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 © 2012 Elsevier Inc. All rights reserved. Ob.Gyn. News0029-7437471January 2012 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.obgynnews.com/article/PIIS0029743712700010/abstract?rss=yesBALTIMORE – In utero exposure to valproate appears to increase the risk of significant adverse effects on fetal brain development that persist into childhood. In two separate studies, children whose mothers took valproate during pregnancy had a higher risk for lower IQ and other cognitive deficiencies, as well as autism and other disorders along the autistic spectrum. “All women with epilepsy of childbearing potential should be informed of the risks. I feel that valproate should not be a first choice antiepileptic drug in women of childbearing potential,” Dr. Kimford J. Meador, director of the Emory Epilepsy Center and professor of neurology at Emory University, Atlanta, said in an interview.Maternal Valproate Tied To Lower IQ, AutismMIRIAM E. TUCKER10.1016/S0029-7437(12)70001-0Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News11http://www.obgynnews.com/article/PIIS0029743712700022/abstract?rss=yes Major Finding: The age-standardized mean femoral neck bone density was significantly lower in women with oophorectomy before age 45 than in those with intact ovaries: 0.711 compared with 0.743 g/m2 (P = .017). In a multivariate logistic regression analysis, women with early oophorectomy had an adjusted 1.78-fold increased likelihood of having osteoporosis, compared with women with intact ovaries.Early Bilateral Oophorectomy Is Linked to Osteoporosis, ArthritisBRUCE JANCIN10.1016/S0029-7437(12)70002-2Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News11http://www.obgynnews.com/article/PIIS0029743712700034/abstract?rss=yesADELPHI, MD. – The benefits of Yasmin and other drospirenone-containing oral contraceptives outweigh their risks, but more information about the agents' risk-benefit profile needs to be added to the labels, according to the majority of a Food and Drug Administration advisory panel.FDA Panel Reviews VTE Risk for Some OCsELIZABETH MECHCATIE10.1016/S0029-7437(12)70003-4Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News22http://www.obgynnews.com/article/PIIS0029743712700046/abstract?rss=yesDespite the Food and Drug Administration's finding that Plan B One-Step, an emergency contraceptive, is safe, effective, and should be approved for nonprescription use by all women of childbearing potential, the drug remains unavailable without a prescription for those under 17 years old.Feds Pull Plug on NonRx Plan B for Young TeensHEIDI SPLETE10.1016/S0029-7437(12)70004-6Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News33http://www.obgynnews.com/article/PIIS0029743712700058/abstract?rss=yesSILVER SPRING, MD.–The iPLEDGE risk management program for isotretinoin has reduced fetal exposure to the teratogen but still needs to be tweaked to reduce burdens on physicians and improve patient access, advisers to the Food and Drug Administration said.FDA Advisers: iPLEDGE Needs More Tweaking: Currently, there are about 20,000 calls a month to iPLEDGE call centers, a decline in volume.ALICIA AULT10.1016/S0029-7437(12)70005-8Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News44http://www.obgynnews.com/article/PIIS002974371270006X/abstract?rss=yesA nationwide texting program for new moms continues to grow in its second year, and an initial evaluation of the enrollees' feedback is showing promising results. The public-private partnership called text4baby sends free educational text messages to expecting and new moms. The program now has over 260,000 enrollees, up from more than 150,000 in April.National Texting Program for New Moms Continues GrowthNASEEM S. MILLER10.1016/S0029-7437(12)70006-XOb.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0News45http://www.obgynnews.com/article/PIIS0029743712700071/abstract?rss=yes Major Finding: Mean operative time was 40 minutes, mean estimated blood loss was 63 mL, and 96% of women were discharged the same day.Outpatient Hysterectomy Results Prove PositiveDAMIAN McNAMARA10.1016/S0029-7437(12)70007-1Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Obstetrics66http://www.obgynnews.com/article/PIIS0029743712700083/abstract?rss=yes Major Finding: Sixty-four of 65 patients saw hCG values return to normal without chemotherapy, and the remaining patient, who had chronic renal failure, remained healthy despite having elevated hCG. Among the 10 patients who received chemotherapy, 6 had complete responses, and 4 had partial or no responses but remained well, even though hCG concentrations in 2 patients continued to be elevated. There was no significant difference in time to normalization between the groups, and no deaths had occurred in either group after a median 2 years' follow-up.No