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Volume 1, No 3 - Summer 2008

Volume 1, No 3 - Summer 2008

Table of Contents

Promoting Evidence-Based Medicine Editorial
[Rev Obstet Gynecol. 2008;1(3):93-94]
Fetiform Teratoma (Homunculus) Images in Ob-Gyn
[Rev Obstet Gynecol. 2008;1(3):95-96]
Surgical Management and Postoperative Treatment of Endometrial Carcinoma Treatment Update
Endometrial carcinoma affects over 40,000 American women annually, making it the most common gynecologic malignancy. Over 80% of disease is diagnosed in the early stages, resulting in a generally favorable prognosis for most patients. However, discrepancies still exist with regard to primary surgical management and postoperative adjuvant therapies directed at reducing recurrence rates and improving survival. In this review, we outline the surgical management of newly diagnosed disease and review the risk factors that guide clinicians in the recommendation for postoperative adjuvant therapy. [Rev Obstet Gynecol. 2008;1(3):97-105]
The Utility of Fetal Fibronectin in the Prediction and Prevention of Spontaneous Preterm Birth Diagnostic Update
Spontaneous preterm birth remains a significant problem in the United States despite intense research to decrease its prevalence. Strategies have been limited by inability to identify patients at risk for preterm birth, as the majority of patients do not have historical risk factors. The development of an assay to detect vaginal fetal fibronectin, along with the use of transvaginal ultrasonography to determine cervical length, has greatly increased our ability to identify those patients at highest risk. This article reviews the most significant studies on this topic, providing a context for suggested management algorithms for both symptomatic and asymptomatic patients at risk for spontaneous preterm birth. [Rev Obstet Gynecol. 2008;1(3):106-112]
Hysteroscopic Sterilization: History and Current Methods Treatment Update
For many practicing obstetrician-gynecologists, tubal ligation was the gold standard by which female sterilization techniques were measured. Yet gynecologic surgeons have simultaneously sought to occlude the fallopian tubes transcervically to avoid discomfort and complications associated with transabdominal approaches. In this review, the history of transcervical sterilization is discussed. Past, current, and upcoming techniques are reviewed. This article focuses on interval sterilization techniques, thus removing post–vaginal and post–cesarean delivery tubal ligations from the discussion. [Rev Obstet Gynecol. 2008;1(3):113-121]
Human Papillomavirus: The Usefulness of Risk Factors in Determining Who Should Get Vaccinated Update in Prevention
Vaccination against human papillomavirus (HPV) promises to dramatically decrease the incidence of HPV-related diseases, including cervical cancer. Although this vaccine is recommended by the Advisory Committee on Immunization Practices and The American College of Obstetricians and Gynecologists for all age-eligible women, challenges related to the vaccine’s high cost and the difficulty in reaching some patients for vaccination may make implementation of this recommendation difficult. As an alternative strategy, some may consider targeting HPV vaccines to specific patients based on their risk for HPV infection or HPV-related disease. This article reviews what is known about risk factors for HPV, and discusses why using risk factors as the basis for targeting HPV vaccination is unlikely to be a viable vaccination strategy. [Rev Obstet Gynecol. 2008;1(3):122-128]
Gestational Diabetes Mellitus Management Review
Gestational diabetes mellitus (GDM) affects between 2% and 5% of pregnant women. Data show that increasing levels of plasma glucose are associated with birth weight above the 90th percentile, cord blood serum C-peptide level above the 90th percentile, and, to a lesser degree, primary cesarean deliveries and neonatal hypoglycemia. Risk factors for GDM include history of macrosomia, strong family history of diabetes, and obesity. Screening protocol for GDM is controversial; some recommend a universal approach, whereas others exempt low-risk patients. The cornerstone of management is glycemic control. Quality nutritional intake is essential. Patients with GDM who cannot control their glucose levels with diet alone will require insulin. There is no consensus as to when to initiate insulin therapy, but more conservative guidelines are in place to help minimize macrosomia and its associated risks to the infant. It is generally recommended that pregnancies complicated by GDM do not go beyond term. [Rev Obstet Gynecol. 2008;1(3):129-134]
Female Genital Cutting: A Persisting Practice Women's Health in the Developing World
More than 130 million women worldwide have undergone female genital cutting (FGC). FGC occurs in parts of Africa and Asia, in societies with various cultures and religions. Reasons for the continuing practice of FGC include rite of passage, preserving chastity, ensuring marriageability, religion, hygiene, improving fertility, and enhancing sexual pleasure for men. The World Health Organization has classified FGC into 4 types depending on the extent of tissue removed. Immediate complications include hemorrhage, infection, sepsis, and death. Long-term complications include pain, scarring, urinary issues, and poor obstetric and neonatal outcomes. Efforts are being made nationally and internationally to eradicate this practice. [Rev Obstet Gynecol. 2008;1(3):135-139]
AROM-Cot®, Utah Medical Products, Inc. Summer 2008 Product Reviews
[Rev Obstet Gynecol. 2008;1(3):140-141]
INSORB®|25 subcuticular skin stapler, Incisive Surgical, Inc. Summer 2008 Product Reviews
[Rev Obstet Gynecol. 2008;1(3):141-142]
Alexis® O™ C-Section Retractor, Applied Medical Resources Corporation Summer 2008 Product Reviews
[Rev Obstet Gynecol. 2008;1(3):142-143]
Labor News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):144-146]
Breast Cancer News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):146]
Preeclampsia News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):146-147]
Laparoscopy News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):147]
Genetics News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):148]
Miscellaneous News and Views from the Literature
[Rev Obstet Gynecol. 2008;1(3):148-149]