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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
Wiberg-Itzel E et al.
Editor's comment: Prof. Jim Thornton: Inverse correlation between rates of operative vaginal delivery and Caesarean
A large Italian registry study has shown, perhaps unsurprisingly, a significant inverse correlation between rates of overall Caesarean birth and operative vaginal delivery rates. The authors note the rising rate of second stage Caesareans, which are often very morbid for both mother and baby, and advocate a careful change in obstetric culture to encourage vaginal instrumental delivery in delayed second stage of labour.
Plevani et al.
Editor's comment: Prof. Jim Thornton: Induction and Autism; reassurance from Sweden
Some previous research had suggested an association between labour induction and autism disorders. However in this large study from Sweden, comparison with siblings whose births were discordant with respect to induction, thus accounting for shared environmental and genetic factors, induction was not associated with autism in the child (HR, 0.99; 95% CI, 0.88-1.1).
Oberg AS et al. Association of Labor Induction With Offspring Risk of Autism Spectrum Disorders. JAMA Pediatr. 2016 Sep