In case you missed it: Here are the top 5 posts this month

FDA approves a bedside test for assessing the risk of spontaneous preterm birth

QIAGEN won FDA approval for marketing its Novel PartoSure® point of care test for estimating the risk of spontaneous preterm birth in patients who present with symptoms of preterm labor. PartoSure represents a breakthrough in research and development of diagnostic tests for preterm birth.

Predicting preterm birth is a diagnostic challenge and nearly 85% of patients admitted to the hospital for threatened preterm labor (PTL) do not deliver within the next 7 days, resulting in unnecessary interventions.

https://obgynupdated.blogspot.com/2018/04/fda-approves-bedside-test-for-assessing.html

Medical management of adenomyosis: current and future therapies

The current issue of Journal of Fertility and Sterility has focused exclusively on etiology, pathophysiology, and medical and surgical treatment of adenomyosis. Adenomyosis has long been the source of controversy and its only with the recent advent of Transvaginal sonography (TVS) and MRI that its etiology and pathophysiology been better understood.

Adenomyosis is a uterine pathology in which the endometrial glands and stroma invaginate within the uterine myometrium. This ectopic endometrium induces hypertrophy and hyperplasia of the myometrium resulting in the typical ‘globular” enlargement of the uterus.

https://obgynupdated.blogspot.com/2018/04/medical-management-of-adenomyosis.html

Significant rise in hysterectomy complications observed following the FDA’s warning against power morcellator

A significant increase in major and minor complications following hysterectomy was noted in a large retrospective cohort study that was conducted after the US Food and Drug Administration (FDA) warned against the use of laparoscopic power morcellation during a hysterectomy in November 2014.

The study was published today April 11 in JAMA Surgery.

The warning was issued because of fear of dissemination of undiagnosed occult leiomyosarcoma in the benign fibroid mass.   

https://obgynupdated.blogspot.com/2018/04/significant-rise-in-hysterectomy.html

Addition of 24-chromosome microarray analysis to standard testing identifies a probable or definitive cause in over 90% of recurrent miscarriages

The new method of 24 Chromosome Microarray, or comprehensive chromosomal screening when added to the standard Recurrent Pregnancy Loss (RPL) evaluation of American Society for Reproductive Medicine (ASRM) could provide a probable or definitive cause in over 90% of patients reports the result of a small prospective cohort study published 1 April 2018 in Journal of Human Reproduction.

In the absence of definitive etiologies and treatment strategies, RPL is one of the most frustrating and difficult to treat entity in reproductive medicine. It affects 2%-5% of couples and a cause can be found only in 50% of the couples after undergoing the standard ASRM workup.

https://obgynupdated.blogspot.com/2018/04/addition-of-24-chromosome-microarray.html

A novel, single-use Foley’s catheter fixation device protects from accidental removal and trauma

Indwelling urinary catheters are very commonly used for inpatients in hospitals and people confined to bed in hospice and nursing homes. It is estimated that 25% of hospitalized patients have catheters placed during their hospital stay.

They are also associated with Urinary Tract Infections (UTI) and account for 70-80% of iatrogenic UTI in hospital and inpatient settings. But, genitourinary trauma is also common because of the inflated balloon during accidental pulling of Foley’s catheter.

https://obgynupdated.blogspot.com/2018/04/a-novel-single-use-foleys-catheter.html

Addition of 24-chromosome microarray analysis to standard testing identifies a probable or definitive cause in over 90% of recurrent miscarriages

http://www.ucl.ac.uk/

The new method of 24 Chromosome Microarray, or comprehensive chromosomal screening when added to the standard Recurrent Pregnancy Loss (RPL) evaluation of American Society for Reproductive Medicine (ASRM) could provide a probable or definitive cause in over 90% of patients reports the result of a small prospective cohort study published 1 April 2018 in Journal of Human Reproduction.

In the absence of definitive etiologies and treatment strategies, RPL is one of the most frustrating and difficult to treat entity in reproductive medicine. It affects 2%-5% of couples and a cause can be found only in 50% of the couples after undergoing the standard ASRM workup.

This single-center study included 100 patients from a private RPL clinic from 2014 to 2017. The maternal age was between 26 to 45 years.

All 100 women had two or more pregnancy losses, with a complete evaluation for RPL as defined by the ASRM, and miscarriage tissue evaluated by 24-chromosome microarray analysis after their second or subsequent miscarriage.

In 95 of 100 patients, a probable or definitive cause of pregnancy loss was identified when 24-chromosome microarray analysis was combined with the standard ASRM RPL workup evaluation at the time of second or subsequent miscarriage.

The standard ASRM RPL workup done alone could only identify an abnormality or cause of miscarriage in 45 of 100 patients while 24-chromosome microarray analysis identified an abnormality in 67 of 100 patients when performed as the initial test on miscarriage tissue.

In only 5 of 100 patients, no cause could be found even after combined testing by ASRM RPL workup and 24-chromosome microarray analysis.

The authors concluded that combining the standard workup and genetic evaluation on miscarriage tissue obtained at the time of the second and subsequent pregnancy losses could offer much more answers towards the probable or definitive cause of RPL. It should be routinely offered to couples who have had two or more consecutive pregnancy losses.

Abstract

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