Pregnancy and Birth

Disclosure Declaration •Grant Support –National Institutes of Health, Ortho-McNeil Pharmaceutical, Inc, Pharmacia Corp., Berlex Laboratories, Proctor and Gamble •Honoraria and consultation fees –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., TAP Pharmaceuticals, Eli Lilly and Co. •Participation in company sponsored speakers’ bureau –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., Merck Pharmaceuticals.

Hormonal Contraception: Combination OCP’s .Contain Synthetic Estrogen/Progestin .Modern E2 Dosage = 50 Mcg .Despite Diversity, Side Effects and Efficacies Similar .Requires Patient Compliance .May Be Monophasic or Triphasic

Definitions Gestational Trophoblastic Neoplasia (GTN)=Malignant Gestational Trophoblastic DiseaseIt is a spectrum of trophoblastic diseases that develops malignant sequelae. GTN includes: • Persistent post molar GTD • Invasive mole • Choriocarcinoma • Placental site trophoblastic tumourThe last 2 may follow abortion, ectopic or normal pregnancy.Disaia &Creasman Clinical Gynecological Oncology 2007 Cunningham et al Williams Obsterics 23rd , 2010

ORAL CONTRACEPTIVES: . Objectives . Know the risks, benefits and side effects of oral contraceptives . Utilize basic concepts in OC prescribing . Know how to modify regiments to manage side effects .Objectives .Know the risks, benefits and side effects of oral contraceptives .Utilize basic concepts in OC prescribing .Know how to modify regiments to manage side effects

Extended Use of Combined Oral Contraceptive PillsDr Hamed EllakwaAssociate Professor of Obsterics and GynecologyMenoufiya University, Egyptdrhamedellakwa@yahoo.com

A New Contraceptive Option: A Focus on the Transdermal Contraceptive System Ronald T. Burkman, MD Baystate Medical Center Tufts University School of Medicine

Endometriosis-An Overview Prof. Dr. Mohammad A. Emam Prof. of Obstetrics and Gynecology Mansoura Faculty of Medicine Mansoura Integrated Fertility Center (MIFC) EgyptEmam MA, EGYPT, 2003

Roberta Speyer: “This is Roberta Speyer and I’m reporting for OBGYN.net. I have the pleasure of talking to Dr. Fleischman who is an Assistant Clinical Professor at Yale University and in private practice with Gynecology & Infertility, PC. Today we are going to talk about urinary incontinence and how OBGYN physicians can fit this into their practice. As a practicing OBGYN yourself, this is something you have a great degree of specialization in. Tell us a little about your practice Dr. Fleischman.”

Thanks to innovative treatments like in vitro fertilization and egg donation, we are able to help thousands of infertile patients build their families.

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 topic of hormone replacement therapy (HRT) continues to emerge as a central theme that we, as clinicians to female patients, address every day. We recognize that the public is much more aware of and interested in HRT now than was the case a decade ago.

Menopausal Hormone Therapy and Other Breast Cancer Risk Factors in Relation to the Risk of Different Histological Subtypes of Breast Cancer: A Case-control Study

In humans, serotonin has typically been investigated as a neurotransmitter. However, serotonin also functions as a hormone across animal phyla, including those lacking an organized central nervous system.

Breast cancer is a growing concern among premenopausal women. With an emphasis on this patient population, this article discusses the known risk factors for breast cancer; models for quantitative risk assessment; and strategies for modifying breast cancer risk, including screening mammography, prophylactic mastectomy, and primary pharmacologic prevention.

The age at which a woman reaches menopause is 85% genetically determined, according to new research published Thursday, in Europe's leading reproductive medicine journal, Human Reproduction*.

Healthy, nonsmoking perimenopausal women can derive a host of benefits from using oral contraceptives (OCs). Along with providing effective contraception, OCs can regulate their menstrual cycles, reduce hot flashes, and protect against two gynecologic cancers.

There are many ways to take estrogens and many philosophies of management. The views expressed on this page represent the opinion of the author and may or may not conform to the current "standard of care" prevalent in the United States today.

Natural Estrogens, Selective Estrogens, Fantasy Estrogens... What is the Perfect Estrogen?

This is adapted from an interview with Dr. Howard Glazer, who has developed a treatment for this condition using a form of biofeedback. This initial interview, covers the history of the disease, as well as Dr. Glazer's background.

Body Mass Index, Percent Body Fat, and Regional Body Fat Distribution in Relation to Leptin Concentrations in Healthy, Non-Smoking Postmenopausal Women in a Feeding Study

Many risk factors for fractures have been documented, including low bone-mineral density (BMD) and a history of fractures.

Diagnostic discordance for osteoporosis is the observation that the T-score of an individual patient varies from one key measurement site to another, falling into two different diagnostic categories identified by the World Health Organization (WHO) classification system.

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.

Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy.

High blood pressure complicates almost 10 percent of all pregnancies, and the incidence is higher if the women are nulliparous or carrying multiple fetuses.

In an extensive, multi-center clinical treatment trial, Canadian researchers evaluated the outcomes of 538 cases of uterine artery embolization for fibroids. Between 20% and 50% of women develop uterine fibroids, benign tumors in the muscular tissue of the uterus that can seriously impact their health and well-being.

This study was designed to determine whether epidural anesthesia would improve external cephalic version success in a safe and effective manner.

The ability to quickly, cost-effectively and accurately predict fetal pulmonary maturity would be a helpful adjunct in the management of problem pregnancies when either delivery or administration of glucocorticoid are management options.