Articles related toObstetrics/Gynecology

In the present case, a 26-year-old nulliparous patient at 39.4 weeks gestational age with a 12×9-cm retroplacental leiomyoma underwent a spontaneous vaginal delivery. Nine weeks after delivery, the patient presented with acute pain and vaginal bleeding. Immediate manual removal of the bulk of the leiomyoma tissue via vaginal approach was performed. Four weeks later, the patient returned for removal of the remaining tissue via hysteroscopic excision. This case demonstrates that a large retroplacental leiomyoma can be associated with both immediate and delayed postpartum complications, and it can be managed in a minimally invasive way.

The authors respond to a letter from John Licciardone, DO, regarding their article: Hensel KL, Roane BM, Chaphekar AV, Smith-Barbaro P. PROMOTE Study: safety of osteopathic manipulative treatment during the third trimester by labor and delivery outcomes. J Am Osteopath Assoc. 2016;116(11):698-703. doi:10.7556/jaoa.2016.140

The author offers feedback on a previously published article: Hensel KL, Roane BM, Chaphekar AV, Smith-Barbaro P. PROMOTE Study: safety of osteopathic manipulative treatment during the third trimester by labor and delivery outcomes. J Am Osteopath Assoc. 2016;116(11):698-703. doi:10.7556/jaoa.2016.140

Maternal mortality from abdominal pregnancy is 7.7 times higher than from tubal ectopic pregnancy. In this case, osteopathic structural examination findings helped identify the abdominal location of a ruptured ectopic pregnancy.

Many women with ectopic pregnancies present under emergent conditions. Osteopathic structural examinations may help physicians locate the fertilized ovum, thus enhancing diagnostic workup and surgical care.

The US opioid epidemic calls for an urgent need to evaluate physician prescribing habits. Obstetrics and gynecology residents attended an opioid prescribing education lecture concerning opioid abuse and strategies to decrease adverse outcomes.

Patient care is directed by clinical practice guidelines. The authors evaluated the reporting of industry payments received by OB/GYN guideline contributors to investigate whether outside influence or conflicts of interest exist.

Nonoperative treatment options for back pain are limited in efficacy and lack evidence of long term pain relief. Intradiscal injections of amniotic membrane and umbilical cord (AMUC) particulate may provide relief. To evaluate the effectiveness of AMUC particulate for discogenic pain, the authors evaluated the outcomes in 11 patients (20 discs).

Long acting reversible contraceptive use among women remains relatively low, despite their 99% effectiveness in preventing pregnancy. Researchers examine key barriers to LARC placement. To better understand barriers, the authors analyzed survey results from 224 providers (obstetricians and gynecologists, family physicians, pediatricians, internal medicine physicians, certified nurse practitioners, and certified nurse midwives) across the state of Ohio.

To further examine whether CV4 could induce uterine contractions and labor as part of the osteopathic manipulative treatment (OMT) protocol used in the Pregnancy Research in Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study, the authors analyzed labor and delivery data collected from 400 patients during the PROMOTE study from 2007-2011.