Pregnancy and Birth

CLINICAL PICTURE •Vaginal Bleeding I. Speculum Examination:The vagina is full with clots, portio exophytic or shows. Carcinoma crater surface bleeding stronger after touching.II. Palpation:Often large tumor that fills the small pelvis.

2. Direct microscopy: >10 WBC in vaginal fluid (in the absence of T.V.): sensitive indicator of cervical inflammation caused by C.T. or N.G., with a high negative predictive value.

It has been suggested that hormonal risk factors act predominantly on estrogen receptor and progesterone receptor (ER/PR)-positive breast cancers. However, the data have been inconsistent, especially in younger women.

In a study published today in Europe's leading reproductive medicine journal Human Reproduction1, researchers from New York's Cornell University report the first IVF pregnancy to result from the use of tamoxifen as an ovarian stimulant.

Human MUC1 mucin, a membrane-bound glycoprotein, is a major component of the ductal cell surface of normal glandular cells. MUC1 is overexpressed and aberrantly glycosylated in carcinoma cells. The role MUC1 plays in cancer progression represents two sides of one coin.

Sore breasts can signal the onset of PMS -- that 'ouch' feeling tells some women they're premenstrual more reliably than a calendar. Cyclical breast soreness shouldn't cause concern, according to Women's Health America. However, breast pain doesn't have to be tolerated. Here's how to minimize discomfort, and how to recognize cautionary signs that should send you to your doctor.

Breast Cancer and Breast Disease

Breast cancer is the most common cancer among women. Most of us are aware of the statistic that one out of every eight women will develop breast cancer at some point in their lifetime. However, an important point about this statistic is that most of these cancers do not occur until after the age of 50.

Disclosure Declaration •Grant Support –National Institutes of Health, Ortho-McNeil Pharmaceutical, Inc, Pharmacia Corp., Berlex Laboratories, Proctor and Gamble •Honoraria and consultation fees –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., TAP Pharmaceuticals, Eli Lilly and Co. •Participation in company sponsored speakers’ bureau –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., Merck Pharmaceuticals.

Hormonal Contraception: Combination OCP’s .Contain Synthetic Estrogen/Progestin .Modern E2 Dosage = 50 Mcg .Despite Diversity, Side Effects and Efficacies Similar .Requires Patient Compliance .May Be Monophasic or Triphasic

Definitions Gestational Trophoblastic Neoplasia (GTN)=Malignant Gestational Trophoblastic DiseaseIt is a spectrum of trophoblastic diseases that develops malignant sequelae. GTN includes: • Persistent post molar GTD • Invasive mole • Choriocarcinoma • Placental site trophoblastic tumourThe last 2 may follow abortion, ectopic or normal pregnancy.Disaia &Creasman Clinical Gynecological Oncology 2007 Cunningham et al Williams Obsterics 23rd , 2010

ORAL CONTRACEPTIVES: . Objectives . Know the risks, benefits and side effects of oral contraceptives . Utilize basic concepts in OC prescribing . Know how to modify regiments to manage side effects .Objectives .Know the risks, benefits and side effects of oral contraceptives .Utilize basic concepts in OC prescribing .Know how to modify regiments to manage side effects

Extended Use of Combined Oral Contraceptive PillsDr Hamed EllakwaAssociate Professor of Obsterics and GynecologyMenoufiya University, Egyptdrhamedellakwa@yahoo.com

A New Contraceptive Option: A Focus on the Transdermal Contraceptive System Ronald T. Burkman, MD Baystate Medical Center Tufts University School of Medicine

Endometriosis-An Overview Prof. Dr. Mohammad A. Emam Prof. of Obstetrics and Gynecology Mansoura Faculty of Medicine Mansoura Integrated Fertility Center (MIFC) EgyptEmam MA, EGYPT, 2003

Roberta Speyer: “This is Roberta Speyer and I’m reporting for OBGYN.net. I have the pleasure of talking to Dr. Fleischman who is an Assistant Clinical Professor at Yale University and in private practice with Gynecology & Infertility, PC. Today we are going to talk about urinary incontinence and how OBGYN physicians can fit this into their practice. As a practicing OBGYN yourself, this is something you have a great degree of specialization in. Tell us a little about your practice Dr. Fleischman.”

Thanks to innovative treatments like in vitro fertilization and egg donation, we are able to help thousands of infertile patients build their families.

Approximately 10% of maternal deaths in the United States are attributed to obstetric hemorrhage, with peripartum hysterectomy for placenta accreta associated with substantial morbidity. To help reduce this morbidity, Dr Jason Wright, assistant professor of obstetrics and gynecology in the College of Physicians and Surgeons, Columbia University, New York, and researchers explored the risk factors associated with large-volume blood loss in patients with placenta accreta who undergo hysterectomy in order to help develop referral recommendations to tertiary facilities with expertise in this condition.

The topic of hormone replacement therapy (HRT) continues to emerge as a central theme that we, as clinicians to female patients, address every day. We recognize that the public is much more aware of and interested in HRT now than was the case a decade ago.

Menopausal Hormone Therapy and Other Breast Cancer Risk Factors in Relation to the Risk of Different Histological Subtypes of Breast Cancer: A Case-control Study

In humans, serotonin has typically been investigated as a neurotransmitter. However, serotonin also functions as a hormone across animal phyla, including those lacking an organized central nervous system.