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Specialty: OBGYN
Condition: Thrombosis

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We appreciate the interest that Drs Aznar and Cerdá have expressed in our Clinical Opinion piece. We did not intend to minimize the importance of factor V Leiden as a risk factor for venous thromboembolism (VTE) in women taking combined oral contraceptives (COCs). However, we primarily addressed the risks of myocardial infarction (MI) and ischemic stroke (IS), which are arterial thrombotic events, with COCs. Accordingly, we cited some well-established risk factors for MI and IS, and we suggested that tools such as the Framingham risk calculator may be helpful adjuncts to American College of Obstetricians and Gynecologists...
Source: American Journal of Obstetrics and Gynecology - March 1, 2013 Category: OBGYN Authors: Christopher R. McCartney, Jennifer P. Beller Tags: Letters to the Editors Source Type: research

Gynecologic Surgery in the Obese Patient
Obesity is a chronic multifactorial disease that presents serious health risks due to excessive fat accumulation in adipose tissue . Determinants such as genetics, psychosocial factors, the environment, poor diet, and physical inactivity all have a role in its development. Obesity was defined in 1998 by the National Institutes of Health clinical guidelines as body mass index (BMI) ≥30 . Obese individuals are at higher risk for many comorbid conditions and for overall mortality than are non-obese individuals. Some of these conditions include type 2 diabetes mellitus, hypertension, coronary artery disease, stroke, obstruc...
Source: The Journal of Minimally Invasive Gynecology - January 23, 2014 Category: OBGYN Authors: Karen Cooper, Tommaso Falcone Tags: Editorial Source Type: research

Risk of thrombosis in women with malignancies undergoing ovarian stimulation for fertility preservation
CONCLUSIONS The available evidence on the risks of thrombosis for women undergoing ovarian stimulation for fertility preservation due to a malignancy is reassuring. However the avoidance of the early form of OHSS in women preserving oocytes/embryos due to malignancy is crucial. For these cycles, we advocate the use of a regimen of ovarian stimulation with gonadotrophin releasing hormone (GnRH) antagonists using GnRH agonists to trigger ovulation, an approach that has been shown to markedly reduce the risk of OHSS. Antithrombotic prophylaxis should be administered only to selected subgroups of women such as those with other...
Source: Human Reproduction Update - October 14, 2014 Category: OBGYN Authors: Somigliana, E., Peccatori, F. A., Filippi, F., Martinelli, F., Raspagliesi, F., Martinelli, I. Tags: Reviews Source Type: research

FDA Approval of Paroxetine for Menopausal Hot Flushes
ABSTRACT: In June 2013, the Food and Drug Administration (FDA) approved paroxetine (Brisdelle, Noven) for the treatment of moderate to severe hot flushes (vasomotor symptoms) associated with menopause. Brisdelle is the only nonhormonal treatment approved by the FDA for this indication. Prior to approval of Brisdelle, FDA-approved treatments for hot flashes were hormones containing either estrogen alone or estrogen plus a progestin. Hormonal therapy is highly effective for treating vasomotor symptoms. However, the use of hormonal therapy dropped substantially after initial findings of the Women’s Health Initiative randomi...
Source: Obstetrical and Gynecological Survey - October 1, 2014 Category: OBGYN Tags: Gynecology: Office Gynecology Source Type: research

Pain Management Strategies for Urogynecologic Surgery: A Review
ABSTRACT: Surgery-related pain is common and is difficult to manage during the postoperative period. In some studies, more than 30% of patients who underwent either vaginal surgery or abdominal surgery reported inadequate pain control at postoperative days 3 and 7. Poor pain control during the acute postoperative period causes heightened sympathetic discharge (increasing the risk for myocardial infarction and stroke) and decreased ambulation (increasing the risk for thromboembolism). Poor acute postoperative pain control can also result in poor inspiratory effort, resulting in an increased risk for postoperative pneumonia,...
Source: Obstetrical and Gynecological Survey - March 1, 2015 Category: OBGYN Tags: Gynecology: Urogynecology Source Type: research

Testosterone supplementation in men: a practical guide for the gynecologist and obstetrician
Purpose of review: Prescribing habits for the treatment of symptomatic hypogonadism have recently stirred controversy surrounding testosterone replacement therapy. As a result, the gynecologist will need to recognize this iatrogenic form of decreased sperm production in couples seeking fertility advice. We have compiled a review of the current literature on testosterone supplementation pertaining to the gynecologic practice. Recent findings: Over the last decade, testosterone use has seen a recent increase including in men desiring to become fathers. Many physicians and hypogonadal men do not recognize that testosterone re...
Source: Current Opinion in Obstetrics and Gynecology - July 4, 2015 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by David L. Olive Source Type: research

