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This month's topics: Chronic Pelvic Pain, Endometriosis & Adenomyosis, Surgery Pain & Adhesions and Other Questions

New Jersey is now the 24th state to pass a law providing contraceptive insurance equity. The new law, A.B. 292, requires most insurers in the state to provide coverage of prescription contraceptive drugs and devices. The law provides an exemption for qualifying religious employers if contraceptive coverage conflicts with the employer's "bona fide religious beliefs and practices," according to the American College of Obstetricians and Gynecologists (Government Relations Newsletter, 1/13/2006).

For all the talk about the importance of rigorous medical research and randomized double-blind trials, many physicians still put more faith in clinical experience than clinical experiment. Is it possible to strike a reasonable balance between the two?

Few ob/gyns are prepared for the terrifying sight of a pregnant woman in the throes of an eclamptic convulsion. You can't predict which preeclamptic patients will go on to develop life-threatening eclampsia. But when they do, you can be ready to follow these seven important steps for stabilization and induction of labor within 24 hours.

Losing a breast or a part of one to disease is traumatic for any woman. Proactive, thorough, and compassionate counseling on reconstructive options is the ob/gyn's responsibility and can help ease a patient's overall recovery.

President Bush used his State of the Union address to once again urge Congress to pass medical liability reform, specifically citing the crisis in obstetrics and gynecology. He said, "And because lawsuits are driving many good doctors out of practice?leaving women in nearly 1,500 American counties without a single ob/gyn?I ask the Congress to pass medical liability this year."

This year's annual report from the National Committee for Quality Assurance showed a mixed bag of good and bad news, reported Managed Care (11/2005). Of the 289 commercial health plans that reported data to the NCQA, the average performance showed improvements in 18 of 22 clinical measures.

New Jersey is now the 24th state to pass a law providing contraceptive insurance equity. The new law, A.B. 292, requires most insurers in the state to provide coverage of prescription contraceptive drugs and devices. The law provides an exemption for qualifying religious employers if contraceptive coverage conflicts with the employer's "bona fide religious beliefs and practices," according to the American College of Obstetricians and Gynecologists (Government Relations Newsletter, 1/13/2006).

Most employers seek to avoid getting into legal hot water with former employees. So, many avoid answering substantive questions about their former employees, and only confirm dates of employment and position held. The practice is believed to reduce the risk of being sued for slander by the former employee, if the employer gives a bad recommendation.

Apparently not. In a FASTER-related study, researchers from seven centers who studied more than 10,000 patients concluded that the association between subclinical hypothyroidism and lower pediatric IQ does not appear to result from obstetric factors. The finding is of special note given controversy on this question raised by recent studies.

Reporting findings that may change current practice, Canadian researchers at the annual SMFM meeting have concluded that two-layer closures during cesarean deliveries are safer than the single-layer closures that have been so widely adapted. In one of the largest series of symptomatic uterine ruptures, University of Montreal investigators found previous locked single-layer closure to be independently associated with uterine rupture.

Is fetal pulse oximetry a waste of time? Riveting results from an important trial presented at the 26th annual SMFM meeting in Miami in February suggest just that?and seemingly shatter the whole premise behind fetal pulse oximetry: that it might either improve perinatal outcome or lower cesarean delivery rates.

Age isn't the only impediment to male fertility; numerous other factors?many of which are controllable?can lessen sperm quality, according to the results of a number of studies reported at a joint meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society in October of 2005.

Twins resulting from subfertility treatment are born about 4 days sooner (95% CI; 2.7?5.2) and are about 60% more likely (OR 1.6; 1.4?1.8) to be born slightly preterm (between 34 and 36 weeks) when compared with naturally conceived twins, according to the results of a population-based cohort study from Belgium. But the differences are largely explained by a first birth effect among subfertile couples and are mitigated by the protective effect of dizygotic twinning; most twins resulting from subfertility treatment are dizygotic.

Left-handed women are more than twice as likely as their right-handed counterparts to develop premenopausal breast cancer, according to the results of a recent prospective study.

In postmenopausal women with endocrine-responsive breast cancer, adjuvant treatment with letrozole, as compared with tamoxifen, results in a higher 5-year disease-free survival (DFS) rate (84% vs. 81.4%) and in a significantly reduced risk of an event ending a DFS period (hazard ratio, 0.81). Such events included a cancer that recurred locally, regionally, or at a distant site, a new invasive cancer in the contralateral breast, or any second non-breast cancer, or death from a prior cancer.

Ask The Expert

I am 39 years old, and the past year I started experiencing night sweats, especially when close to having my period, including insomnia and acne breakouts.

It is in your best health interest to see your gynecologist or primary care physician regarding specific medical problems or concerns.

It is in your best health interest to see your gynecologist or primary care physician regarding specific medical problems or concerns.

It is in your best health interest to see your gynecologist or primary care physician regarding specific medical problems or concerns.

This month's topics: Ovarian Pain & Cysts, Surgery Pain & Adhesions, Vulvodynia, Vulvar Pain and Other Questions