OB/GYN Clinical Alert – July 1, 2004

July 1, 2004

• Perinatal Mortality and Assisted Reproductive Technologies: A Meta-Analysis

  Some European studies indicate that 2-3% of pregnancies occur through assisted reproductive techniques (ART) while US statistics suggest that about 0.9% of all pregnancies result from ART. Although there has been much written about the profusion of multiple gestations secondary to ART, little attention has been directed toward singleton pregnancies.

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• Endometrial Biopsy Using Intrauterine Lidocaine Plus Naproxen Sodium

  Endometrial biopsies were performed using intrauterine lidocaine only, naproxen only, both, or neither. Intrauterine lidocaine significantly reduced the pain when used in conjunction with oral naproxen sodium.

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• Ovarian Carcinoma Treated with High-Dose Chemotherapy and Autologous Stem Cell Transplantation

  Patients in clinical remission are most likely to benefit from autologous transplantation, with the exception of patients with clear cell histology.

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• Ultrasonographic Occiput Position in Early Labor in the Prediction of Cesarean Section

  An enlightening article recently appeared in the British Journal of Obstetrics and Gynaecology by Akmal and colleagues. They performed sonograms in 601 women in active labor to assess the position of the fetal head as it entered the maternal pelvis. Using the simple end point of Cesarean section, they then folded in a variety of other variables, such as maternal age, parity, maternal height, ethnicity, fetal gender, gestational age, and whether labor was spontaneous or induced.

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• Laparoscopic Uterine Vessel Occlusion vs Uterine Artery Embolization for Fibroids

  In a comparison with uterine artery embolization, laparoscopic occlusion of uterine vessels for the treatment of symptomatic uterine fibroids had less associated postoperative pain and comparable effects on fibroid-associated symptoms.

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• Genomic Imprinting in Disruptive Spermatogensis

  Oligoasthenospermia (male factor infertility) is associated with abnormal genomic imprinting of the sperm, a feature that may predispose to abnormal embryogenesis, including a risk of rare developmental abnormalities and cancer in adulthood, if fertilization occurs, as it may because of the availability of assisted reproductive techniques.

  Read more about Genomic Imprinting in Disruptive Spermatogensis - OB/GYN Clinical Alert – July 1, 2004

• Pharmacology Watch: Britain to Allow Over-the-Counter Sales of Zocor

  Recombinant Erythropoietin Products May Stimulate Tumor Growth; Rosuvastatin: Markets Most Potent Statin; FDA Actions.

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• Clinical Briefs in Primary Care supplement

  Read more about Clinical Briefs in Primary Care supplement - OB/GYN Clinical Alert – July 1, 2004