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  • June 21, 2017 8:53 AM | Deleted user

    APAOG members may view recorded webinars at anytime. Please check out our latest addition, Menopause, Where are we now? presented by Elyse Watkins, PA-C. 

    Click here to view the webinar library. *Must be logged in to view webinar library. 

  • June 20, 2017 11:02 AM | Deleted user

    APAOG Members Elyse, Audrey, and Christina featured in latest AAPA E-blast for article in JAAPA.

    Caring for a patient with first-trimester bleeding

    Watkins, Elyse J. DHSc, PA-C; Hellams, Audrey; Saldanha, Christina

    Journal of the American Academy of Physician Assistants: June 2017 - Volume 30 - Issue 6 - p 15–20
    doi: 10.1097/01.JAA.0000516341.64222.81
    CME: Women's Health


  • June 19, 2017 7:48 AM | Deleted user

    Published: Thursday 15 June 2017

    A minimally invasive treatment can help restore fertility in women with uterine fibroids, according to a new study published online in the journal Radiology.

    Uterine fibroids, abnormal masses of fiber and muscle tissue in the wall of the uterus, are considered one of the most common causes of infertility and complications related to pregnancy. Previous research has found that one out of every four women with fibroids has problems related to fertility. The standard treatment option for such women is myomectomy, or surgical removal of the fibroids.

    However, myomectomy is not always possible or effective and can result in major complications including hysterectomy, according to study co-author João Martins Pisco, M.D., Ph.D., from the Department of Interventional Radiology at Saint Louis Hospital in Lisbon, Portugal.

    Uterine fibroid embolization (UFE) is a less invasive option that involves injection of an embolic agent, typically made up of very small beads, into the uterine arteries to block the blood supply to the uterus and fibroids. As the fibroids die and begin to shrink, the uterus fully recovers. UFE can be performed in patients with a prior myomectomy or in vitro fertilization (IVF).

    Despite its less invasive nature, UFE has yet to be fully embraced in the medical community as a fertility-preserving treatment for women with symptomatic fibroids due to concerns that the procedure may cause inadequate blood flow to the endometrium, or lining of the uterus, and the ovaries.

    For the new study, Dr. Pisco and colleagues assessed pregnancy rates in 359 women with uterine fibroids who were unable to conceive and who underwent either conventional or partial UFE. In conventional UFE, all uterine artery branches are embolized. However, the partial procedure requires treatment of only the small vessels to the fibroids, leaving the corresponding larger vessels unaffected. Partial UFE may help reduce the risks of infertility associated with conventional UFE.

    After an average follow-up of almost six years, 149 of the 359 women, or 41.5 percent, had become pregnant one or more times, and 131 gave birth to a total of 150 babies. It was the first pregnancy for more than 85 percent of the women who gave birth.

    The procedures had a clinical success rate of approximately 79 percent for fibroid-related symptoms. Complication rates were 14.6 percent for partial UFE and 23.1 percent for conventional UFE. The procedure was repeated in 28 patients whose fibroids had not been fully treated, as shown by MRI, and 11 of those patients subsequently got pregnant.

    "Our findings show that UFE is a fertility-restoring procedure in women with uterine fibroids who wish to conceive, and pregnancy following UFE appears to be safe with low morbidity," Dr. Pisco said. "Women who had been unable to conceive had normal pregnancies after UFE and similar complication rates as the general population in spite of being in a high-risk group."

    Dr. Pisco suggested that UFE may become the first-line treatment for women with fibroids who wish to conceive, particularly for those with numerous or very large fibroids. Such patients have a fibroid recurrence rate of more than 60 percent after myomectomy, making UFE an important option.

    The researchers are continuing the treatments and compiling data. Since the time of writing, there were 12 additional pregnancies.

    "In our study there are now almost 200 newborns following UFE," Dr. Pisco said. "Our next step will be a randomized study comparing the results of partial and conventional UFE."

    Article: Spontaneous Pregnancy with a Live Birth after Conventional and Partial Uterine Fibroid Embolization, João M. Pisco et al., Radiology, doi: 10.1148/radiol.2017161495, published online 13 June 2017.


  • June 14, 2017 10:08 AM | Deleted user

    a pregnant woman holding a glass of wine

    Medical News Today

    Even low levels of alcohol during pregnancy may alter the facial development of offspring.

    A new study affirms that there is no safe level of alcohol consumption during pregnancy, after finding that even the occasional drink can affect a baby's facial development.

    Researchers from Belgium and Australia assessed the drinking habits of more than 400 women during pregnancy and mapped the facial features of their offspring at the age of 1 year.

    The team found that prenatal alcohol exposure - even at low levels - subtly influenced the formation of facial features in the womb, including the nose, chin, and eyes.

