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Outpatients undergoing early uterine evacuations in your office require a safe environment and a clinician with a thorough knowledge of the medical and surgical techniques. This practical review provides protocols for medical abortion and early pregnancy failures and guides you through the manual vacuum aspiration procedure.

Cervical length assessment is just one of several powerful tools for detecting or excluding patients at risk for preterm birth. An expert tells how to assess and counsel a patient pregnant with triplets on her chances of carrying all three fetuses to at least 32 weeks.

Women who smoke cigarettes during their third trimester give birth to boys with IQs up to 6.2 points lower than boys born to non-smoking counterparts, according to a recent Danish study.

Low-dose aspirin combined with low-molecular-weight heparin (LMWH) during pregnancy is just as safe and effective as aspirin with unfractionated heparin (UFH) for preventing recurrent pregnancy loss due to antiphospholipid syndrome, according to a prospective, controlled, multicenter pilot study.

The caduceus is the modern American symbol of the medical profession. But the Asklepian, which I encountered on a recent trip to the Greek island of Kos, may be a far better emblem for the values we as ob/gyns hold dear. Allow me to explain the import of two snakes versus one.

Once considered extremely rare, CDSP has become more common as cesarean rates have risen. Consider CDSP when you see a gestational sac in the lower uterine segment on U/S.

Recently, I was privileged to spend several days on a National Institutes of Health consensus panel evaluating current evidence on menopause symptomatology.

In a previous article, we reviewed coding changes for vaginal colpopexy. This article looks at a related code introduced in CPT 2005 and how to report multiple services provided during the same surgery.

Once considered extremely rare, CDSP has become more common as cesarean rates have risen. Consider CDSP when you see a gestational sac in the lower uterine segment on U/S.

Postterm birth seems to get a lot less attention than preterm birth when clinicians are discussing the risks of complications and death. But, unlike babies born too soon, timely delivery can almost entirely prevent the risks—including stillbirth—linked with prolonged pregnancy.

Contemporary OB/GYN was recently honored by American Business Media (ABM) with two Jesse H. Neal National Business Journalism Awards.

Evidently not, according to a large, Danish, population-based, case–control study.

As I write this I am post-call, which may account for the tone of my meandering discourse. At my age, the problem is not so much taking call but surviving the next day. While tackling clinical challenges can be exciting, what I find most stimulating is the chance to teach and learn from my residents.

"This is a silent disease with fracture as the primary presentation," said Elwyn Grimes, MD, from the John H. Stroger Jr. Hospital of Cook County in Chicago, IL. "It is a condition that is silent and has mortality as an important outcome. It has the potential to have a significant impact across the nation."

There's a good chance that you are asking the wrong questions and not enough questions when it comes to taking family cancer histories. "It is not enough to ask 'Did anybody in your family die of cancer, yes or no?'" said Louise Strong, MD, Section Head of Clinical Cancer Genetics and Professor of Cancer Genetics at the University of Texas M.D. Anderson Cancer Center in Houston, TX.

First-year data from the 2-year MOBILE study of monthly administration of ibandronate for postmenopausal osteoporosis have been released. All women achieved significant response, but women taking the agent once a month had a greater increase in bone mineral density (BMD) than similar women taking the drug on a daily schedule.

Women being treated for osteoporosis expressed an overwhelming preference for monthly dosing over weekly dosing in a recent nationwide survey. The study, directed by Wulf Utian of The Cleveland Clinic in Cleveland, OH, supports the monthly dosing schedule offered by ibandronate, a competing oral bisphosphonate.

The 4th Current Issues Update yesterday offered late breaking news in five specialty areas: urogynecology, STD treatment guidelines, reproductive medicine, gynecologic oncology, and maternal-fetal medicine.

Intramuscular injection of depot medroxyprogesterone acetate (DMPA) is a highly effective and popular form of contraception. It is used by about 2 million women in the US and 25 million women worldwide, according to Andrew Kaunitz, MD, from the University of Florida Health Science Center in Jacksonville, FL.

Is concomitant sterilization using the ESSURE method with Thermachoice III endometrial ablation feasible and safe? Absolutely yes, said Rafael Valle, MD, from Northwestern University Medical School in Chicago. Data presented during the second session of Papers on Current Clinical and Basic Investigation yesterday afternoon helped convince the Food and Drug Administration to approve the combination procedure.

Cost effectiveness may change the way physicians treat uterine fibroids. The newest procedure, uterine fibroid embolization (UFE) offers financial advantages over hysterectomy or myomectomy for insurers, hospitals, and the health-care system.

Cryoablation has been reported as an effective treatment for abnormal uterine bleeding in the short term, but longer-term data have been lacking. New data from Raffaele Bruno, MD, and a research team at Lahey Clinic in Burlington, MA, indicate that cryoabalation is also effective into the second year after treatment.

A growing number of physicians and patients are looking to continuous use of oral contraceptives (OCs) to reduce the number of menstrual days and provide other quality-of-life improvements. But there are unanswered questions about the effect of different hormones used in OC on bleeding patterns.

Medical abortions using mifepristone 200 mg followed by vaginal misoprostol are 95% to 98% effective. A pilot study at Boston University suggests that mifeprestone 100 mg plus misoprostol at the same time is equally effective.

American College of Obstetricians and Gynecologists (ACOG) Junior Fellows stumped the Professors at ACM's 5th Scientific Session. ACOG's annual brainteaser that pits senior residents against a panel of professors left the profs guessing on three of four test cases.

Phase II studies have shown that lasofoxifene, a next-generation selective estrogen-receptor modulator, increased bone mineral density and improved both objective measures of vaginal atrophy and reported symptoms. Margery Gass, MD, and a team from the University of Cincinnati Medical Center reported yesterday that a double-blind, randomized, placebo-controlled Phase III trial produced similar results.