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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.

Breast masses are common findings during pregnancy and often difficult to accurately diagnose. That difficulty combined with the false sense of security that a negative ultrasound might impart, can occasionally lull a physician into downplaying what may be a very serious condition.

Questions this month have been answered by:Simon Kipersztok, MD, OBGYN.net Osteoporosis Editorial Advisor Alice Rhoton-Vlasak, MD, OBGYN.net Osteoporosis Editorial AdvisoBarry L. Gruber, MD, OBGYN.net Osteoporosis Editorial Advisor Harvey S.Marchbein, MD, USA, OBGYN.net Osteoporosis Chairman and Editorial Advisor

The possibility that contraceptives are more likely to fail in obese patients is only one reason why you need to take a different tack when counseling them about their most appropriate birth control options. . .

Recently I had the honor to serve as Acting Chair of a Food and Drug Administration (FDA) advisory committee meeting called to provide advice to the Agency on the creation of new guidelines to improve manufacturer-sponsored clinical trials for hormonal contraceptive (HC) agents. . .

No firm relationship exists between folate intake or blood folate levels and breast cancer risk, according to a recent meta-analysis of prospective and case–control studies on the subject, but discrepancy exists in the findings.

It's never too late to quit smoking when it comes to bone density, according to a recent prospective study of postmenopausal women. And it doesn't take long for benefits to begin to accrue.

Women who stop taking alendronate after 5 years do not seem to be at any greater risk for fractures than women who continue treatment, but they do seem to experience a moderate decline in bone mineral density (BMD) and a gradual rise in chemical markers associated with fractures.

Call systems for practicing obstetricians vary widely, with many obstetricians being on call for long hours and most lacking recovery periods after being on call, according to the results of a Wisconsin study published in the January issue of the American Journal of Obstetrics & Gynecology.

Repeating bone mineral density (BMD) scans among postmenopausal women reveals little new information that is helpful in predicting fractures, according to a report in the Jan. 22 issue of the Archives of Internal Medicine.

Children who had nuchal translucency thickening during the first trimester, but a normal karyotype and no structural abnormalities, are clinically and developmentally normal during the first 2 years of life, according to a study in the January issue of the American Journal of Obstetrics & Gynecology.

Good morning. Thank you very much for showing up at this time of morning. I’m astounded at the number of people here, the buzz. It’s terrific. I think Karen emphasized the importance of pelvic floor support.