Ob.Gyn. News RSS feed: Current Issue. Ob.Gyn. News is an independent newspaper that provides the practicing obstetrician/gynecologist with timely and relevant news and commentary about clinical developments in the field and about the impact of health care policy on the specialty and the physician's practice. To order this journal, and for more information, go to http://www.imng.com/ http://www.obgynnews.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Ob.Gyn. News0029-7437458August 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.obgynnews.com/article/PIIS0029743710702895/abstract?rss=yesAttempting vaginal birth after cesarean is appropriate for the majority of women who have had a prior cesarean and for many women who have had two prior cesareans, according to new guidelines from the American College of Obstetricians and Gynecologists.New ACOG Guidelines Encourage VBACROBERT FINN10.1016/S0029-7437(10)70289-5Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News11http://www.obgynnews.com/article/PIIS0029743710702901/abstract?rss=yesSAN DIEGO — The scale that weighs risks and benefits tips more favorably for newly menopausal women who begin hormone therapy at age 50-59 years and who use it for 5 years, compared with women who start the therapy in their 60s, according to a systematic review of several studies and position statements.Hormone Tx Risk:Benefit Ratio Favors Use in Newly MenopausalDOUG BRUNK10.1016/S0029-7437(10)70290-1Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News11http://www.obgynnews.com/article/PIIS0029743710702913/abstract?rss=yesPhysicians once again find themselves staring at significantly lower Medicare fees for next year, based yet again on the Medicare Sustainable Growth Rate formula. Under a stop-gap law passed in June, doctors currently are receiving a 2.2% increase in Medicare payments—but only through Nov. 30. In the absence of Congressional action, that increase will be rolled back and the prior pay cut of approximately 21% will go into effect for the month of December.CMS Proposes the 2011 Physician Fee ScheduleNASEEM S. MILLER10.1016/S0029-7437(10)70291-3Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News22http://www.obgynnews.com/article/PIIS0029743710702925/abstract?rss=yesSAN DIEGO — Nearly one-third of women who presented to a major academic medical center for first-trimester screening had inaccurate perceptions of what the process entails, results from a large survey showed.Perceptions of First-Trimester Screening Often InaccurateDOUG BRUNK10.1016/S0029-7437(10)70292-5Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News22http://www.obgynnews.com/article/PIIS0029743710702937/abstract?rss=yes Major Finding: Using less invasive three-dimensional ultrasound for quantitative sensory testing of the bladder appeared to be comparable to retrograde cystometry results in the literature.3-D Sonography Appears Comparable to CystometrySHERRY BOSCHERT10.1016/S0029-7437(10)70293-7Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News33http://www.obgynnews.com/article/PIIS0029743710702949/abstract?rss=yes Major Finding: Women who applied a 1% tenofovir vaginal gel before and after sex had a significant 39% relative cut in HIV infection rate during 30 months of treatment, compared with placebo.Experimental Tenofovir Vaginal Gel Stops HIV InfectionMITCHEL L. ZOLER10.1016/S0029-7437(10)70294-9Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2News44http://www.obgynnews.com/article/PIIS0029743710702950/abstract?rss=yes Major Finding: Among 287 patients who underwent supracervical laparoscopic hysterectomy, only 0.7% were readmitted within 48 hours, and 3.4% within 3 months. Among 241 patients who underwent total laparoscopic hysterectomy, only 0.4% were readmitted within 48 hours, and 4.1% within 3 months.Same-Day Discharge Safe in Lap. HysterectomySHERRY BOSCHERT10.1016/S0029-7437(10)70295-0Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology67http://www.obgynnews.com/article/PIIS0029743710702962/abstract?rss=yesSAN FRANCISCO — A folate-fortified oral contraceptive significantly improved folate levels in red blood cells and plasma compared with a conventional oral contraceptive after 24 weeks, in a preliminary randomized, double-blind trial of 379 healthy U.S. women seeking contraception.Fortified OC Raised Blood Folate LevelsSHERRY BOSCHERT10.1016/S0029-7437(10)70296-2Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology77http://www.obgynnews.com/article/PIIS0029743710702974/abstract?rss=yes Major Finding: One year after surgery for urinary incontinence with retropubic or transobturator midurethral slings, results were similar in objective cure rates (81% vs. 78%) and subjective cure rates (62% vs. 56%), but various adverse events differed significantly between groups.Efficacy of Midurethral Slings Similar After 1 YearSHERRY BOSCHERT10.1016/S0029-7437(10)70297-4Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology99http://www.obgynnews.com/article/PIIS0029743710702986/abstract?rss=yes Major Finding: Irrespective of HPV type, the vaccine reduced the risk for ASCUS by 8%, the risk for LSILs by 14%, and the risk for HSILs by 41%. The risk for CIN2 and CIN3 was 30% and 33% lower than in the control group.HPV Vaccine Reduced Abnormal Pap ResultsSHERRY BOSCHERT10.1016/S0029-7437(10)70298-6Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology1010http://www.obgynnews.com/article/PIIS0029743710702998/abstract?rss=yesScreening young women before the age of 21 doesn't reduce cervical cancer rates, according to an opinion from the American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care.Cervical Cancer Screens Should Begin at Age 21 In Most Young WomenJANUARY W. PAYNE10.1016/S0029-7437(10)70299-8Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology1111http://www.obgynnews.com/article/PIIS0029743710703001/abstract?rss=yesThe Management of Myelomeningocele Study (MOMS) is a randomized, controlled clinical trial that continues to enroll pregnant women between 19 and 25 weeks' gestation. Funded