OB GYN News articles from April 2001

OB GYN News archives from April 2001

Fired Male Ob.Gyn.Claims Gender Bias.
April 1, 2001... Dr. David Garfinkel, a Morristown, N.J., ob.gyn., is still hoping for his day in court to tell a judge about how he believes he was wrongfully fired from an ob.gyn. practice solely because he is a man. Dr. Garfinkel is one of many male...

Multiple Courses of Prenatal Steroids Should Be Avoided.
April 1, 2001... Higher rates of chorioamnionitis, infant sepsis seen among women with PROM. RENO, NEV. -- Evidence continues to mount that multiple courses of prenatal steroids should not be routinely used in women at risk for preterm de livery. In...

Use of Sequential Vacuum, Forceps Raises Injury Risk.
April 1, 2001... Hemorrhages, nerve injury, lacerations seen. RENO, NEV. -- The risks of both maternal and fetal injury are increased with the sequential use of vacuum extraction and forceps for assisted vaginal delivery, Dr. Carolyn Gardella reported at...

Most Down Syndrome Markers Deemed Unreliable.
April 1, 2001... None of the markers for Down syndrome on second-trimester ultrasonography are sensitive enough to reliably discriminate between affected and unaffected fetuses, a metaanalysis of 56 studies involving over 132,000 pregnancies has shown. ...

A Look Forward to the Past.
April 1, 2001... Probably the most classic operation in gynecology, other than dilatation and curettage, is the total abdominal hysterectomy with bilateral salpingo-oophorectomy. It is important to realize, however, that the majority of these operations...

LETTERS.
April 1, 2001... Don't Squeeze! Women in labor may be setting themselves up for shoulder dystocia if they fight the urge to defecate or pass wind. During the second stage of labor the vagina dilates enormously, and the disposition of the pelvic floor...

Ultrasound, Triple Screen Predict Trisomy 18 Risk.
April 1, 2001... RENO, NEV. -- Ultrasound markers and biochemical findings can accurately predict trisomy 18 risk in fetuses with choroid plexus cysts, eliminating the need for amniocentesis in a large percentage of cases, Dr. Lorraine Dugoff reported. She...

NSAIDs During Pregnancy Raise Miscarriage Risk.
April 1, 2001... The use of nonsteroidal anti-inflammatory drugs during pregnancy raised the risk, of miscarriage but not other adverse outcomes in an observational study by researchers in Denmark. Using data on all pregnancies listed in a countywide birth...

Fetal Fibronectin Useful After Fetal Reduction.
April 1, 2001... RENO, NEV. -- Fetal fibronectin was a useful predictor of preterm delivery in women who had undergone multifetal pregnancy reduction, Dr. Andrei Rebarber said in a poster session at the annual meeting of the Society for Maternal-Fetal...

Routine Sonography of Fetal Heart Advocated.
April 1, 2001... MARINA DEL REY, CALIF. -- Sono graphic evaluation of the fetal heart should be part of every routine fetal examination after 18 weeks' gestation when a fairly complete image can help diagnose cardiac abnormalities, Dr. Beryl R. Benacerraf said...

3-D Ultrasound Helps Identify Abnormalities in Fetal Brain, Spine, Abdomen.
April 1, 2001... MARINA DEL REY, CALIF. -- Three dimensional ultrasound images capture data about the uterus and fetus that are unavailable with standard two-dimensional ultrasound, Dr. Lawrence D. Platt said at a conference on ultrasound and women's health....

Safety of Dextromethorphan.
April 1, 2001... Dextromethorphan, the active ingredient in many over-the-counter cough and cold remedies, is probably the most widely used: anticoughing ingredient in the world. More than 70 cough and cold and flu products containing dextromethorphan are...

First-Trimester Serum Screening Called Premature.
April 1, 2001... VAIL, COLO. -- Physicians now offering first-trimester screening for aneuploidies are jumping the gun, according to Dr. Richard L. Berkowitz, professor and chairman of ob.gyn. at Mt. Sinai School of Medicine in New York. This screening...

