annually. (2) (Center for Disease Control and Prevention, Tracking the Hidden Epidemics., Trends in STDs in the U.S. 2000, Atlanta, Georgia, 2000)

OBGYN.net Broadcasting present Part VIII of a series on Weight Loss Surgery. This series is unique in that we follow the patient from pre-op to one year post-op.

OBGYN.net Broadcasting present Part VI of a series on Weight Loss Surgery. This series is unique in that we follow the patient from pre-op to one year post-op.

Test your ob/gyn knowledge in our DailyDx.

OBGYN.net Conference CoverageFrom AIUM 44th Conference held in San Francisco, California - April, 2000

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.

In light of ongoing threats of radiation exposure during the earthquake, tsunami, and nuclear crisis in Japan, OBGYN.net has put together a list of resources and information for doctors and patients who want to learn more about the dangers of radiation and exposure during pregnancy.

To review utilisation of elective embryo cryopreservation in the expectant management of patients at risk for developing ovarian hyperstimulation syndrome (OHSS), and report on reproductive outcome following transfer of thawed embryos.

The first vaccine to prevent human papillomavirus (HPV) and cervical cancer has been licensed, and in future, vaccination may be routinely offered to 10–14 year old girls. HPV is a sexually transmitted virus and some parents may refuse consent for vaccination.

Classification of Heart Diseases in Pregnancy: Incidence: 1% of all pregnancies 1-Rheumatic valve diseases (still the most common in the developing countries.) MS, MR, DM, AS, AR. 2-Congenital disorders (The most common in developed countries.) ASD, VSD, PDA, coarcitation of the aorta, Fallot's tetralogy, Eisenminger syndrome and Marfan syndrome. 3-Others: Arrhythmias, ischemic heart disease and cardiomyopathy.

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.

Significance of the umbilical cord: the umbilical cord can be aptly termed the life line for the fetus during its intrauterine life but can often be the cause for its misery in case of cord pathology.

ACOG has recently 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.

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.

OBGYN.net Conference CoverageFrom American Association of Reproductive Medicine55th Annual Meeting of ASRM held conjointly with CFAS- Toronto, Ontario, Canada - September, 1999

Asherman’s Syndrome is an extremely common and occasionally complicated disease entity. It takes many forms and can follow a routine D&C, a hysteroscopy, a delivery or even a surgical procedure such as a myomectomy or polypectomy. This case study from Dr. Alan Copperman reviews diagnosis and treatment options.

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.

Laparoscopic Myomectomy uses a small telescope placed through the belly button along with several small instruments to remove fibroids from the uterus. The technique of actually removing the fibroid from the uterus is similar to that of an abdominal myomectomy except we use small instruments placed through the abdominal wall. Once the fibroid is freed from the uterus it needs to be removed from the abdomen. In order to remove a large fibroid from a small incision we use an instrument called a morcellator, to cut it into pieces small enough to be removed through the small incisions.

In the United States, 20% of preschoolers are overweight and, of those, 50% are obese. Children who are obese are more likely to be obese in adulthood and thus are at greater risk for chronic diseases such as heart disease, stroke, and type 2 diabetes mellitus. A baby’s risk of becoming overweight or obese is reduced with each month of breastfeeding. The American Academy of Pediatrics recommends that healthy babies be given only breast milk for the first 6 months of life.

When an adverse outcome and missed diagnosis occur, problems in the organization of care and issues with communication between caregivers are frequently the true cause rather than an isolated error made by one practitioner. In recent years, seeking to capitalize on frustration with the health care delivery, plaintiff’s lawyers have sought to identify disagreements among providers in patient management and/or errors within the patient care management system. Allegations that nonphysician personnel should have recognized a problem with the care plan and accessed the “chain of command” in an effort to alter the clinical course are included in these types of claims.

What are echogenic intracardiac foci (EIF)? EIF are small, echogenic lesions seen (on sonography) inside the left or right ventricles of the fetal heart within the papillary muscles or chordae tendinae. These lesions are not attached to the wall of the ventricles.