by the National Institute of Child Health and Human Development, the trial will compare the safety and efficacy of prenatal versus postnatal closure of myelomeningocele. Participating MOMS centers are the Children's Hospital of Philadelphia; Vanderbilt University Medical Center in Nashville, Tenn.; and the University of California at San Francisco.The MOMS Spina Bifida Trial Seeks Pregnant Enrollees10.1016/S0029-7437(10)70300-1Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Gynecology1111http://www.obgynnews.com/article/PIIS0029743710703013/abstract?rss=yes DR. POLICAR is a clinical professor of obstetrics and gynecology and reproductive sciences at the University of California, San Francisco, School of Medicine. He is also medical director at the UCSF Family PACT Evaluation and The Bixby Center for Global Reproductive Health, UCSF. He reported having no conflicts of interest.No More Routine Pap Tests for Adolescents … It's About Time!MICHAEL S. POLICAR10.1016/S0029-7437(10)70301-3Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Colleague Commentary1111http://www.obgynnews.com/article/PIIS0029743710703025/abstract?rss=yes DR. PASIC is a consultant for Ethicon Endo-Surgery Inc., Terumo Medical Corporation, and CooperSurgical Inc. He also has a grant from Karl Storz Endoscopy-America Inc. Endometriosis affects about 2.5%-3.3% of reproductive-aged women and is characterized by extrauterine growth of endometrial tissue consisting of endometrial glands and stroma. Its depth ranges from superficial to deep infiltration.Obliterated Cul-de-Sac DissectionRESAD PASIC, CHARLES E. MILLER10.1016/S0029-7437(10)70302-5Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Master Class1617http://www.obgynnews.com/article/PIIS0029743710703037/abstract?rss=yes Major Finding: A 1-minute, 3-question screening tool predicted individuals in the top 20th percentile of pain scores, with a sensitivity of 67% and a specificity of 72%.Screening Tool Predicted Pain After C-SectionMIRIAM E. TUCKER10.1016/S0029-7437(10)70303-7Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Obstetrics1818http://www.obgynnews.com/article/PIIS0029743710703049/abstract?rss=yes DR. COHEN directs the perinatal psychiatry program at Massachusetts General Hospital, Boston, which provides information about pregnancy and mental health at www.womensmentalhealth.org. He said he had no disclosures related to the manufacturers of anticonvulsants.New Data on Valproic AcidLEE COHEN10.1016/S0029-7437(10)70304-9Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Drugs, Pregnancy, and Lactation1818http://www.obgynnews.com/article/PIIS0029743710703050/abstract?rss=yes Major Finding: Before use of the form, 39% of physicians documented estimated fetal weight, compared with 84% after adoption. The rate of documenting the head-to-shoulder delivery interval increased from 15% in the earlier time period to 77% after adoption of the form.Use of Form Improves Dystocia DocumentationSHERRY BOSCHERT10.1016/S0029-7437(10)70305-0Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Obstetrics2020http://www.obgynnews.com/article/PIIS0029743710703062/abstract?rss=yes Major Finding: Measurements of vaginal cervical length using a disposable probe were similar to fetal fibronectin tests in predicting the likelihood of preterm delivery in women with threatened preterm labor.Cervical Length Measurement Predicts Preterm DeliverySHERRY BOSCHERT10.1016/S0029-7437(10)70306-2Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Obstetrics2020http://www.obgynnews.com/article/PIIS0029743710703074/abstract?rss=yesThe use of proton pump inhibitors doesn't appear to raise the risk of hip fracture in postmenopausal women but may raise the risk of spine, forearm, wrist, and total fractures modestly, according to a report.PPIs May Up Risk of Some Fractures, but Not HipMARY ANN MOON10.1016/S0029-7437(10)70307-4Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Clinical Rounds2929http://www.obgynnews.com/article/PIIS0029743710703086/abstract?rss=yesTucked within the Affordable Care Act is a provision aimed at reining in health care spending. The provision creates the Independent Payment Advisory Board (IPAB), a panel of 15 experts charged with slowing the growth of Medicare and private health care spending, as well as improving health care quality. By law, the board's recommendations will take effect unless Congress enacts its own cost-cutting plan that achieves the same level of savings. The board isn't expected to submit its first recommendations to Congress until 2014, but already the medical community is crying foul.Payment Advisory Board Is Not a Physician Favorite10.1016/S0029-7437(10)70308-6Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Implementing Health Reform3030http://www.obgynnews.com/article/PIIS0029743710703098/abstract?rss=yesDuring the first half of 2010, lawmakers had introduced measures in 18 states to limit insurance coverage of abortion, according to an analysis by the Guttmacher Institute. In those states, five new laws were enacted. The laws either restrict abortion coverage in private health insurance policies written in a state, limit coverage in policies to be included in state-based health insurance exchanges created under health reform, or restrict coverage in policies offered to state employees. Additionally, a separate list of 18 states saw proposals to make ultrasounds part of abortion procedures. Some measures would require physicians to offer women ultrasounds before abortions, others would require that any ultrasound images made be shown or made available to women seeking abortions, and others would mandate an ultrasound before any abortion. So far this year, new abortion-ultrasound laws have been enacted in six states, the institute reported.Policy & Practice: Want more health reform news? Subscribe to our podcast – search ‘Policy & Practice’ in the iTunes storeMary Ellen Schneider10.1016/S0029-7437(10)70309-8Ob.Gyn. News 45, 8 (2010)2010-08-01Ob.Gyn. News2010-08-01458S0029-7437(10)X7008-2Practice Trends3030