Don't Go Overboard When Prescribing Tocolytics.
April 1, 2001... VAIL, COLO. -- The indications for to-colytic therapy have shrunk considerably in recognition of the drugs' lack of substantial benefit in preventing preterm birth coupled with their significant potential for harm, Dr. Debra Guinn said at a...

Vaginal Misoprostol Superior to Oral for Induction.
April 1, 2001... RENO, NEV. -- Vaginally administered misoprostol was more effective than the oral drug for cervical ripening and labor induction in a double-blind, randomized, controlled trial. A group of 126 women undergoing labor induction was given 50...

Ethnicity Impacts First-Trimester Fetal Heart Rate.
April 1, 2001... RENO, NEV. -- The reliability of first-trimester fetal heart rate for predicting chromosonal abnormalities may be improved by adjusting for ethnicity. This was the conclusion of a multicenter, prospective study presented in a poster...

Ultrasound Useful for Shoulder Dystocia Detection.
April 1, 2001... VAIL, COLO. -- Fetuses at high risk for shoulder dystocia can be identified by late third-trimester ultrasound evaluation looking for body-to-head disproportion, Dr. John C. Hobbins said at a conference on obstetrics and gynecology sponsored....

Drug Update: Premenstrual Syndrome.
April 1, 2001... About 95% of women in their reproductive years are affected by premenstrual syndrome, and 5% of these women have a severe form of the condition known as premenstrual dysphoric disorder. Premenstrual dysphoric disorder (PMDD) is cyclical and...

3-D Ultrasound Flags Congenital Uterine Defects.
April 1, 2001... MARINA DEL REY, CALIF. - High resolution three-dimensional ultrasound images of the uterus can be a valuable tool in the diagnosis and management of uterine abnormalities, Dr. Dolores H. Pretorius said at a conference on ultrasound and women's...

Biopsy to Confirm Endometriosis Before Ablation.
April 1, 2001... CHICAGO -- Gynecologic surgeons performing laparoscopy to confirm or exclude a diagnosis of endometriosis should excise lesions or at least biopsy them before ablation, according to Dr. Andrew Walter. Traditional laparoscopic means of...

Endometrial Volume Helps Predict Cancer.
April 1, 2001... MARINA DEL REY, CALIF. -- Indistinguishing endometrial cancer from benign pathology, volume measurements of the endometrium, obtainable only with three-dimensional ultrasound, may be more predictive of endometrial cancer than thickness...

Collagen Injections Temporary Fix for Incontinence.
April 1, 2001... VAIL, COLO. -- Transurethral collagen injections are a valuable therapeutic option in selected women with stress urinary incontinence, Dr. Nicollete S. Horbach said at a conference on obstetrics and gynecology sponsored by the University of...

New Endometrial Ablation Device on the Horizon.
April 1, 2001... ORLANDO, FLA. -- Women with menorrhagia may soon have a new outpatient treatment option. The Hydro ThermAblator, an investigational device that circulates hot saline through the uterus to ablate the endometrium, is under review by the...

Zoladex Before Ablation Leads to Better Outcomes.
April 1, 2001... ORLANDO, FLA. -- Pretreatment with goserelin acetate improves long-term outcomes in patients undergoing endometrial ablation for dysfunctional uterine bleeding, a recent study found. The 358 premenopausal patients in the study were treated...

Mesh Reinforcement Cuts Cystocele Recurrence.
April 1, 2001... CHICAGO -- Reinforcing a cystocele repair with an absorbable mesh significantly reduces the incidence of recurrence, ac cording to findings from the first randomized study to evaluate the use of adjunctive materials in cystocele repair. ...

Conservative Vulvar Ca Therapy Easier on Patients.
April 1, 2001... HOT SPRINGS, VA. -- Increasingly conservative approaches to treating patients with invasive squamous cancers of the vulva haven't compromised outcomes and have spared many patients considerable morbidity associated with extensive surgical...

Is Cystoscopy Unwarranted, Following Burch Procedures?
April 1, 2001... HOT SPRINGS, VA. -- Rou tine intraoperative cystoscopy to identify lower urinary tract in juries caused during Burch procedures adds time and expense and is not warranted, Dr. Edward J. Gill said. In recent years, findings from several...

