OB/GYN Clinical Alert
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Trends in OB/GYN Malpractice Litigation
In this review of medicolegal claims data from 2005-2014, obstetric and gynecologic surgery had the second highest average indemnity payment compared to other specialties, topped only by neurosurgery. Of the 10,915 claims identified, the majority (60%) were dropped, withdrawn, or dismissed; 31.1% of claims were paid by the defendant (90% before trial); and 7.5% were successfully defended by the physician.
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New Treatment Option for Women at Risk of Fragility Fractures
A randomized trial demonstrated a reduced risk of fragility fractures in high-risk women with osteoporosis treated monthly with the monoclonal antibody romosozumab compared with weekly alendronate.
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Management of Chronic Hypertension in Pregnancy
Chronic hypertension complicates about 5% of pregnancies and has been associated with higher rates of intrauterine growth restriction (IUGR), stillbirth, and, most importantly, superimposed preeclampsia. Although the condition is far from being solved, there have been some major inroads made into its understanding through contemporary investigation.
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The LNG IUS and Stress Reactivity: A Mechanism for Mood Effects or False Signal?
Users of the levonorgestrel (LNG) intrauterine system showed an exaggerated response to stress compared to women using a combined LNG pill or those with natural cycles.
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Just Which Patients Are at Risk of Developing Uterine Fibroids?
Uterine fibroids occur commonly and are the most frequent reason for hysterectomy in the United States. Recognizing the risk factors for developing fibroids can help clinicians identify affected individuals and may lead to new approaches to treatment.
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Subclinical Hypothyroidism: What Is It and When Should We Treat It?
The current diagnosis and treatment of subclinical hypothyroidism in women of reproductive age is controversial and may well change as new studies become available.
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Antenatal Steroids for Very Early PTB
A large European multicenter study has shown that antenatal corticosteroid administration in patients at risk for imminent very early preterm birth (24 to 31 weeks) will decrease perinatal mortality and morbidity substantially, even after only three hours of exposure.
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Irritable Bowel Syndrome, Constipation, and Quality of Life in Women
Irritable bowel syndrome has a negative effect on women’s quality of life and affects one-third of women who present for care with fecal incontinence.
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Do Antibiotics Reduce Hormonal Contraceptive Effectiveness?
This is a systematic review of studies evaluating the effect of concomitant non-rifamycin antibiotic use on hormonal contraceptive effectiveness. Although data are limited, there is no evidence to support the existence of drug interactions.
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Reproductive Rights in 2017: Follow-up and Call for Advocacy
The Trump administration has made good on a number of promises to roll back reproductive rights. As clinicians, we need to fight back to ensure access for our patients to essential services. This article seeks to document where we stand as of summer 2017, and present opportunities for engagement.