Obstetrics/Gynecology
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New option for vaginal discomfort after menopause
Results of a recent Phase III trial suggest that intravaginal dehydroepiandrosterone could provide women who cannot or do not wish to use intravaginal estrogen with an effective vaginal alternative for easing vaginal symptoms and pain with sex after meno-pause.1 The drug, under development as Intrarosa by Endoceutics, a North American biopharma company, is under review by the FDA.
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Supreme Court cases loom large in 2016
The most consequential reproductive health-related drama in Congress in 2016 most likely played out in January.
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Elevated testosterone levels might increase risk of uterine fibroids
Women who have high levels of both testosterone and estrogen in midlife might face a greater risk of developing benign uterine fibroids than women with low levels of the hormones, results of a new study indicate.1
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Antifungal drug tied to miscarriage risk
In a retrospective analysis of 1.4 million pregnancies in Denmark, use of the oral antifungal medication fluconazole during pregnancy was tied to a significantly increased risk of spontaneous abortion associated with fluconazole exposure (HR, 1.48; 95%CI, 1.23-1.77), compared with risk among unexposed women and women who used a topical antifungal during pregnancy. Until more data on the association are available, cautious prescribing of fluconazole in pregnancy might be advisable. Although the risk of stillbirth wasn’t significantly increased, this outcome should be investigated further.1
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Could premenstrual syndrome be a flag for future risk of hypertension?
Results of a new study indicate that women with moderate-to-severe PMS had a 40% higher risk of developing high blood pressure during the following 20 years compared to women experiencing few menstrual symptoms.1
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Push is on to increase postpartum use of LARC
Your next patient is a young mother of two, and her youngest child is less than a year old. While she was using combined oral contraceptives to prevent pregnancy, her busy schedule compromised compliance. The lab results are in: The pregnancy test is positive.
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Is There a Link Between Miscarriage and Future Cardiovascular Disease?
In this Scottish retrospective cohort study of 60,000 women, two or more miscarriages were found to increase the risk of future ischemic heart disease by two- to three-fold.
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Does a History of D&C Increase the Risk of Premature Delivery?
In a meta-analysis, a history of dilation and curettage for management of miscarriage or termination of pregnancy was associated with an increased risk of preterm birth in a subsequent pregnancy but the association is weak and most likely explained by confounding.
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Low-dose Aspirin and Preeclampsia
A study comparing outcomes before and after offering low-dose aspirin to patients who were deemed to be high risk by a first trimester protocol showed a decrease in preterm birth prior to 34 weeks and a decrease in early-onset preeclampsia.
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Menopausal Hormone Therapy: Useful and Indicated for Vasomotor Symptoms
The benefits may exceed the risks for most women within 10 years of menopause.