    Study co-leader Evi Muggli, of the Murdoch Children's Research Institute in Australia, and colleagues recently reported their results in JAMA Pediatrics.

    The Centers for Disease Control and Prevention (CDC) state that there is no safe amount of alcohol to drink during pregnancy, nor is there a safe time to drink alcohol while pregnant.

    However, a 2015 study from the CDC found that around 1 in 10 expectant mothers in the United States report having consumed alcohol within the past 30 days.

    Alcohol consumption during pregnancy can cause a number of physical and developmental problems for offspring, including low birthweight, learning disabilities, small head size, intellectual disabilities, and problems with vision or hearing. These conditions fall under the umbrella of fetal alcohol spectrum disorder (FASD).

    It is also known that prenatal alcohol exposure can influence a child's facial development, though the level of alcohol intake that causes such an effect has been unclear.

    For their study, Muggli and colleagues set out to investigate how different levels of prenatal alcohol exposure affect facial development.


  • June 14, 2017 10:05 AM | Deleted user

    Duke University researchers have developed a handheld device for cervical cancer screening that produces high-quality images on a smartphone or laptop, part of an initiative to make screenings more accessible, easier to conduct and less costly than studies using expensive traditional equipment.

    Read more.

  • June 14, 2017 9:31 AM | Deleted user

    06/08/2017

    June 8, 2017 – The U.S. Preventive Services Task Force posted today a draft research plan on screening for syphilis infection in pregnant women. The draft research plan is available for review and public comment from June 8, 2017 through July 5, 2017. To review the draft research plan and submit comments, go to http://www.uspreventiveservicestaskforce.org/Page/Name/us-preventive-services-task-force-opportunities-for-public-comment.

     


  • June 14, 2017 7:59 AM | Deleted user

    By 

    HealthDay Reporter

    TUESDAY, June 6, 2017 (HealthDay News) -- Gaining too much or too little weight during pregnancy can harm both baby and mom, researchers say.

    In a review of more than 1.3 million pregnancies, investigators found that 47 percent of women gained too much weight. And, 23 percent did not gain enough weight to meet recommended levels.

    "Healthy recommended pregnancy weight gain depends on a mother's starting weight, with women with a higher weight recommended to gain less in pregnancy," said lead researcher Dr. Helena Teede.

    "Regardless of a mother's starting weight, unhealthy weight gain in pregnancy is now very common and carries significant health risks for mothers and babies," said Teede, a professor of women's health at Monash University in Melbourne, Australia.

    Weight gain below the recommended amount was associated with a higher risk of having a small baby and preterm delivery, the researchers found.

    On the other hand, packing on more weight than recommended was tied to a greater risk of a having a larger and heavier infant (a condition called fetal macrosomia) and a cesarean delivery.

    Around the world, prevalence of obesity and excess weight gain in pregnancy are increasing. And, about 4 out of 10 U.S. women are obese, according to background notes in the study.

    For the study, Teede and her American and international colleagues reviewed 23 previously published studies from developed countries around the world. This type of study is called a meta-analysis, in which researchers pool data from divergent studies to tease out common trends.

    Specifically, the researchers looked at how much weight women gained during pregnancy and whether it met the weight gain recommended by the U.S. Institute of Medicine.

    Institute of Medicine guidelines recommend that underweight women gain from 28 to 40 pounds during pregnancy. Normal-weight women should gain between 25 and 35 pounds. Overweight women should add just 15 to 25 pounds. And obese women should limit weight gain to 11 to 20 pounds.

    The report was published June 6 in the Journal of the American Medical Association.

    Teede said that doctors need to monitor weight gain in pregnancy and to help women eat healthier and stay mobile and active.

    "Women need to be aware of what their individual recommended healthy pregnancy weight gain is and note that the old stories of confinement or resting throughout pregnancy and eating for two are not healthy for mothers or their babies," she said.

    Other specialists agreed.

    "Pregnancy is not a time for 'eating for two,' but a great time to eat healthfully and exercise," said Dr. Aaron Caughey, chair of obstetrics and gynecology at Oregon Health and Science University.

    Efforts to help women with diet and exercise have only demonstrated small benefits at best, said Caughey, who wrote an editorial accompanying the study.

    "We may need newer ideas about how to counsel and incentivize pregnant women to achieve better outcomes," he said.

    Another specialist said it's best to get to a healthy weight before pregnancy.

    "Doctors need to help patients to optimize their weight before they become pregnant," said Dr. Jill Rabin of Northwell Health in New Hyde Park, N.Y.

    "If you take care of yourself before you are pregnant, you are going to have a healthier baby," said Rabin, who is co-chief of ambulatory care in Northwell's women's health programs.