Progestin + Estrogen Multiplies Breast Ca Risk.
April 1, 2001... SAN ANTONIO -- Adding a progestin to estrogen replacement therapy markedly increases breast cancer risk over that with estrogen alone, Dr. Ronald K. Ross reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute. ...

Ductoscopy May Aid Diagnosis of Nipple Discharge.
April 1, 2001... SAN ANTONIO -- Mammary fiberoptic ductoscopy is a useful emerging technique in the diagnosis of pathologic nipple discharge, Dr. Jill R. Dietz said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Breast cancer...

More Aggressive Breast Tumors Seen in Blacks.
April 1, 2001... SAN ANTONIO -- The relatively poor breast cancer survival of African American women may be due in part to a more aggressive tumor biology, Dr. William M. Butler said at a breast cancer symposium sponsored by the San Antonio Cancer Institute....

Cognitive Dysfunction Linked to Chemotherapy.
April 1, 2001... SAN ANTONIO -- Cancer chemotherapy appears to have adverse effects upon specific areas of cognitive function, according to two reports at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Dr. Nadine Tchen said...

Oncologists Nix High-Dose Chemo for Ovarian Ca.
April 1, 2001... SOUTH LAKE TAHOE, NEV. -- The strategy of using high-dose chemotherapy and bone marrow transplantation in ovarian cancer has been abandoned by most oncologists, Dr. Sidney Scudder said at an obstetrics and gynecology conference sponsored by...

Pelvic Pain: Evaluate Clinically, Treat Medically.
April 1, 2001... CHICAGO -- Patients with chronic pelvic pain should be evaluated clinically -- without the aid of a laparoscope--and if causes other than endometriosis are ruled out, medical therapy should be pursued to avoid surgery, Dr. Craig Winkel...

Antidepressant May Reduce Hot Flashes.
April 1, 2001... The antidepressant venlafaxine (Effexor) significantly reduced hot flashes in a randomized, controlled trial of 191 menopausal women, reported Dr. Charles L. Loprinzi of the Mayo Clinic, Rochester, Minn., and his associates. These...

Fall Prevention Is Key to Reducing Risk of Fracture.
April 1, 2001... ANAHEIM, CALIF. -- The best way to help your patients reduce their risk of bone fracture is to first focus on fall prevention efforts, Dr. Gail Greendale said at a meeting on controversies in women's health sponsored by the University of...

Hip Osteopenia More Common With Epilepsy.
April 1, 2001... LOS ANGELES -- Women with epilepsy may have a greater-than-expected prevalence of hip osteopenia, Dr. Martha Morrell said in a poster session at the annual meeting of the American Epilepsy Society. She and her associates enrolled 72 women...

Early Data Show Low-Dose Estrogen Cream Improves Urogenital Atrophy.
April 1, 2001... HOT SPRINGS, VA. -- A very low dose of locally applied estrogen effectively treats the urethral symptoms of uro-genital atrophy without creating unacceptable spikes in systemically absorbed estrogen levels, according to preliminary findings...

HRT Improves Pulmonary Function in Elderly.
April 1, 2001... Hormone replacement therapy, especially combination therapy, was associated with improved pulmonary function in a population-based, longitudinal study of more than 3,300 postmenopausal women. Current HRT users were about 25% less likely to...

Identifying Teens at Risk for Female Athletic Triad.
April 1, 2001... VAIL, COLO. -- The adolescent well-health exam provides what may well be a once-in-a-lifetime opportunity to identify patients at risk for the female athletic triad before permanent damage occurs, Dr. Stephen M. Scott said at a conference on...

Brief Estrogen Trial May Ease Mild Perimenopausal Depression.
April 1, 2001... SOUTH LAKE TAHOE, NEV. -- Perimenopausal women with mild depression deserve a trial with estrogen replacement therapy to see if it improves their mood, Dr. Vivien K. Burt said at an obstetrics and gynecology conference sponsored by the...