Prevalence of menopausal symptoms among mid-life women: findings from electronic medical records
Conclusion: Our findings provide recent data on the types of menopausal symptoms experienced by mid-life women prescribed HT. Electronic medical records may be a rich source of data for future studies of menopausal symptoms in this population.
Source: BMC Women's Health - August 13, 2015 Category: OBGYN Authors: Matthew SussmanJeffrey TrocioCraig BestSebastian MirkinAndrew BushmakinRobert YoodMark FriedmanJoseph MenzinMichael Louie Source Type: research

Contraception and obesity.
Abstract The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and th...
Source: Gynecologie, Obstetrique et Fertilite - October 30, 2015 Category: OBGYN Authors: Lobert M, Pigeyre M, Gronier H, Catteau-Jonard S, Robin G Tags: Gynecol Obstet Fertil Source Type: research

Contraception et obésité
Publication date: Available online 31 October 2015 Source:Gynécologie Obstétrique & Fertilité Author(s): M. Lobert, M. Pigeyre, H. Gronier, S. Catteau-Jonard, G. Robin La prévalence de l’obésité augmente massivement depuis plusieurs dizaines d’années dans les pays industrialisés. Les femmes obèses ont une activité sexuelle, non différente des femmes de poids normal, et bénéficieraient d’une couverture contraceptive moindre et d’un risque de grossesse non désirée plus élevé. En outre, l’obésité constitue un facteur de risque important d’accident thromboembolique veineux et arté...
Source: Gynecologie Obstetrique and Fertilite - November 5, 2015 Category: OBGYN Source Type: research

To Bleed or to Clot: Managing Menorrhagia in a Teenager With Von Willebrand’s Disease and Elevated Lipoprotein (A), A Case Report
We present a case of an adolescent with elevated lipoprotein(a) and von Willebrand’s disease and discuss principles for balancing menorrhagia control and thrombosis risk.
Source: Journal of Pediatric and Adolescent Gynecology - February 19, 2016 Category: OBGYN Authors: Anna Jo Bodurtha Smith, Kathleen F. Harney Source Type: research

Atrial Fibrillation in a Structurally Normal Heart during Pregnancy: A Review of Cases From a Registry and From the Literature.
CONCLUSION: The GÉMOQ's Registry added 12 cases (16 pregnancies) to the existing literature. AF during pregnancy is an arrhythmia that is mainly unprovoked, paroxysmal, and stable, with spontaneous cardioversion occurring usually within 24 hours. It is associated with good pregnancy outcomes. PMID: 28062018 [PubMed - in process]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - January 12, 2017 Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research

Clinical follow ‐up of women after hypertensive disease in pregnancy
This article is protected by copyright. All rights reserved.
Source: BJOG: An International Journal of Obstetrics and Gynaecology - April 25, 2017 Category: OBGYN Authors: H A Boyd Tags: Mini ‐commentary Source Type: research

The 2017 hormone therapy position statement of The North American Menopause Society
Abstract: The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and a...
Source: Menopause - June 27, 2017 Category: OBGYN Tags: Position Statement Source Type: research

Pancreatic Cancer in Pregnancy Presenting with Thromboembolic Events: Case Report and Review of the Literature
We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer. Although rare in pregnancy, a new diagnosis of malignancy should be considered in patients with recurrent unexplained hypercoagulable complications. We propose an evidence-based algorithm for evaluation of occult malign...
Source: Gynecologic and Obstetric Investigation - June 8, 2018 Category: OBGYN Source Type: research

Diagnosing causes of headache within the postpartum period.
CONCLUSIONS: Research has shown that many postpartum headaches go undiagnosed and as a result are poorly treated, often returning following discharge from secondary care (Nelson-Piercy 2010 ). The hope is that the introduction of this adjuvant will allow clinicians to identify the cause of postpartum headaches earlier and will allow life threatening diagnoses to be quickly excluded. PMID: 29944052 [PubMed - in process]
Source: Journal of Obstetrics and Gynaecology - June 28, 2018 Category: OBGYN Tags: J Obstet Gynaecol Source Type: research