For over 25 years, obstetricians have been searching for the definitive tool that will ultimately improve perinatal outcomes and lower the cesarean section rate. Unfortunately, while there have been several promising technologies, none has significantly reduced the rate of cerebral palsy due to intrapartum fetal hypoxia. The search nevertheless continues and no one is suggesting we give up on this important goal. With that in mind, in this issue of Contemporary OB/GYN, Dr. Lawrence Devoe discusses fetal ECG waveform analysis as an adjuvant to electronic fetal monitoring. Preliminary data from randomized clinical trials using the STAN system suggest that this technology may reduce operative delivery rates, neonatal metabolic acidosis, and hypoxic-ischemic encephalopathy.
Of course, high-risk obstetrics is not the only specialty affected by changing technology. Changes in malpractice rates, surgical reimbursements, personal time management, and improved patient care have encouraged many gynecologists to move high-tech operative procedures from the hospital OR to the office. Endometrial ablation and office tubal sterilization have led the way for global reimbursement for office-based procedures that provides physicians with the financial incentive to offer these procedures in the office instead of taking up valuable time in the operating room. Patient satisfaction rates are extremely positive for these office-based procedures. Dr. Jim Presthus reviews the current state of office-based gynecologic procedures and makes a strong case for incorporating these techniques in your practice.
As gynecologic surgeons, we are trained to treat common conditions first with medication followed by surgery if the medication fails. Too often, we neglect to consider alternative approaches for which we have little experience or no exposure. Drs. Diwadkar and Rosenblatt point out that overactive bladder affects up to 17% of women and can significantly affect quality of life. They provide an excellent review of the evidence on the effectiveness of alternative approaches to this condition including hypnosis, weight loss and nutrition, nerve stimulation, acupuncture, and biofeedback.
Severe maternal morbidity linked to mental health risks post-delivery
April 26th 2024A recent study revealed that severe maternal morbidity during pregnancy increases the likelihood of mental health hospitalizations or emergency department visits up to 13 years post-delivery, emphasizing the need for mental health screening.
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FDA approves updated label for Biktarvy against HIV-1
April 26th 2024Gilead Sciences has announced FDA approval of an updated Biktarvy label, showcasing safety and efficacy data from a phase 1b trial, positioning it as a pivotal treatment option for pregnant individuals with HIV-1 and suppressed viral load.
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No link found between antenatal corticosteroids and child neurodevelopment
April 25th 2024A recent study found no link between antenatal corticosteroid administration and adverse neurodevelopmental outcomes in children aged 6 years or older, offering reassurance for late preterm delivery practices.
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