Depression Predicts CVD.
April 1, 2001... The evidence is mounting that depression predicts the onset of cardiovascular disease, yet many clinicians aren't adequately addressing the interface between the two disorders. Few primary care physicians who evaluate patients for...

Check Non-HDL Cholesterol.
April 1, 2001... Non-HDL cholesterol--total cholesterol minus HDL cholesterol--will be a major secondary therapeutic target, Dr. Donald B. Hunninghake predicted at a conference sponsored by the American College of Cardiology Many experts are convinced that...

Delaying HIV Treatment.
April 1, 2001... New HIV treatment guidelines are on track regarding recommendations to delay initial antiretroviral therapy, new research findings confirm. The treatment guidelines from the Department of Health and Human Services aim to balance the...

Drug-Resistant HIV.
April 1, 2001... An estimated 14% of patients with acute HIV infection are resistant to one class of antiretroviral agents. Just 3 years ago, 3.5% of acutely infected patients had HIV infections that were resistant to one drug class. The rapid increase has...

Migraine's Fellow Travelers.
April 1, 2001... Patients with migraine headaches are more likely than nonmigraineurs to have coexisting affective or anxiety disorders, stroke, epilepsy, or sleep disorders, Dr. Lawrence C. Newman said at the annual meeting of the American Headache Society....

Workouts Halve Headache Frequency.
April 1, 2001... A 45-minute aerobic exercise regimen performed 3 days a week can halve the number of tension headaches and migraines that patients experience after 2-3 months, Dr. Fred D. Sheftell said at the annual meeting of the American Headache Society....

Toss Old Cosmetics.
April 1, 2001... When a patient complains that she has started developing irritation to her cosmetics, the easiest "fix" is to replace the old cosmetics with new ones, Dr. Zoe Draelos said. Most cosmetics have a shelf life of no longer than 6 months once...

Melanoma Risk 1 in 71.
April 1, 2001... One in 71 Americans will develop melanoma at some time in their lives, according to new data from the National Cancer Institute, Dr. Darrell S. Rigel said at a seminar on clinical dermatology sponsored by Bristol-Myers Squibb Co. That's up...

Popular Diets Can Work But Are Unbalanced.
April 1, 2001... SAN FRANCISCO -- Your obese patients can rest assured that they'll start losing weight if they carefully follow any of today's popular diet plans, Dr. David Gray said at the annual meeting of the California Academy of Family Physicians. ...

Feds, Insurers Turn Up Heat on Health Care Fraud.
April 1, 2001... WASHINGTON -- Increased public and private antifraud efforts paid off last year as the Federal Bureau of Investigation charged 741 people with health care fraud and recovered $290 million for public and private insurers, Dennis Lormel, the...

RN Shortage at Hospitals Sets Stage for More Medical Errors.
April 1, 2001... Waning numbers of competent registered nurses have doctors worried that the level of medical expertise in hospitals will eventually drop--leaving room for more medical errors. Health organizations and witnesses at congressional hearings...

BILL WOULD LIFT GLOBAL GAG RULE.
April 1, 2001... Congressional lawmakers are trying to lift a ban on international family planning funds imposed by President George W. Bush. Legislation introduced in the House and Senate would repeal the reinstated Reagan-era policy, which denies U.S. funding...

INCREASE FOR HEALTH RESEARCH.
April 1, 2001... President Bush is proposing almost a 14% budget hike for the National Institutes of Health in fiscal year 2002, NIH's "largest increase ever," Tommy Thompson, secretary of the Department of Health and Human Services, says. President Bush's...

WILL EC Go OTC?
April 1, 2001... Emergency oral contraception should be available over the counter, the American College of; Obstetricians and Gynecologists says. ACOG is one of the, latest organizations to speak out in favor of making emergency contraception available to...

COURT UPHOLDS ABORTION LAW.
April 1, 2001... In a move that opponents say undermines abortion rights, the U.S. Supreme Court has upheld the legality of a 27-page book of state regulations for South Carolina's abortion providers. The book contains numerous regulations that do not apply to...

HOMICIDE IN PREGNANCY.
April 1, 2001... Homicide is an underreported and overlooked cause of death among pregnant women, a new study says. In a study of the autopsy reports of pregnant women in the District of Columbia, researchers found that homicide was not considered a...

