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Volume 4, No 2 - 2011

Volume 4, No 2 - 2011

Table of Contents

FDA Approval for Use of Medications in Pregnancy: An Uphill Battle
[Rev Obstet Gynecol. 2011;4(2):39-41 doi: 10.3909/riog0162] © 2011 MedReviewsÆ, LLC
Comment on "Management of First Trimester Pregnancy Loss Can Be Safely Moved Into the Office"
[Rev Obstet Gynecol. 2011;4(2):42-44 doi: 10.3909/riog0154] © 2011 MedReviewsÆ, LLC
The Diagnosis of Polycystic Ovary Syndrome in Adolescents Diagnosis Review
Polycystic ovary syndrome (PCOS) is recognized as the most common endocrinopathy in reproductive-aged women. The symptoms of PCOS vary with age, race, weight, and medications, adding to the challenges of accurate diagnosis. Adolescent patients pose particular diagnostic problems because characteristics of normal puberty often overlap with signs and symptoms of PCOS. This article reviews the diagnosis of PCOS in adolescents. [Rev Obstet Gynecol. 2011;4(2):45-51 doi: 10.3909/riog0151] © 2011 MedReviewsÆ, LLC
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention Management Update
Folate (vitamin B9) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities). This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of L-methylfolate for the prevention of pregnancy-related complications other than neural tube defects. [Rev Obstet Gynecol. 2011;4(2):52-59 doi: 10.3909/riog0157] © 2011 MedReviewsÆ, LLC
Progesterone Supplementation and the Prevention of Preterm Birth Management Update
<p>Preterm birth is currently the most important problem in maternal-child health in the United States and possibly throughout the world. It complicates one in eight US deliveries, and accounts for over 85% of all perinatal morbidity and mortality. Although survival of preterm infants has increased steadily over the past four decadesódue in large part to the use of antenatal corticosteroids, improvements in neonatal resuscitation, and the introduction of neonatal intensive care unitsóefforts to prevent preterm birth have been largely unsuccessful. On February 3, 2011, the US Food and Drug Administration (FDA) approved the use of progesterone supplementation (hydroxyprogesterone caproate) during pregnancy to reduce the risk of recurrent preterm birth in women with a history of at least one prior spontaneous preterm delivery. This is the first time that the FDA has approved a medication for the prevention of preterm birth, and represents the first approval of a drug specifically for use in pregnancy in almost 15 years. This article reviews the evidence behind the use of progesterone for the prevention of preterm birth, and provides guidelines for the use of progesterone supplementation in clinical practice. A number of areas of ongoing controversy are addressed, including the optimal formulation and route of administration, the safety of progesterone supplementation in pregnancy, and its proposed mode of action. [Rev Obstet Gynecol. 2011;4(2):60-72 doi: 10.3909/riog0163] © 2011 MedReviewsÆ, LLC</p>
Hysteroscopic Morcellation for Treating Intrauterine Pathology Treatment Update
Changes in hysteroscopic capabilities have been preceded by technological advances that have enabled them. Modern operative hysteroscopes rely on a variety of different-sized optical, inflow, outflow, and working channels to enable clear visualization of the endometrial cavity as well as the surgical removal of intracavitary lesions such as polyps and myomas. This review examines the relative merits of various hysteroscopic treatment options with a focus on the most recent operative hysteroscopic technique, hysteroscopic morcellation, and how this new technology fits into the armamentarium of the gynecologist. [Rev Obstet Gynecol. 2011;4(2):73-80 doi: 10.3909/riog0159] © 2011 MedReviewsÆ, LLC
Prevention of Vulvovaginal Sequelae in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Management Update
<p>Vulvovaginal sequelae of Stevens-Johnson syndrome and toxic epidermal necrolysis are well documented in the literature, although little consensus exists about effective prevention strategies. This review summarizes the available literature and offers expert opinion about how to minimize long-term vaginal impairment from these rare but often devastating illnesses. [Rev Obstet Gynecol. 2011;4(2):81-85 doi: 10.3909/riog0152] © 2011 MedReviewsÆ, LLC</p>
The Use of Blood in Obstetrics and Gynecology in the Developing World Women's Health in the Developing World
Access to safe blood is critical in comprehensive emergency obstetric care and for reducing maternal mortality. Many countries have inadequate blood supplies, and this disproportionately affects women and children in need of life-saving blood transfusions. Although preventative measures aimed at reducing postpartum hemorrhage by treating underlying anemia and infectious diseases are critical, they are insufficient for obstetric hemorrhage. In the developing world, efforts should focus on alternative means of providing safe blood in cases of hemorrhage, with particular focus on rapid testing, donation of warm whole blood, and autologous blood transfusion. [Rev Obstet Gynecol. 2011;4(2):86-91 doi: 10.3909/riog0160] © 2011 MedReviewsÆ, LLC
Microbiology News and Views From the Literature
[Rev Obstet Gynecol. 2011;4(2):92-93 doi 10.3909/riog0155a] © 2011 MedReviewsÆ, LLC
Delivery News and Views From the Literature
[Rev Obstet Gynecol. 2011;4(2):93-94 doi 10.3909/riog0155b] © 2011 MedReviewsÆ, LLC
Pregnancy Management News and Views From the Literature
[Rev Obstet Gynecol. 2011;4(2):95 doi 10.3909/riog0155e] © 2011 MedReviewsÆ, LLC
Miscellaneous News and Views From the Literature
[Rev Obstet Gynecol. 2011;4(2):95-96 doi 10.3909/riog0155f] © 2011 MedReviewsÆ, LLC
Summer 2011 Product Review Koh-Efficient&trade;
[Rev Obstet Gynecol. 2011;4(2):97-98 doi: 10.3909/riog0161] © 2011 MedReviewsÆ, LLC