    More information

    For more about weight gain during pregnancy, visit the March of Dimes.

    SOURCES: Helena Teede, M.B.B.S., Ph.D., professor, Monash University, Melbourne, Australia; Aaron Caughey, M.D., Ph.D., professor and chair, department of obstetrics and gynecology, Oregon Health and Science University, Portland; Jill Rabin, M.D., co-chief, ambulatory care, Women's Health Programs, PCAP Services, Northwell Health, New Hyde Park, N.Y.; June 6, 2017, Journal of the American Medical Association

    Last Updated: 


  • June 06, 2017 1:08 PM | Deleted user

    In the fall, the NCSH's Health Care Action Group released "Sexual Health and Your Patients: A Provider's Guide" to help providers in primary care and other settings better integrate sexual health conversations and related preventive sexual health services into routine adolescent and adult visits. It features tables and charts to help providers easily find key information, and was pre-tested with primary care providers.   

    By using this guide, providers can:  

    *    Streamline their sexual history-taking by asking a few essential questions   

    *    Increase their delivery of recommended preventive sexual health services 

    *    Improve care for LGBT patients 

    *    Be better prepared to discuss sexual health topics and answer patient questions 

    *    Become more knowledgeable about sexual health

    Providers can do much to improve sexual health in the United States. Please share this resource with health care providers you know and/or work with.  


  • June 06, 2017 12:13 PM | Deleted user

    2018 APAOG Board Election

    The 2018 APAOG Board of Directors elections are now open. Each APAOG Fellow & Student Member is eligible to cast one ballot.

    The positions will take office on July 1, 2017. 

    Voting will be anonymous but we request your name to ensure that when the administrative office tallies the votes, only one ballot per member is cast.

    Ballots must be received by Friday, June 23, 2017. Election results will be announced the next week

    View nominations here.

    Locate the voting link in your APAOG E-Blast or E-Newsletter.


  • May 26, 2017 11:49 AM | Deleted user

    Women with obstructive sleep apnea (OSA) appear to be at greater risk for serious pregnancy complications, longer hospital stays and even admission to the ICU than mothers without the condition, according to a new study of more than 1.5 million pregnancies presented at the ATS 2017 International Conference.

    The researchers analyzed the medical records of 1,577,636 pregnant women in the U.S. National Perinatal Information Center database from 2010 and 2014. Of those women, 0.12 percent had been formally diagnosed with OSA. Those with the diagnosis were typically older and more likely to be African American and smokers. They were also more likely to have pre-pregnancy hypertension, diabetes and coronary artery disease.

    After adjusting for obesity and many other potential confounders, the researchers found that the risk of ICU admission was 174 percent higher in pregnant women with OSA compared to those without OSA and total hospital length of stay was significantly higher (5 days in women with OSA compared to 3 days in women without OSA).

    There was also an increased risk of rare but severe complications such as hysterectomy (126 percent), cardiomyopathy (259 percent), congestive heart failure (263 percent) and pulmonary edema (406 percent) associated with a diagnosis of OSA.

    In addition, OSA in pregnancy resulted in an increased risk of pregnancy-related complications, including hypertensive disorders such as preeclampsia (122 percent) and eclampsia (195 percent), a severe form of preeclampsia that can lead to seizures. OSA also resulted in an increased risk of gestational diabetes (52 percent).

    "Given that pregnancy is a 'window' into future cardiovascular and metabolic health, OSA is a diagnosis worthy of investigation in pregnancy," said lead study author Ghada Bourjeily, MD, associate professor of medicine at Brown University. "Early intervention in these women, as well as in their children, may represent a great opportunity to offer treatment strategies that may offer long-term health benefits."

    In addition to the large sample size, Dr. Bourjeily said, study strengths included the diversity of the population and participating hospitals that enabled the researchers to identify a sample that is representative of the U.S. population. "This allowed us to demonstrate associations with rare medical outcomes, including hysterectomy and ICU admission, pulmonary edema, cardiomyopathy and congestive heart failure that would have been more difficult to prove with prospective studies," she said.

    To the researchers' knowledge, no other study has reported on the association of OSA in pregnancy with hysterectomy and ICU admission.

    Study limitations include not having information about whether OSA was being treated or not. Lack of this information, along with the under-diagnosis of OSA generally, likely led to underestimating the association between OSA and other health problems, Dr. Bourjeily added.

    The authors are now analyzing the association between OSA and birth outcomes and neonatal health and examining biological mechanisms underlying the association of OSA in pregnancy with adverse outcomes, as well as physiologic mechanisms that lead to the development of OSA in pregnancy.​

    Source:

    http://www.thoracic.org/


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