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We know that tocolytic agents effectively inhibit uterine contractions, but the evidence for improved perinatal outcomes is much less clear. Why is this so, and what are the implications for your patients?

In the May 2006 issue of Obstetrics & Gynecology, the American College of Obstetricians and Gynecologists (ACOG) reaffirmed its recommendation that teenage girls first visit an OB/GYN between the ages of 13 and 15.

Questions this month have been answered by:Simon Kipersztok, MD, OBGYN.net Osteoporosis Editorial AdvisorHarvey S. Marchbein, MD, USA, OBGYN.net Osteoporosis Chairman and Editorial Advisor

The cost of malpractice premiums threatens our specialty's very survival. Yet powerful interest groups impede tort reform. What if, however, physicians concede the point that tort reform is not our priority? A strategy of if we can't beat them, join them might ultimately prove the key to the enduring solutions that we seek.

May Case Summaries

Clinical situations that typically result in litigation and the variation in jury verdicts and awards across the nation.

After reading the latest report from the Women's Health Initiative (WHI), I've struggled with my emotional reaction. The data in this report is not new. The risk of CHD was present only in the oldest women in the trials. . .

New Products

The latest in medical products for obstetrics and gynecology.

from The North American Menopause Society: The position statement evaluates the risk-benefit ratio of peri- and postmenopausal estrogen therapy and estrogen-progestogen therapy for both treatment of menopause-related symptoms and disease prevention.

New Products

The latest in medical products for obstetrics and gynecology

Array-based comparative genomic hybridization detects significantly more and smaller abnormalities than standard chromosome analysis. Already in limited use, the test may well replace karyotyping for prenatal diagnosis of genetic disorders.

After thromboembolic disease, preeclampsia is the second most common cause of maternal death in the US. Although the condition can't be prevented, early identification of women at risk for developing it would enable obstetricians to improve clinical outcomes for both mother and child. With the recent identification of angiogenic factors present in high concentrations in the urine of women at risk, a urinary screening test may soon be a reality.

Questions this month have been answered by:R. Wayne Whitted, MD, MPh, OBGYN.net Osteoporosis Editorial AdvisorHarvey S. Marchbein, MD, USA, OBGYN.net Osteoporosis Chairman and Editorial AdvisorPaul D. Burstein, MD, FACOG, USA, OBGYN.net Osteoporosis Editorial Advisor

Answer from Dr. Gruber The answer to your question is not entirely known, although certain factors probably contribute. First however, it is important to recognize that the data indicate that among Asians the rate of hip fractures varies considerably whether one is speaking of Japanese, American-Asians, Koreans, New Zealand, Hawaii, etc. In general, Asian women have higher fracture rates than African-Americans but lower than Caucasians. Presumably racial and ethnic influences on risk for developing osteoporosis and fragility fractures depends on (undefined) genetic factors which govern bone mass, geometry, and size of bones (all contributing to strength), bone turnover rates, overall body composition (both muscle mass and fat lessen fracture rates), and calcium metabolism. In addition, lifestyle issues such as physical activity, smoking, etc. probably play a role although this has not been well studied in terms of its relationship to race and ethnicity. In summary, a wide range in fracture incidence worldwide suggests that many factors enter into the determination of skeletal health. Bone mass itself (i.e., bone density) is only a portion of the risk profile.