Chemo if hCG Falls After Molar PregnancyJENNIE SMITH10.1016/S0029-7437(12)70008-3Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Obstetrics77http://www.obgynnews.com/article/PIIS0029743712700095/abstract?rss=yesIn a previous issue of Ob. Gyn. News (“Purity of Compounded 17P Is Questioned,” December 2011, p. 6), we mischaracterized Makena (17-alpha hydroxyprogesterone caproate [17P]). It is a Food and Drug Administration–approved prescription drug used to reduce the risk of certain preterm births in patients who had already experienced a prior preterm birth.Correction10.1016/S0029-7437(12)70009-5Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Erratum77http://www.obgynnews.com/article/PIIS0029743712700101/abstract?rss=yesPregnant women taking selective serotonin reuptake inhibitors for depression may continue to do so, despite a 2006 warning that the drugs may predispose infants to persistent pulmonary hypertension, the Food and Drug Administration has announced.FDA: Appropriate SSRI Use OK in PregnancyMICHELE G. SULLIVAN10.1016/S0029-7437(12)70010-1Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Obstetrics88http://www.obgynnews.com/article/PIIS0029743712700113/abstract?rss=yes Major Finding: Compared with normal weight women undergoing IVF, a live birth was significantly less likely among overweight (adjusted OR, 0.96) and obese women in class I (0.63), class II (O.39), and class III (0.32).Overweight and Obese Women Deliver Fewer IVF Live BirthsDAMIAN McNAMARA10.1016/S0029-7437(12)70011-3Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Obstetrics88http://www.obgynnews.com/article/PIIS0029743712700125/abstract?rss=yes Major Finding: Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.Cutting Calories Gives Cardiac Benefit in DiabetesSUSAN BIRK10.1016/S0029-7437(12)70012-5Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Clinical Rounds99http://www.obgynnews.com/article/PIIS0029743712700137/abstract?rss=yesSAN DIEGO – Triptans are routinely prescribed to migraine patients who have a history of cardiovascular disease, according to evidence from a large medical claims database study.Triptans Being Prescribed Despite Cardiac ContraindicationsBETSY BATES10.1016/S0029-7437(12)70013-7Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Clinical Rounds99http://www.obgynnews.com/article/PIIS0029743712700149/abstract?rss=yesHOLLYWOOD, FLA.–Women who undergo hysterectomy via one of three surgical approaches experience similar outcomes, with one caveat, according to findings of a retrospective study.Hysterectomy Approaches: Adverse Events DifferDAMIAN McNAMARA10.1016/S0029-7437(12)70014-9Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1010http://www.obgynnews.com/article/PIIS0029743712700150/abstract?rss=yes Major Finding: Median estimated blood loss overall and in each BMI group was 100 mL. Median length of hospital stay of 1 day, likewise, was the same overall and in each group. The overall complication rate of 12%, including 4% major and 8% minor complications, did not differ significantly by BMI.Robotic Hysterectomy Safe in Morbidly Obese: All BMI groups had similar outcomes and complication rates in this study.DAMIAN McNAMARA10.1016/S0029-7437(12)70015-0Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1111http://www.obgynnews.com/article/PIIS0029743712700162/abstract?rss=yes Major Finding: Robotic-assisted hysterectomy was associated with a significantly longer mean operating room time, 246 minutes, compared with a mean 172 minutes with a laparoscopic approach.Longer OR Times Confirmed in Robotic HysterectomyDAMIAN McNAMARA10.1016/S0029-7437(12)70016-2Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1111http://www.obgynnews.com/article/PIIS0029743712700174/abstract?rss=yes Major Finding: Screening mammogram patients with correctly matched breast and detector sizes received an average mean glandular dose per breast of 3.3 mGy vs. 4.9 mGy for mismatched patients with large breasts (P value less than .05).Detector Mismatch Raises Radiation ExposurePATRICE WENDLING10.1016/S0029-7437(12)70017-4Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1212http://www.obgynnews.com/article/PIIS0029743712700186/abstract?rss=yesSAN ANTONIO – A phase III trial of an adjuvant breast cancer vaccine began enrollment before the end of 2011 as a result of favorable 5-year efficacy and safety data in a phase II study.Adjuvant Breast Cancer Vaccine in Phase III TrialBRUCE JANCIN10.1016/S0029-7437(12)70018-6Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1212http://www.obgynnews.com/article/PIIS0029743712700198/abstract?rss=yesWomen who don't carry their family's BRCA1 or BRCA2 mutation showed no increase in breast cancer risk in a study of 3,047 population-based families reported . “These results support the standard clinical practice of advising noncarriers