Obstetrics and gynecology
Article Abstract:
Several topics of current interest in obstetrics and gynecology are reviewed. Research concerning the use of gonadotropin-releasing hormone agonist (GnRH-a) therapy has reported positive outcomes in reducing female infertility in cases of ovulatory failure. GnRH stimulates the release of two hormones (LH, luteinizing hormone and FSH, follicle-stimulating hormone), but has often been unsuccessful in treating infertility due to ovarian failure. Leuprolide, an agonist (compound with similar action) to GnRH, resulted in an 87 percent fertilization rate when administered with human menopausal gonadotropin (hMG). GnRH-a also shows promise in treating endometriosis, a chronic condition associated with abnormally placed and functioning endometrial (uterine lining) tissue, and leiomyomas, benign tumors of the uterus. Long-term studies of these effects are needed. Another important advance in obstetrics is vaginal delivery in women with previous cesarean section. The rate of cesarean births in the US is high (24.4 percent in 1987), and much of this results from earlier beliefs that 'once a cesarean, always a cesarean'. It now seems that vaginal delivery is possible for many women after one, or even two, cesarean sections. Almost 10 percent of women with previous cesarean births delivered vaginally in 1987, compared with 3.4 percent in 1980. Maternal and infant mortality and morbidity are lower if vaginal delivery is attempted. Guidelines for this procedure have been issued by the Committee on Obstetrics: Maternal and Fetal Medicine of the American College of Obstetricians and Gynecologists, and are presented. Urban hospitals will find adherence to the guidelines easier than rural centers. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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Obstetrics and Gynecology
Article Abstract:
A brief overview of the association between infertility treatment and ovarian cancer and Food and Drug Administration (FDA) approval of Depo-Provera and Norplant is offered. Little information is available on the number of women exposed to fertility drugs. Some studies have suggested a link between fertility drugs and ovarian cancer but questions were raised about the methodology of the studies. FDA approval of a long-acting, injectable contraceptive known as Depo-Provera and a subdermal implant known as Norplant offers US women contraceptive options that have long been available in other parts of the world. Women using Depo-Provera receive an injection every three months. Side effects include acne, weight gain, irregular bleeding and cessation of menstruation. Norplant was approved for use in the US in December 1990. More than 600,000 women have been implanted with the system as of December 1992. Reported side effects are similar to those for Depo-Provera.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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Obstetrics and gynecology
Article Abstract:
Loop electrosurgical excision procedure (LEEP), is a new procedure to treat cervical intraepithelial neoplasia (CIN), a cervical disease that can become malignant. The procedure uses a low current instrument which combines cutting and coagulation. Compared to laser surgery, LEEP costs less, patients recover more quickly and have fewer complications and the physician can obtain a more complete tissue specimen. Women need a sensitive, caring and qualified physician. Consumer education on the qualifications of fertility specialists will help to prevent unethical treatment of infertile women. Several state legislatures have passed bills requiring insurance companies to pay for the costs of infertility diagnosis and treatment, including test tube fertilization and other procedures. The American Fertility Society has a large patient education library. RESOLVE, a support group for infertile couples, is another resource.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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