Prenatal Vitamins.
April 1, 2001... A new prenatal vitamin, StuartNatal Plus 3, comes in a formulation that pregnant women can tolerate without increased nausea. Available by prescription, the supplement contains 27 mg of bioavailable iron, vitamin [B.sub.6] to reduce nausea,...

Overactive Bladder Treatment.
April 1, 2001... Detrol-LA (tolterodine tartrate extended-release capsules), indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, is now available in 2-mg and 4-mg extended-release capsules. This once-daily therapy...

Reusable Retractor Ring.
April 1, 2001... The Model 1104 lightweight aluminum reusable retractor ring can be used for a wide variety of vaginal, urologic, and rectal surgical procedures. Constructed of anodized aluminum with surgical-grade stainless steel hinge screws and threads, the...

Health Care Cleanup.
April 1, 2001... The WypAll L30 Economizer wipers, which are used in health care settings for contamination control areas, emergency rooms, as well as general cleanup. With double recrepe fabric technology, the wipers stay strong when wet.

Cancer Care.
April 1, 2001... Tamoxifen and Adriamycin CareSheets are patient information brochures that provide concise information on oncology care. Recently updated, these brochures are just two of more, than 80 sheets that can save health care providers time and money...

Feminine Support Garment.
April 1, 2001... V-Brace is a support garment designed to help relieve symptoms of vulvar varicosities and genital prolapse. It can also minimize perineal edema following abdominal liposuction. V-Brace uses a cross-elastic support system to lift and support the...

Watertight Sheath.
April 1, 2001... The Watertight Shower Sheath is a formfitting, nonslip, reusable, leak-proof sheath designed to enable patients wearing a bandage or cast to keep the affected areas dry while showering. Adult and children's sizes are available for arms, feet,...

Thiazide Helps Preserve Bone Mineral Density.
April 1, 2001... Low-dose thiazide helped preserve bone mineral density in the hip and spine among older patients in a study reported by Andrea Z. LaCroix, Ph.D, of the Group Health Cooperative of Puget Sound, Seattle, and her colleagues. In the 3-year...

Extra Credentialing Worries Experts.
April 15, 2001... The next time you're performing a laparoscopically assisted vaginal hysterectomy, think about this: The same insurance company may be paying another gynecologist almost a third more than you for performing the same procedure. What's the...

Incontinence Risk Highest After Forceps Delivery.
April 15, 2001... Prospective study shows almost tripling of risk, compared with vaginal delivery. LAKE BUENA VISTA, FLA. -- Forceps delivery in primiparous women is significantly more likely than vacuum extraction or spontaneous vaginal delivery to...

Miscarriage Rate in PCOS Falls to 12% With Metformin.
April 15, 2001... Extend use throughout entire pregnancy. ARLINGTON, VA. -- Metformin, a drug that allows women with polycystic ovary syndrome to ovulate normally and conceive, should be continued throughout their pregnancies because it also prevents...

VITAL SIGNS.
April 15, 2001... VITAL SIGNS Average Tax Break for Families Receiving Employer-Based Health Insurance [*] Family Income Under $15,000 $79 $15,000-$19,999 $331 $20,000-$29,999 $559 $30,000-$39,999 $949 $40,000-$49,999 $1,338 ...

DATA WATCH.
April 15, 2001... DATA WATCH Percent of Assisted Reproductive Technology Cycles That Resulted in Pregnancy, 1998 [*] Clinical Pregnancy 30.5% Multiple-Fetus Pregnancy 11.8% Single-Fetus pregnancy 18.7% Ectopic Pregnancy ...

Western Views of Acupuncture.
April 15, 2001... Clan Western science support a 2,000-year-old Eastern medical system whose principles predate any real knowledge of anatomy or physiology, to say nothing of modern diagnostics and therapeutics--or even the germ theory of disease? That question...

LETTERS.
April 15, 2001... Forceps/Incontinence Questions I read the article "Forceps Linked to Stress Urinary Incontinence" with great interest, but Dr. Katherine Van Kessel's study posed many questions Jan. 15, 2001, p. 13). Operative vaginal delivery (OVD)...