that they do not have any increase in breast cancer risk attributable to the family-specific BRCA mutation and, in the absence of other strong risk factors, should follow general population guidelines for breast cancer screening,” said Dr. Allison W. Kurian of Stanford (Calif.) University and her associates.Breast Ca Risk Not Worse for Noncarriers in BRCA FamiliesMARY ANN MOON10.1016/S0029-7437(12)70019-8Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1212http://www.obgynnews.com/article/PIIS0029743712700204/abstract?rss=yesADELPHI, MD. – Advisors to the Food and Drug Administration voted 19-5 that the benefits of the Ortho Evra contraceptive patch outweighed its risks, although they agreed with epidemiologic evidence that use of the patch is associated with an increased risk of venous thromboembolic events.FDA Panel: Ortho Evra Benefits Outweigh RisksELIZABETH MECHCATIE10.1016/S0029-7437(12)70020-4Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1313http://www.obgynnews.com/article/PIIS0029743712700216/abstract?rss=yes DR. BRILL said he is a consultant and speaker for Ethicon Endosurgery, Gynecare, Conceptus, and Karl Storz. The Food and Drug Administration's warning last summer of the risks associated with transvaginal placement of mesh for repair of pelvic organ prolapse and stress urinary incontinence – and its overall, ongoing review of how mesh products are cleared for use–have changed the climate for ob.gyns. and patients. It has upped the ante for comprehensive patient counseling and brought to the fore the fact that pelvic floor repair is a combination of art, science, judgment, skill, training, and experience.The Hoopla Over Mesh: What It Means for PracticeANDREW I. BRILL, CHARLES E. MILLER10.1016/S0029-7437(12)70021-6Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Master Class1415http://www.obgynnews.com/article/PIIS0029743712700228/abstract?rss=yesDebilitating pain, abscess formation, and other serious complications associated with the use of vaginal synthetic mesh for pelvic organ prolapse surgery have been addressed in a joint statement issued by the American College of Obstetricians and Gynecologists and the American Urogynecologic Society that recommends the development of a national patient registry for “all current and future vaginal mesh implants.”ACOG-AUGS Says Limit Use of Mesh for ProlapseELIZABETH MECHCATIE10.1016/S0029-7437(12)70022-8Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1616http://www.obgynnews.com/article/PIIS002974371270023X/abstract?rss=yes Major Finding: Hysteroscopy for the diagnosis of endometrial cancer was associated with 94% sensitivity, 98% specificity, a 73% positive predictive value, and a 99.6% negative predictive value.Study Supports Hysteroscopy to Diagnose Endometrial CaDAMIAN McNAMARA10.1016/S0029-7437(12)70023-XOb.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Gynecology1616http://www.obgynnews.com/article/PIIS0029743712700241/abstract?rss=yesIf it takes an entire village to raise a child, it's going to take an entire country to raise maternal/fetal outcomes. Everyone involved in maternity care – from payers and hospital administrators to laboring women and their nurses–needs to team up to improve the health of moms and newborns, even if that means admitting that mistakes can be made.Joint Efforts Will Help Maternity OutcomesMICHELE G. SULLIVAN10.1016/S0029-7437(12)70024-1Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Practice Trends2323http://www.obgynnews.com/article/PIIS0029743712700253/abstract?rss=yesThe number and rate of abortions performed in the United States remained about the same from 2007 to 2008, according to the latest abortion surveillance data collected by the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention. The data, published in Morbidity and Mortality Weekly Report, showed that in 2008 more than 825,500 abortions were reported to CDC. This resulted in an abortion rate of 16 abortions per 1,000 women aged 15-44 years, the same as in 2007. This rate is consistent with the recent leveling off of the abortion rate after years of steady declines, the CDC researchers wrote. However, the abortion ratio, which calculates the number of abortions compared to live births, increased slightly between 2007 and 2008. The 2008 abortion ratio was 234 abortions per 1,000 live births, a 1% increase over 2007. The CDC figures also showed a 17% increase in the number of nonsurgical abortions performed between 2007 and 2008. In 2008, of the abortions performed at 8 weeks gestation or earlier, 22% were nonsurgical.Policy & practice: Want more health reform news? Subscribe to our podcast – search ‘Policy & Practice’ in the iTunes storeMary Ellen Schneider10.1016/S0029-7437(12)70025-3Ob.Gyn. News 47, 1 (2012)2012-01-01Ob.Gyn. News2012-01-01471S0029-7437(12)X7001-0Practice Trends2323