Diagnosing chronic pelvic pain
August 1st 2010Chronic pelvic pain is common in women. The broad differential diagnosis for chronic pelvic pain and overlap in symptoms among etiologies makes diagnosis challenging but underscores the need to conduct a detailed history and careful examination that considers the full spectrum of cases, according to one expert.
Guidelines relax stance on vaginal birth after cesarean
August 1st 2010New guidelines issued by the American College of Obstetricians and Gynecologists are less restrictive about attempting vaginal birth after cesarean delivery, reflecting concerns about the soaring rate of cesarean deliveries in the United States.
Amenorrhea caused by extremes of body mass: pathophysiology and sequelae
August 1st 2010Amenorrhea is defined as the abnormal absence of menstrual periods. Abnormal or pathologic amenorrhea should be distinguished from absence of menses because of physiologic causes such as pregnancy, lactation, and menopause.
VBAC attempt: Induction and augmentation of labor
August 1st 2010A woman had a cesarean delivery through a lower-segment transverse incision in her first pregnancy because of arrest of descent. She has had a uncomplicated second pregnancy and desires a trial of labor; however, at 39 weeks, she requests labor induction because of her husband's travel schedule. Learn how labor induction can affect the risk associated with vaginal birth after cesarean delivery.
Stress incontinence surgeries are not equivalent in all ways
August 1st 2010Although retropubic and transobturator midurethral slings may be objectively equivalent in their treatment of stress incontinence, women do not find them subjectively so, and complication rates can difer, according to a randomized trial.
Woman claims she was not informed of risk of Down syndrome
August 1st 2010A Maryland woman received prenatal care from her obstetrician and delivered a child with Down syndrome in 2006. The patient sued her doctor, claiming that he failed to tell her that the "triple screen" blood test he ordered had revealed a 1-in-37 chance of her child being born with Down syndrome. She claimed that had she been informed of the test results, she would have terminated the pregnancy.
Vitamin D supplements may cut breast cancer risk
August 1st 2010Although vitamin D and calcium absorbed from food and total combined intake from food and supplements do not seem to influence breast cancer risk, vitamin D supplement intake greater than 10 mcg/d compared with no intake reduced the risk of breast cancer by about 25% according to results of a Canadian study.
Use of bar-code technology drastically reduces medication errors
July 1st 2010Using bar-code verification technology within an electronic medication administration system substantially reduces transcription and medication administration errors along with related potential drug-related adverse events, according to a new study.
Screen with cytology triage catches more cancers than cytology alone
July 1st 2010Primary human papillomavirus DNA screening with cytology triage in a routine organized screening program detects more cervical intraepithelial neoplasia III+ lesions in all age groups than conventional cytology, according to new study findings.
Perceptions about cause of dystocia lead to litigation
July 1st 2010A patient presents to a hospital with onset of contraction and spontaneous rupture of the fetal membranes. The rupture revealed clear amniotic fluid. The resident evaluating the patient noted that her cervix was 3 cm dilated and 70% effaced, and the fetus was at -2 station and in vertex position. The patient was placed on oxytocin and was 6 cm to 7 cm dilated within 90 minutes.
Surgical debulking of ovarian cancer: Past, present or future
July 1st 2010Ovarian cancer is the "silent killer," causing more deaths in the United States than all other gynecologic malignancies combined. This article focuses on the recent debate or whether or when patients with advanced disease should undergo debulking surgery.