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Volume 4, No 3/4 - 2011

Volume 4, No 3/4 - 2011

Table of Contents

Prenatal Diagnosis of Unilateral Pulmonary Dysplasia
Pulmonary hypoplasia is a rare congenital disorder; most cases occur in association with other congenital abnormalities, including congenital diaphragmatic hernia, oligohydramnios, and/or skeletal deformities. The authors report a case of unilateral pulmonary hypoplasia diagnosed prenatally and confirmed at autopsy. [Rev Obstet Gynecol. 2011;4(3/4):99-102 doi: 10.3909/riog0158] © 2011 MedReviews®, LLC
Vascular Network Modeling Reveals Significant Differences in Vascular Morphology in Growth-Restricted Placentas
Aim: To construct and examine models of the vascular networks using the technique of vascular corrosion casting in placentas collected from normal pregnancies and from pregnancies complicated by fetal growth restriction (FGR). Methods: Twenty placentas were collected from normal term pregnancies (Group NP) and an equal number from pregnancies with idiopathic term FGR (Group FGR) and placental vascular network models constructed by perfusing an acrylic-based solution separately into the umbilical vein and arteries. Placental blood volumes and blood vessel characteristics (number of branches, diameter, and morphology) were then examined and compared. Results: In placentas from Group NP, the veins branched five to seven times with a peripheral artery-to-vein ratio ranging from 1:2 to 1:3. In placentas from Group FGR, the veins branched only four to five times with an artery-tovein ratio of 1:1 to 2:1 and increased evidence of nodularity and pitting of the vessel walls. The two groups showed significant differences in placental blood volume and in the mean diameters of umbilical veins and arteries. In Group FGR, significant positive correlations could be found between birth weight and placental volume, venous diameters, and select arterial diameters. Conclusion: Vascular network models can be constructed from term placentas. Such modeling may provide novel insights and improve our understanding of the placental vascular system in both health and disease. [Rev Obstet Gynecol. 2011;4(3/4):103-108 doi: 10.3909/riog0174] © 2011 MedReviews®, LLC
An Evidence-Based Approach to Determining Route of Delivery for Twin Gestations Management Update
Approximately 50% of twin pregnancies deliver preterm, and major complications associated with prematurity include respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and sepsis. These complications drive the perinatal mortality rate of twins to seven times that of singletons. Although delivery may take place due to iatrogenic or spontaneous etiologies—no matter what the indication—optimizing the route of delivery for twins is an important component of care that must be thoughtfully considered. [Rev Obstet Gynecol. 2011;4(3/4):109-116 doi: 10.3909/riog0168] © 2011 MedReviews®, LLC
Laparoscopic Surgical Staging of Early Ovarian Cancer Management Update
Since its advent in the early 1990s, laparoscopic surgical staging for early ovarian cancer has been explored as an option with the potential to offer women equivalent cancer control and survival as provided by laparotomy but with the clear benefits of minimally invasive surgery. A limited but expanding body of literature suggests aggressive surgical staging can be performed with equivalent tissue assessment compared with laparotomy. Given the lack of randomized, controlled trials, the risks and benefits of such a procedure remain ambiguous. This review summarizes the current body of literature regarding the role of laparoscopy in upfront surgical staging of ovarian cancer. This review presents the history, rationale, and established benefits and risks of utilizing this approach in women who present with malignancy that appears confined to the ovary. Although retrospective data confirm the feasibility, safety, and efficacy of laparoscopic staging of early ovarian cancer, more prospective data will be required to confirm equivalent survival in a patient population that has the potential to be cured. [Rev Obstet Gynecol. 2011;4(3/4):117-122 doi: 10.3909/riog0166] © 2011 MedReviews®, LLC
Side Docking: An Alternative Docking Method for Gynecologic Robotic Surgery
The authors propose an alternative method of robotic docking for gynecologic surgery. In this side-docking method, the robot is docked at an approximately 45° angle to the lower torso, aligned with the outer border of either the left or right stirrup, depending on the surgeon's preference for left or right side-docking. The remainder of the patient and trocar setup is similar to traditional docking. The authors have had an excellent experience with this method as there does not seem to be an increased risk of robotic arm collision as long as the surgeon respects the basic principle of maintaining at least an 8- to 10-cm distance between each of the instrument ports. The significantly improved access to the vagina and perineum may facilitate robotically assisted gynecologic surgical procedures and reduce assistant fatigue and the potential for injury due to a collision with the robotic arms. [Rev Obstet Gynecol. 2011;4(3/4):123-125 doi: 10.3909/riog0170] © 2011 MedReviews®, LLC
Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and L-Methylfolate
In this Key Opinion Leader interview, co-Medical Editor of Reviews in Obstetrics & Gynecology James A. Greenberg speaks with nutritionist Stacey J. Bell about prenatal vitamins. [Rev Obstet Gynecol. 2011;4(3/4):126-127 doi: 10.3909/riog0165] © 2011 MedReviews®, LLC
News and Views From the Literature Miscarriage and Preterm Birth
[Rev Obstet Gynecol. 2011;4(3/4):128-129 doi 10.3909/riog0169b] © 2011 MedReviews®, LLC
News and Views From the Literature Hysterectomy
[Rev Obstet Gynecol. 2011;4(3/4):128 doi 10.3909/riog0169a] © 2011 MedReviews®, LLC
News and Views From the Literature Osteoporosis
[Rev Obstet Gynecol. 2011;4(3/4):129 doi 10.3909/riog0169c] © 2011 MedReviews®, LLC
News and Views From the Literature Cancer
[Rev Obstet Gynecol. 2011;4(3/4):129-130 doi 10.3909/riog0169d] © 2011 MedReviews®, LLC
News and Views From the Literature Birth Control
[Rev Obstet Gynecol. 2011;4(3/4):130 doi 10.3909/riog0169e] © 2011 MedReviews®, LLC
News and Views From the Literature Miscellaneous
[Rev Obstet Gynecol. 2011;4(3/4):130-131 doi 10.3909/riog0169f] © 2011 MedReviews®, LLC