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Latest articles on obstetrics and gynecology
On this page an overview of all articles can be found.
Selected EJOG Papers
Editor's comment: Prof. Tak Yeung Leung: Balloon catheters for induction of labor at term after previous cesarean section: a systematic review
While there are a number of studies on balloon catheters for induction of labor (IOL) in non-scarred uterus, its use for IOL in scarred uterus is not well studies, as illustrated from the systematic review by Kehl et al. With a limited sample size and retrospective analyses, Kehl demonstrated a moderate increase in the risk of uterine scar rupture (OR = 2.45) when balloon catheters were used. Further RCT is needed to confirm such risk.
Balloon catheters for induction of labor at term after previous cesarean section: a systematic review
Sven Kehl, Christel Weiss, Werner Rath
European Journal of Obstetrics & Gynecology and Reproductive Biology, September 2016, Pages 44 - 50
Editor’s comment: Prof. Tak Yeung Leung: Endometrial cancer can be accurately predicted by transvaginal ultrasonic measurement of endometrial thickness
With a cohort of 4383 women presented with postmenopausal bleeding, of whom 168 (3.8%) had endometrial cancer, a Hong Kong group has shown that transvaginal ultrasonic (TVS) measurement of endometrial thickness (ET) can achieve a satisfactory detection rate of endometrial cancer. The area under curve (AUC) and Youdens Index was respectively 0.92 (95% CI 0.88–0.96) and 0.71 (Sensitivity = 82.7%; Specificity = 88.3%; +ve LR = 6.38; −ve LR = 0.2). The performance of TVS in predicting endometrial cancer is significantly superior to that by patient’s history and characteristics. Training of TVS is important to ensure the accuracy of ET measurement and predictive power of this tool. http://www.ejog.org/article/S0301-2115(16)30210-X/fulltext
Alyssa Sze-Wai Wong, Chun Wai Cheung, Linda Wen-Ying Fung, Terence Tzu-Hsi Lao, Ben Willem J. Mol, Daljit Singh Sahota
European Journal of Obstetrics & Gynecology and Reproductive Biology, August 2016, Pages 220 - 224
Editor’s comment: Prof. Tak Yeung Leung: Beware of co-existing endometrial carcinoma in patients who are treated for atypical endometrial hyperplasia
A French group has looked into 32 patients who were initially diagnosed to have atypical endometrial hyperplasia (AEH) based on hysteroscopic resection products, and then subsequently underwent hysterectomy. Two out of these 32 cases (6.2%) was finally diagnosed to have coexisting endometrial carcinoma, while 6/32 (18.8%) cases had residual AEH, and the remaining 24/32 (75%) cases had no more AEH. Endometrial carcinoma cannot be totally excluded with hysteroscopic resection. Hysterectomy remains to be a definite treatment for AEH for those patients with no fertility wish. Close and long term follow-up is necessary if patients decline hysterectomy.
Risk of coexisting endometrial carcinoma in case of atypical endometrial hyperplasia diagnosed on total hysteroscopic resection
Audrey Pivano, Patrice Crochet, Xavier Carcopino, Ludovic Cravello, Léon Boubli, Aubert Agostini
European Journal of Obstetrics & Gynecology and Reproductive Biology, August 2016, Pages 210 - 213
From the other Journals
Editor's comment: Prof. Jim Thornton: The addition of misoprostol to 3rd stage oxytocin does not prevent postpartum haemorrhage
A large, 1,721 participant, randomized controlled trial from France comparing oxytocin plus oral misoprostol with oxytocin alone, for post-partum haemorrhage prophylaxis in the 3rd state of labour was negative. Rates of moderate and severe bleeding were not reduced, and side effects were significantly higher in the misoprostol group.
Active Management of the Third Stage of Labor With a Combination of Oxytocin and Misoprostol to Prevent Postpartum Hemorrhage: A Randomized Controlled TrialObstet Gynecol. 2016 Oct;128(4):805-11
Editor's comment: Prof. Jim Thornton: Oil is better than water
A randomised trial from the Netherlands among 1119 infertile women, compared hystero-salpingography with oil or water contrast medium. Ongoing pregnancies and live births were significantly higher in the oil contrast group. RR 1.37; 95% CI 1.16-1.61, and RR 1.38; 95% CI 1.17-1.64 respectively.N Engl J Med. 2017 May 25;376(21):2043-2052.
Editor's comment: Prof. Jim Thornton: Closing in on the “pre-eclampsia gene”
The InterPregGen group of researchers performed genome wide sequencing studies on 2,658 offspring from pre-eclamptic pregnancies and controls, using cohorts collected from UK, Iceland, Finland and Norway. After testing over 7 million sequence variations they identified one, rs4769613, which was associated with the disease at the P = 3.2 x 10-8 significance level. Unlike previous purported associations this one is likely to be real. rs4769613 is located near the FLT1 locus.
McGinnis R et al.Nature Genetics, Volume:49,Pages:1255–1260, 2017