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Volume 6, No 1 - 2013

Volume 6, No 1 - 2013

Table of Contents

Prenatal Screening for Fragile X: Carriers, Controversies, and Counseling Diagnostic Update
In addition to causing developmental disability in future offspring, fragile X carrier status has important reproductive and mental health implications for the individual being tested. Accordingly, prenatal carrier screening and diagnosis using DNA-based molecular methods has become crucial in early detection, intervention, and family planning. Although the list of known genetic disorders is growing daily, controversy remains over who should be tested for fragile X. FMR1 gene mutations can result in inherited intellectual disability, infertility, and neurodegeneration syndromes that are encountered by clinicians in a variety of settings. Patients and clinicians are still largely unfamiliar with this disorder, its complicated inheritance, and its heterogeneous phenotype. Debate continues over who should be offered prenatal carrier screening. As more disease screening is offered, pretest counseling will become only more complex and clinicians will further struggle to balance the needs of the individual and allocation of public health resources. [ Rev Obstet Gynecol. 2013;6(1):e1-e7 doi: 10.3909/riog0203] © 2013 MedReviews®, LLC
Safety Considerations for Office-Based Obstetric and Gynecologic Procedures Treatment Update
The migration of gynecologic procedures to office-based settings provides numerous advantages for patients and providers alike, including reduced patient expenses, improved scheduling convenience, favorable provider reimbursement, and enhanced continuity of care and patient satisfaction. With rising health care costs—a major concern in health care—procedures will continue to shift to practice environments that optimize care, quality, value, and efficiency. It is imperative that gynecologic offices ensure that performance and quality variations are minimized across different sites of care; physicians should strive to provide care to patients that optimizes safety and is at least equivalent to that delivered at traditional sites. The gynecologic community should nonetheless heed the Institute of Medicine’s recommendations and embrace continuous quality improvement. By exercising leadership, office-based gynecologists can forge a culture of competency, teamwork, communication, and performance measurement. [Rev Obstet Gynecol. 2013;6(1):e8-e14 doi: 10.3909/riog0211] © 2013 MedReviews®, LLC
Fetal and Neonatal Alloimmune Thrombocytopenia Diagnosis and Management Update
Fetomaternal alloimmune thrombocytopenia (FMAIT) is a relatively uncommon disease, but is the leading cause of severe thrombocytopenia in the newborn. It can cause severe complications and long-term disabilities. The main objective of screening is to reduce both the morbidity and mortality associated with FMAIT, primarily by preventing intracranial hemorrhage. However, controversy surrounds both pre- and antenatal management. This article discusses pathogenesis, screening, diagnosis, and both pre- and neonatal management of FMAIT. [Rev Obstet Gynecol. 2013;6(1):e15-e21 doi: 10.3909/riog0202] © 2013 MedReviews®, LLC
Sex Trafficking of Women and Girls Women's Health in the Developing World
Sex trafficking involves some form of forced or coerced sexual exploitation that is not limited to prostitution, and has become a significant and growing problem in both the United States and the larger global community. The costs to society include the degradation of human and women’s rights, poor public health, disrupted communities, and diminished social development. Victims of sex trafficking acquire adverse physical and psychological health conditions and social disadvantages. Thus, sex trafficking is a critical health issue with broader social implications that requires both medical and legal attention. Healthcare professionals can work to improve the screening, identification, and assistance of victims of sex trafficking in a clinical setting and help these women and girls access legal and social services. [Rev Obstet Gynecol. 2013;6(1):e22-e27 doi: 10.3909/riog0214] © 2013 MedReviews®, LLC
Application of Robotics in Adnexal Surgery The Operator's Manual
This review discusses in detail robotic tubal reanastomosis as one of the classic reproductive surgery procedures. Other applications of robotics in adnexal surgery are also reviewed, including adult and pediatric adnexectomy, resection of endometriosis, benign ovarian mass resection, early ovarian cancer resection and staging, ovarian transposition, and treatment of ovarian remnant syndrome and ovarian vein syndrome. [Rev Obstet Gynecol. 2013;6(1):e28-e34 doi: 10.3909/riog0199] © 2013 MedReviews®, LLC
News and Views From the Literature
[Rev Obstet Gynecol. 2013;6(1):e35-e38 doi 10.3909/riog0212] © 2013 MedReviews®, LLC
Weck EFx™ Endo Fascial Closure System
[Rev Obstet Gynecol. 2013;6(1):e39-e40 doi: 10.3909/riog0213a] © 2013 MedReviews®, LLC
VersaPort™ Bladeless Optical 5-mm trocar
[Rev Obstet Gynecol. 2013;6(1):e40-e41 doi: 10.3909/riog0213b] © 2013 MedReviews®, LLC
McCarus-Volker FORNISEE™ System
[Rev Obstet Gynecol. 2013;6(1):e41-e42 doi: 10.3909/riog0213c] © 2013 MedReviews®, LLC