OB/GYN Clinical Alert
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Endocrine-disrupting Chemicals and Female Reproductive Disorders
The endocrine-disrupting chemicals diphenyl-dichloroethene and phthalates appear to contribute substantially to the incidence of the most common reproductive disorders in women, endometriosis and fibroids, and lead to total costs of 1.5 billion euros in the European Union.
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Still Highly Effective: LNG IUS 52 mg at 7 Years
Data from a large randomized study conducted by the World Health Organization demonstrate that pregnancy rates do not increase after year five, and support the continued use of the levonorgestrel intrauterine system 52 mg for contraception through seven years.
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Infection Risk with Same-day Testing and IUD Insertion
In this prospective trial of same-day chlamydia/gonorrhea testing with intrauterine device insertion among 1,714 women, the risk of subsequent pelvic infection was extremely low (0.2%) over two years of follow-up.
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Prolonged Second Stage of Labor
A recent randomized clinical trial has shown that using a more liberal threshold for second stage labors in nulliparous patients with and without epidural can result in a major decrease in the need for cesarean sections.
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In Memoriam
On May 4, 2016, Dan Mishell, MD, passed away at home surrounded by family.
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Vulvar Squamous Intraepithelial Lesions
The International Society for the Study of Vulvovaginal Disease adapted Lower Anogenital Squamous Terminology to the specifics of the vulva and released the 2015 terminology. Vulvar Low-grade squamous intraepithelial lesion is benign and includes HPV effect and flat condyloma. Vulvarhigh-grade squamous intraepithelial lesion is the usual HPV-associated type of high-grade vulvar intraepithelial neoplasia and the non-HPV-associated type is labeled differentiated-type vulvar intraepithelial neoplasia.
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Colpocleisis: Body Image, Satisfaction, and Regret at 24 Week
Colpocleisis is an effective surgical treatment for pelvic organ prolapse. Women report high satisfaction and low regret.
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Pessaries in Patients with Short Cervices
The largest multicenter, randomized, controlled trial so far has found no significant benefit of pessaries to prevent preterm birth or to decrease neonatal morbidity in patients with short cervices.
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Early Initiation of Postmenopausal Estrogen Therapy
Women randomized to oral estradiol therapy showed less progression of subclinical atherosclerosis than those who received placebo.
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Accidental Bowel Leakage
Although there has been increased awareness of pelvic floor disorders in recent years, fecal incontinence, defined by the unintentional loss of solid or liquid stool, remains a silent epidemic.