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Readers react

Readers write in about their thoughts on the annual labor force survey, the conundrum presented by cesarean delivery and defensive medicine, more information on treating women who have been the victim of sexual assault, and what is adding to the stress of the job.

Can adopting quality measures decrease the cesarean rate? Plus: The Government Accountability Office issues a report on power morcellators and the FDA's system of evaluation. Also, does the volume of one type of heart fat indicate the risk of heart disease?

An analysis looks at the impact of diet on bone mineral density. Also, an examination of which antidepressants in pregnancy may increase the risk of birth defects. Plus: Is the mortality rate of cervical cancer underestimated?

Contemporary OB/GYN’s Editor-in-Chief, Dr Charles J. Lockwood, was honored by the Society for Maternal-Fetal Medicine (SMFM) with a Lifetime Achievement Award at the 37th Annual Pregnancy Meeting in Las Vegas. SMFM President Dr Mary Norton said that Dr. Lockwood was selected “because he really has had a remarkable career.”

De-stressing ob/gyn

The January 2017 issue of Contemporary OB/GYN provided a window into the minds of some of our colleagues by reporting the results of our second annual Labor Force survey. About 670 of our readers responded.

The plaintiff asserted that during the diagnostic laparoscopy, Dr A and Dr B should have detected the ectopic pregnancy in the right fallopian tube. Her attorneys claimed that based upon the plaintiff’s abdominal pain, vaginal bleeding, and β- hCG levels, and absent evidence of intrauterine pregnancy on ultrasound, the defendants should have presumed ectopic pregnancy and adequately evaluated the fallopian tube before discharging the patient, thus avoiding rupture.

Ob/gyns have witnessed how development of antibiotic resistance has affected disease management in our specialty. Increased resistance of Neisseria. Gonorrhea (N. gonorrhea) to penicillins and quinolones, emergence of methicillin-resistant staphylococcus aureus (MRSA) and resistance of Group B Streptococcus to erythromycin and clindamycin have led us to modify our antibiotic treatment regimens.

67% of residency directors reported that a lack of faculty expertise in medical ethics was a significant barrier to their attempts to provide a more comprehensive educational process. I have a proposal for a solution to these problems: Teaching about the “house of ethics” in ob/gyn, as we do at Vanderbilt University.

Pregnancy-related deaths in the United States have risen from a low of 7.2 per 100,000 live births in 1987 to a high of 17.3 per 100,000 live births in 2013, according to the Centers for Disease Control and Prevention (CDC) Pregnancy Mortality Surveillance System.

Fibroids are extremely common in women of reproductive age. One large study reported that 70% of Caucasian and 80% of African-American women had at least one ultrasound- or pathology-confirmed fibroid by the end of their reproductive years. While many of these women experience no negative effects of fibroids on their reproductive function, a significant number are at increased risk of infertility, miscarriage, or poor obstetric outcomes.