Skip to main content
Volume 3, No 3 - Summer 2010

Volume 3, No 3 - Summer 2010

Table of Contents

The Use of Barbed Sutures in Obstetrics and Gynecology Technology Review
Despite the multitude of different procedures performed with a host of different wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations. In recent years, a new class of suture material—barbed suture—has been introduced into the surgeon’s armamentarium. This review focuses on barbed suture to better understand the role of this newer material in obstetrics and gynecology.[Rev Obstet Gynecol. 2010;3(3):82-91 doi: 10.3909/riog0124]
Type 1 Diabetes Mellitus and Pregnancy Management Review
Diabetes complicates up to 10% of all pregnancies in the United States. Of these, 0.2% to 0.5% are patients with type 1 diabetes mellitus (T1DM). Pregnancies affected by T1DM are at increased risk for preterm delivery, preeclampsia, macrosomia, shoulder dystocia, intrauterine fetal demise, fetal growth restriction, cardiac and renal malformations, in addition to rare neural conditions such as sacral agenesis. Intensive glycemic control and preconception planning have been shown to decrease the rate of fetal demise and malformations seen in pregnancies complicated by T1DM. Recent advances in insulin formulations and delivery methods have increased the number of options available to the obstetric team. Insulin regimens should be tailored to each individual patient to maximize compliance and ensure proper glycemic control. Intensive preconception counseling with frequent follow-up visits emphasizing tight glucose control is recommended for adequate management.[Rev Obstet Gynecol. 2010;3(3):92-100 doi: 10.3909/riog0114]|
A Review of Clinical Data for Currently Approved Hysteroscopic Sterilization Procedures Technique Review
Two hysteroscopic permanent sterilization procedures are approved for use in the United States: Essure® Permanent Birth Control System (Conceptus Incorporated, Mountain View, CA) and Adiana® Permanent Contraception (Hologic, Inc., Bedford, MA). This review compares the clinical trial data for these procedures. A notable difference is the resultant clinical pregnancy risk. The clinical trials for the Essure procedure have reported no pregnancies in 643 relying women in the 9 years since initiation of the studies. The clinical trial for the Adiana procedure has reported 12 pregnancies in 570 relying women in nearly 5 years of collected data. Other clinical outcome parameters concerning Essure and Adiana are examined in this review.[Rev Obstet. Gynecol. 2010;3(3):101-110 doi: 10.3909/riog0128]
Surgical Debulking of Ovarian Cancer: What Difference Does It Make? Treatment Update
Three-quarters of women who are newly diagnosed with invasive epithelial ovarian cancer present with stage III to IV disease. Recent data on the efficacy of neoadjuvant chemotherapy have served to challenge the conventional dogma that the preferred initial treatment is surgical debulking. Most of these patients will achieve remission regardless of initial treatment, but|80% to 90% of patients will ultimately relapse. The timing and clinical benefit of a second debulking operation is even more contentious. This article focuses on the recent debate of when or if patients with ovarian cancer should undergo aggressive surgical resection of bulky disease.[Rev Obstet Gynecol. 2010;3(3):111-117 doi: 10.3909/riog0111]
The KRAS-Variant Genetic Test As a Marker of Increased Risk of Ovarian Cancer Diagnostic Update
Ovarian cancer (OC) is the fifth leading cause of cancer death in women. High mortality rates are due to vague symptoms of early disease, leading to diagnosis at a late stage. Approximately 10% of OCs are considered hereditary. The KRAS-variant is an inherited, germline variant that has been demonstrated to serve as a genetic marker of increased risk of OC. The KRAS-variant is easily tested in a blood or saliva sample, and has been shown to be at a high prevalence in OC patients. This test could serve as an answer to patients with a family history of ovarian and breast cancer without a previously identifiable genetic mutation.[Rev Obstet Gynecol. 2010;3(3):118-121 doi: 10.3909/riog0130]
Cancer Care Inequity for Women in Resource-Poor Countries Women’s Health in the Developing World
Cervical, endometrial, and breast cancers are paradigms for global health disparity. The paucity of well-designed and -used cancer registries obstructs accurate assessment and planning for international agency resource allocation. Increasing rates of both smoking and obesity in resource-poor nations will lead to increases in the incidence of cancers in developing nations. Women residing in the developing world continue to present in later stages of disease and have fewer options for treatment than those in developed countries.|[Rev Obstet Gynecol. 2010;3(3):122-132 doi: 10.3909/riog0107]
Single-Port Gynecologic Surgery The Operator’s Manual
Innovation in gynecologic surgery is constantly evolving toward making procedures less invasive. The benefits of laparoscopic surgery over conventional abdominal surgery have been well demonstrated in terms of reducing postoperative pain and decreasing postoperative morbidity, hospital stay duration, and postoperative recovery time. The minimally invasive single-port laparoscopic surgery is another innovation that may further improve gynecologic surgery outcomes. This article reviews the history and types of single-port procedures available, as well as the advantages and challenges that physicians face regarding the adoption of these procedures into general practice.[Rev Obset Gynecol. 2010;3(3):133-139 doi: 10.3909/riog0121]
Delivery Reviewing the Literature
Multiple Sclerosis Risk Reviewing the Literature
Misoprostol Reviewing the Literature
Cesarean Delivery Reviewing the Literature
Miscellaneous Reviewing the Literature