Combo Screen 98% Sensitive for Down Syndrome.
April 15, 2001... RENO, NEV. -- The use of ultrasound plus maternal serum screening in women 35 and older is a "very powerful" tool for detecting Down syndrome with an overall sensitivity of 97.6%, Dr. James Egan said at the annual meeting of the Society for...

Preterm Delivery After Reduction.
April 15, 2001... RENO, NEV. -- Cervical length maintained its clinical relevance as a predictor of preterm delivery in twin gestations after multifetal pregnancy reduction, Dr. Andrei Rebarber reported in a poster session at the annual meeting of the Society...

Trial of Labor, Repeat C-Section Equally Hazardous.
April 15, 2001... RENO, NEV. -- Women who chose elective repeat cesarean section and those who failed vaginal birth after cesarean were at similar risk for major operative bladder and bowel injuries in a large retrospective cohort study. These findings are...

Moistened 600-[micro]g Vaginal Tablet of Misoprostol Is Best.
April 15, 2001... Moistened 600-[micro]g vaginal tablets of misoprostol offer the best combination of fast action and limited side effects in women undergoing medical abortion, according to Dr. Ellen R. Wiebe of the department of family practice at the...

Antiretrovirals Work Even With Low Viral Loads.
April 15, 2001... CHICAGO -- Even among women with low viral loads, standard antiretroviral prophylactic therapy provides as much as a 90% reduction in the risk of perinatal HIV transmission, Dr. John P.A. loannidis said at a conference on retroviruses and...

Film Mammography Still Best Breast Cancer Screen.
April 15, 2001... WASHINGTON -- Standard film mammography remains the preferred method for breast cancer screening, according to a report issued by the Institute of Medicine. "Although many of the newer [breast cancer screening] tools offer certain...

Lymphatic Mapping Studied in Cervical, Vulvar Ca.
April 15, 2001... NASHVILLE, TENN. -- Lymphatic mapping, although still investigational in gynecologic oncology, is showing promise in the management of cervical cancer, according to Dr. Charles Levenback, one of the gynecologic pioneers of this technique. ...

Many Endometrial Ca Patients Get Unnecessary Radiation Post Surgery.
April 15, 2001... NASHVILLE, TENN. -- Many women who have endometrial cancer are indiscriminately given pelvic radiation after hysterectomy regardless of whether they need it, according to one gynecologic oncologist. Dr. John Soper of Duke University Medical...

Aspirin Use Linked to 40% Reduction in Ovarian Ca Risk.
April 15, 2001... NASHVILLE, TENN. -- Long-term aspirin use may lower a woman's risk of ovarian cancer by 40%, Dr. Arslan Akhmedkhanov reported during the annual meeting of the Society of Gynecologic Oncologists. But this finding must be confirmed in larger,...

Chronic Wounds Benefit From Vacuum Closures.
April 15, 2001... HOT SPRINGS, VA. -- Patients with chronic wounds from gynecologic surgery may benefit from the use of a vacuum-assisted wound closure system initially developed for managing pressure ulcers. The system consists of a foam dressing made from...

Are Glove Changes Unnecessary During Some Pelvic Surgeries?
April 15, 2001... LAKE BUENA VISTA, FLA. -- Think you need to change gloves during combined-approach abdominovaginal pelvic reconstructive surgery? You may need to think again. Early data from an ongoing study suggest that using the same pair of sterile...

High Removal Rates Seen With Collagen-Impregnated Slings.
April 15, 2001... LAKE BUENA VISTA, FLA. -- Collagen-impregnated slings can cause significant morbidity when used in a suburethral sling operation, often necessitating removal. Twenty-one percent of collagen-impregnated slings placed during a 2-year period...

New Web Site Gives Boost to Electronic Prescribing.
April 15, 2001... The trend toward electronic prescribing is likely to accelerate rapidly with the entry into the field of three major players in pharmacy benefits. Announced in March, the new "Rx-Hub" electronic exchange technology will link physicians to...