Vol 65 No 06

Paucity of evidence limits known impact of CSPs

June 12, 2020

As we are now incorporating the new post-COVID-19 “normal” into our routines, our editor-in-chief, Dr. Catherine Spong, reflects on parallels with changes that went into play with the identification and management of patients with HIV.

The Society for Maternal-Fetal Medicine consult series #49 on cesarean scar pregnancy

June 11, 2020

Cesarean scar pregnancy (CSP) is a complication in which an early pregnancy implants in the scar from a prior cesarean delivery. Incidence and recognition of this condition appear to have increased over the past two decades, perhaps due to high worldwide cesarean delivery rates. The clinical presentation is variable, and many women are asymptomatic at presentation. CSP can be difficult to diagnose in a timely fashion. Ultrasound is the primary imaging modality for CSP diagnosis. Expectantly managed CSP is associated with high rates of severe maternal morbidity such as hemorrhage, placenta accreta spectrum (PAS), and uterine rupture. Given these substantial risks, pregnancy termination is recommended after CSP diagnosis. Several surgical and medical treatments have been described for this disorder, but at this time, optimal management remains uncertain.

Legally Speaking: Did contraindicated hysterectomy lead to HIT and limb loss?

June 11, 2020

The patient had a history of fibroid uterus and dilated pelvic vessels in the left adnexal region, obscuring the left ovary. On April 2, 2014, the patient was seen as a gyn outpatient at the clinic by Defendant OB. The patient complained it caused her urinary tract irritative symptoms and back pain. An MRI was ordered for evaluation. A 9.9cm exophytic fibroid arising from the posterior uterine body with focal cystic degeneration was seen.

Lessons learned from postmenopausal hormone therapy

May 12, 2020

The timing of postmenopausal hormone therapy (HT) significantly impacts coronary risk and overall benefit-to-risk profile, according to an overview of Women’s Health Initiative (WHI) results in the journal Menopause.

Impact of exercise on bone mass with caloric restriction

June 02, 2020

Physical training can preserve and even significantly bolster the bone mass of the hip and femoral neck in individuals under caloric restriction, according to a systematic review and meta-analysis of 13 randomized clinical trials.

The Society for Maternal-Fetal Medicine Consult series #49 on cesarean scar pregnancy: Summary of Recommendations

June 12, 2020

Cesarean scar pregnancy (CSP) is a complication in which an early pregnancy implants in the scar from a prior cesarean delivery. Incidence and recognition of this condition appear to have increased over the past two decades, perhaps due to high worldwide cesarean delivery rates. The clinical presentation is variable, and many women are asymptomatic at presentation. CSP can be difficult to diagnose in a timely fashion. Ultrasound is the primary imaging modality for CSP diagnosis. Expectantly managed CSP is associated with high rates of severe maternal morbidity such as hemorrhage, placenta accreta spectrum (PAS), and uterine rupture. Given these substantial risks, pregnancy termination is recommended after CSP diagnosis. Several surgical and medical treatments have been described for this disorder, but at this time, optimal management remains uncertain.