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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.

Dyspareunia is a significant problem in postmenopausal women. A recent study at George Washington University found that up to 92% of sexually active women reported moderate or severe symptoms. Forty percent of women cited dyspareunia as their most bothersome problem associated with vaginal atrophy. A recent Phase III trial showed that lasofoxifene can significantly improve the symptoms of dyspareunia as well as increase bone mineral density (BMD) in postmenopausal women.

Louis Weinstein, MD, Professor and Chair of Obstetrics at Thomas Jefferson University in Philadelphia, wants to transform obstetrics. Just as overworked and frustrated internists gave rise to the hospitalist in the 1990s, Dr. Weinstein sees overworked and frustrated obstetricians evolving into laborists.

Analysis of preterm delivery (PTD) patterns among Mormon women in Utah and surrounding states indicates that genetics play a leading role in preterm delivery. If the genetic link holds, obstetricians can expect to see even higher rates of PTD in future years.

Dyspareunia is a significant problem in postmenopausal women. A recent study at George Washington University found that up to 92% of sexually active women reported moderate or severe symptoms. Forty percent of women cited dyspareunia as their most bothersome problem associated with vaginal atrophy. A recent Phase III trial showed that lasofoxifene can significantly improve the symptoms of dyspareunia as well as increase bone mineral density (BMD) in postmenopausal women.

Many middle-aged women are getting more Pap tests than they need. Women aged 45 to 60 are typically advised to get an annual Pap test, noted George Sawaya, MD, Associate Professor of Obstetrics, Gynecology, and Reproductive Science at the University of California San Francisco. But in a paper presented yesterday, Dr. Sawaya concluded that women with a history of three or more normal Paps should only be screened once every 3 years.

The identification of abnormal growth in triplet fetuses has been difficult because there have been no standards for comparison. A study at Tufts-New England Medical Center in Boston has produced curves for growth as measured by estimated fetal weight, abdominal circumference, biparietal diameter, head circumference, and femur length. All measurements were conducted sonographically.

Do even half of your patients keep their appointments for annual gynecologic exams? Compliance with annual checkups is so poor that most ob/gyns would have to answer "no." Boris Petrikovsky, MD, PhD, and a research team at Nassau University Medical Center in East Meadow, NY, found that simply inviting women to visit their physician can boost compliance rates by nearly a third.

Healthy women who have had a prior cesarean delivery can safely delivery vaginally. That is the conclusion of a 14-year retrospective study at the John H. Stroger Jr. Hospital of Cook County, IL.

The day begins at 7:45 am with a repeat showing of prize-winning films from the ACOG Film Festival (concludes at 8:45 am) and the 7th scientific session. Karen Lu, MD, presents the John I. Brewer Memorial Lecture, "Update in Ovarian Cancer Screening and Prevention."The annual Presidential Inauguration and Convocation runs from 9:00 to 10:30, featuring the installation of Michael Mennuti, MD, as ACOG's 56th President.The exhibit hall and the final poster session are both open from 10:30 am to 2:30 pm. The final day of postgraduate courses begins at 10:45, with session 2 running through 12:15 pm.

Tuesday is Go Red for Heart Health Day, sponsored in part by the American Heart Association. Heart disease is the number one killer of women over the age of 25, but fewer than half of all women know they are more likely to die of cardiovascular disease than from any other cause. All attendees are urged to wear red on Tuesday in support of heart health. The day begins at 8:30 am with the 4th Scientific Session. Charles Hammond, MD, and Peter Schwartz, MD, present the Irvin M. Cushner Memorial Lecture on "Ethical Issues Related to Expert Testimony," which ends at 9:45 am.ACOG's live telesurgery session begins at the same time and runs until 11:30 am. This course is limited to professional attendees and has limited seating. Admission is by ticket only.

The ACM got off to a strong start at 8:30 am with the opening ceremony and first scientific session, better known as the President's Program. This year's program focuses on Sex, Power, and Politics. Malcolm Potts, MB, BChir, PhD, FRCOG, leads off with the Samuel A. Cosgrove Memorial Lecture, asking the provocative question "Why Can't a Man Be More Like a Woman? The Behavioral Background of Ob-Gyn Practice."

The American College of Obstetricians and Gynecologists brings its Annual Clinical Meeting back to San Francisco's Moscone Convention Center for 2005. The City by the Bay has long been one of ACOGs's most popular venues, said president Vivian Dickerson, MD, in her official welcome message on the College's Web site. The 2005 clinical meeting is no exception.

Delivering an extremely low birthweight (ELBW) infant (

An expert examines the evidence for the effectiveness of a wide array of drugs and surgical approaches used to treat, and overtreat, heavy menstrual bleeding.

If your patient is planning a trip to a foreign country, this practical advice can help her make the visit both safe and enjoyable.

Some women appear to have a gradual, yet premature, decline in ovarian function that is distinct from ovarian failure. In the author's experience, there is hope for successful pregnancy in these cases, with quick and correct diagnosis and the right treatment.

We can do a better job of screening and testing sexually active teens and young adults for STIs. Keeping up with the latest evidence can help you decide when to test, whom to test, and which of a wide array of office- and lab-based tests to choose.

Delivering an extremely low birthweight (ELBW) infant (