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Combined hormonal contraception and migraine: are we being too strict?
Purpose of review Combined hormonal contraception has been contraindicated in migraines, especially in migraines with aura, because of ischemic stroke risk. Newer formulations are now available and physicians may unnecessarily be limiting access to contraceptive and medical therapeutic options for patients with migraines. This review summarizes the available data regarding ischemic stroke risk of modern combined hormonal contraception in the setting of migraines. Recent findings Limited data exists on current formulations of combined hormonal contraception and outcomes in migraine patients. Studies indicate ischemic s...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

Family planning in adolescents
Purpose of review As politics continue to shape contraception and abortion care, providers have a responsibility to address the specific needs of the adolescent patient. Here we review the current literature on contraception and abortion in adolescents. Recent findings Shared decision-making among patients, parents, and providers is the cornerstone of successful adolescent family planning. Providers should be aware of local state regulations related to consent in minors. When provided directive and noncoercive contraception counseling at no cost, adolescents are motivated and effective decision-makers in their care. L...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

Postpartum hormonal contraception in breastfeeding women
Purpose of review To provide an overview of recent research and guidelines regarding contraception and breastfeeding. Recent findings Recent studies assessed lactogenesis, breastfeeding rates, and milk supply concerns in patients starting postpartum hormonal contraception. One study showed a small but statistically significant increase in milk supply concerns between users and nonusers of postpartum hormonal contraception. Mean time to lactogenesis and breastfeeding rates were similar between patients with immediate and delayed insertion of the levonorgestrel (LNG) implant in one study and the LNG intrauterine device ...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

Self-managed abortion
Purpose of review To review the current state of self-managed or self-induced abortion in the United States and the emerging legal, political, and research questions surrounding this issue. Recent findings With the exponential rise of restrictive antiabortion laws in the United States, it has become increasingly difficult to access safe and legal abortion services. One response to this hostile environment for reproductive care access is an increased interest in methods of self-induced or self-managed abortions, primarily by medications sourced outside the medical setting. Medication abortion is established as a safe a...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

Editorial: Developments in family planning and abortion care: dangerous liaisons? Not
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

The efficacy of using acupuncture in managing polycystic ovarian syndrome
Purpose of review Polycystic ovarian syndrome (PCOS) is a common reproductive disorder, which significantly impairs the fertility of 3–10% of women at reproductive age. It is getting very popular for women with PCOS to seek alternative therapies to treat PCOS, for example, acupuncture. This review examines the currently available evidence from the randomized controlled trial to guide future recommendation on using acupuncture to assist the treatment of PCOS. Recent findings PCOS is manifested by oligo-amenorrhoea, infertility, and hirsutism. The standard treatment of PCOS includes oral pharmacological agents, lifest...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Junctional zone endometrium alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment
Purpose of review To investigate the JZE alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment. Recent findings JZE was found to be significantly extended in patients with endometriosis, leading to the conclusion that endometriosis is a primary disease of the uterus, much like adenomyosis. Statistical correlation was then demonstrated between the severity of endometriosis and the depth of the adenomyosis infiltrates, hence the thickening of the JZE. Stem cells, predominantly found in the JZE were also found in histological sections of leiomyoma, suggested to be the ori...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Antepartum and intrapartum risk factors for neonatal hypoxic–ischemic encephalopathy: a systematic review with meta-analysis
Purpose of review To review literature about risk factors of neonatal hypoxic–ischemic encephalopathy (HIE). Recent findings Search in PubMed, MEDLINE, Embase, Clinicaltrials.gov and reference lists from 1999 to 2018. Inclusion criteria: study population composed of neonates who manifested HIE within 28 days from delivery, data reported as proportional rate. Studies were excluded if they included preterm pregnancies, postnatal conditions leading to HIE and/or fetal malformations, focused on a single risk factor, were not in English language. PRISMA guidelines were followed. Interstudies heterogeneity was assessed an...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Performance of ultrasound for the visualization of the placental cord insertion
Purpose of review The purpose of this review was to review the literature on the performance of ultrasound for the visualization of the placental cord insertion (PCI) and for the diagnosis of abnormal placental cord insertion (APCI). APCI included both marginal cord insertion (MCI) and velamentous cord insertion (VCI) PCI. Recent findings The overall rate of visualization of the PCI across all trimesters is 90.3% and for those studies routinely using color Doppler, 98.1% (P  (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

General anaesthesia during caesarean sections: implications for the mother, foetus, anaesthetist and obstetrician
Purpose of review A general anaesthetic is usually given for an emergency caesarean section (Category 1), where there is imminent threat to the mother or foetus. There are many risks in performing a general anaesthetic. The aim of this review is to highlight the effects and risks to the mother and foetus of each step of a general anaesthetic. Recent findings Anaesthetic techniques are changing, and the traditional mantra of using a general anaesthetic for an emergency caesarean sections is being challenged. There are also multiple potential risks of a general anaesthetic that are being better defined. This ranges from...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Revisiting the basis for haemoglobin screening in pregnancy
The objective of this review is to describe the current landscape of haemoglobin testing in pregnancy in low and high-income countries. Recent findings Current definitions of anaemia in pregnancy comprise a laboratory threshold of haemoglobin below which treatment is offered. Haemoglobin measurement is not sensitive in detecting iron deficiency – the most common cause of maternal anaemia. Furthermore, these historical thresholds were derived from heterogeneous populations comprising men and women. Women with anaemia in pregnancy are offered iron therapy, without testing for the underlying cause. This may be appropriat...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Obstetric complications in pregnancies with life-limiting malformations
Purpose of review The implementation of palliative care at birth has led to a significant rise in the number of couples who choose to continue with pregnancies complicated by life-limiting malformations (LLMs). Prenatal counselling and appropriate antenatal/perinatal management in these cases are poorly studied and may pose significant challenges. The purpose of this review is to outline specific obstetric risks and to suggest management for mothers who choose to continue with pregnancies with the most common LLMs. Recent findings In pregnancies complicated by LLMs where parents opt for expectant management, clinician...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Preventing term stillbirth: benefits and limitations of using fetal growth reference charts
Purpose of review This review examines the variation in clinical practice with regards to ultrasound estimation of fetal weight, as well as calculation of fetal weight centiles. Recent findings Placental dysfunction is associated with fetal smallness from intrauterine malnutrition as well as fetal disability and even stillbirth from hypoxemia. Although estimating fetal weight can be done accurately, the issue of which fetal weight centile chart should be used continues to be a contentious topic. The arguments against local fetal growth charts based on national borders and customization for variables known to be associ...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Optimizing surgical management of patients who decline blood transfusion: Erratum
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - August 31, 2019 Category: OBGYN Tags: ERRATUM Source Type: research