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A study from Belgium has found that women with typical symptoms of urinary tract infection (UTI) may still be infected with the uropathogen Escherichia coli despite a negative culture result.

Shoulder dystocia is a known complication of vaginal delivery that can be extremely challenging to manage, mostly because it is unpredictable and unpreventable. Hence, shoulder dystocia needs to be remedied with the maneuvers that the obstetrician is already trained in, according to a presentation at the 2018 Annual ACOG Meeting in Austin.

Results of a recent extended study of prolapse surgery  showed that in 60% of women, two common procedures failed within 5 years, but patients still reported a higher quality of life than before the surgery. Plus: ACOG has released a revised Committee Opinion to emphasize the idea of the “fourth trimester” in an attempt to reduce maternal morbidity and mortality numbers. Also: A recent study suggests that entering menopause later in life may be associated with a small boost in memory performance years later.

The following board members - both past and current - authors and collaborators will be appearing in Austin at the ACOG Annual Clinical and Scientific Meeting in April. Here is a rundown on where you can find them, the programs they will be participating in, plus links to their recent articles in Contemporary OB/GYN.

Enhanced recovery pathways (ERP) are rapidly gaining acceptance and use in gynecologic surgery. These handouts from the ERAS Society provide the physician and patient with valuable information for both pre- and post-operative care.

Analysis of data from more than 50 million pregnancy-related hospitalizations shows that more needs to be done to identify new mothers at high risk for heart failure (HF) before they leave the hospital. Plus: Incidence of occult cancer during benign gynecology surgery is low but not insignificant. Also: According to a recent study, nearly 5% of non-pregnant women of childbearing age experience major depression, but less than half of those patients use antidepressants.

ERPs may take a year or two to get gong but the benefits to patients and the healthcare system can be significant.

The Food and Drug Administration (FDA) has issued an order restricting sales and distribution of the contraceptive device Essure. Plus: Can a Pap test one day be used to diagnose ovarian, endometrial cancers?

A collection of standards, guidelines, tools and articles for further reading on maternal mortality. ACOG guidelines for emergencies and adverse effects; resources for coping with the death of a patient. Plus, news from Haiti about using mobile technology to save mothers.

A 26-year-old G0 comes to the office complaining of dysuria and painful lesions on her vulva. Can you make the correct diagnosis and treatment plan?

Contemporary OB/GYN will post links to reports on OB hospital closures to help illustrate the impact these closures have on their patients and maternal mortality rates. Be sure to check back often for the very latest links and information.

A family history of uterine cancer prompted the patient to seek a hysterectomy.

Readers write in about their thoughts on Contemporary OB/GYN's coverage of the maternal mortality issue, urge the avoidance of politicizing issues, and argue for the reduction of cesarean deliveries.

The U.S. Food and Drug Administration (FDA) has done women a disservice by incompletely examining the evidence for risk and benefits associated with morcellation for women undergoing surgery for suspected fibroids. Of note, within days of the FDA report, the Agency for Healthcare Quality and Research (AHRQ) of the US Department of Health and Human Services published a more rigorous and complete analysis of available data with entirely different results and conclusions. Thirty-six signees recommend that Contemporary OB/GYN’s readers review the AHRQ findings and decide which report serves women best.

Dr. James Greenberg gives his review of the LiquiBand Exceed Topical Skin Adhesive.

Two physicians recount their experiences of losing a patient.

From our own experience in academic medicine, Dr. Ed Funai and I can vouch for the fact that most medical students are going into medicine for the right reasons-to help others via a career wedded in both science and humanity. Ironically, those same medical students are also experiencing record levels of burnout, substance abuse and depression as they enter their third and fourth years.

The purpose of this article is to review the steps in a cesarean delivery and examine the best available evidence for performing the procedure.

Findings from a recent study indicate that trimethoprim 200 mg BID for 3 or 7 days is the most effective antibiotic for uncomplicated urinary tract infection (UTI) when levels of local resistance to the drug are < 30%. However, when it is ≥ 35%, a single dose of fosfomycin 3g or nitrofurantoin 100 mg BID for 7 days is more cost-effective.