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American College of Obstetricians and Gynecologists, May 3-7, 2008

56th Annual Meeting of the American College of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists (ACOG) 56th Annual Clinical Meeting convened in New Orleans from May 3-7, 2008, and included thousands of physicians and other experts from around the world. Conference highlights included sessions dedicated to discussing health care reform and bioethical issues. In addition, poster sessions presented the latest research on a variety of topics, including advances in contraception, management of dysfunctional uterine bleeding, screening for cervical and ovarian cancer, and issues in urogynecologic surgery.

The need for health care reform was highlighted at the conference. A leading health care economist who spoke during the meeting's opening session, Gail Wilensky, discussed key reform areas, including controlling spiraling health costs, improving patient safety and improving appropriateness of delivered care. ACOG president Kenneth L. Noller, M.D., who moderated the talk, expressed the ACOG's commitment to health care reform: "We strongly believe that quality assurance and patient safety programs are pivotal to advancing women's health. We will advocate for these important issues in any and all health care reform."

Reforming the medical malpractice system was another key topic discussed at the conference. "America's medical liability crisis is severely threatening the future of women's health," explained Noller. "ACOG believes a comprehensive, multi-pronged approach is needed to address the liability problem, and it likely will require innovative and effective solutions."

Robert C. Lyneham, M.D., chair of the Medicolegal Committee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, described Australia's experience in finding solutions to its medical liability crisis, which included collaboration between government, business and medical professionals. Because complaints had been made about misuse of expert witness testimony, the College decided to introduce an "Expert Witness Register," which required that physicians meet certain criteria before serving as expert witnesses. In the future, completion of an expert witness training program will be required as a prerequisite to be listed on the register.

Noteworthy research presented at the conference included data on a new non-hormonal vaginal contraceptive ring, which acts by blocking sperm motility. Guiseppi Del Priore, M.D., of New York Presbyterian Healthcare Center in New York City, presented preliminary data on the Ovaprene ring (Poly-Med, Inc). The ring acts by eluting ferrous gluconate, which binds to sperm and interferes with motility. The ring was safe and well-tolerated in preliminary studies, and postcoital testing revealed complete absence of sperm motility. "This was just a safety and tolerability study, so we can't really say anything about its actual contraceptive efficacy, but since we saw a 100 percent lack of motility on the slides, theoretically we think it would be an effective device," explained Del Priore in a statement.

Bliss Kaneshiro, M.D., of the University of Hawaii in Honolulu, won first prize for her research examining the impact of body mass index on sexual behavior. Kaneshiro and colleagues found that, contrary to some physicians' biases, women who are overweight or obese did not differ from normal weight women in objective measures of sexual behavior. "This study indicates that all women deserve diligence in counseling on unintended pregnancy and STD prevention, regardless of body mass index," noted Kaneshiro.

In another study, Ozgul Muneyyirci-Delale, M.D., of SUNY Downstate Medical Center in Brooklyn, N.Y., performed endovaginal ultrasound on premenopausal women with dysfunctional uterine bleeding and biopsied the endometrial lining of women who had evidence of a thickened endometrium. She found that over 50 percent of these women had endometrial hyperplasia, meaning they were at risk for developing endometrial cancer, and two patients, one of whom was only 29, had already developed cancer. Muneyyirci-Delale noted that after treatment with megesterol acetate, the dysfunctional uterine bleeding and hyperplasia resolved in the vast majority of patients.

ACOG: Intrauterine Device Has Benefits Beyond Contraception

THURSDAY, May 8 (HealthDay News) -- The intrauterine device, in addition to being an effective contraceptive, may also provide protection against endometrial cancer, according to an update in contraception lecture presented at the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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ACOG: Maternal Blood Test May Predict Meconium Risk

WEDNESDAY, May 7 (HealthDay News) -- Maternal serum inhibin-A levels during the second trimester of pregnancy may help predict which deliveries will be complicated by meconium passage, according to research presented this week at the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in New Orleans.

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ACOG: Embryo Screening Raises Bioethical Concerns

WEDNESDAY, May 7 (HealthDay News) -- Advances in the field of reproductive technology offer couples wishing to conceive unprecedented choices, such as the ability to avoid inherited disease in their offspring, but also create new ethical dilemmas, according to a speech delivered during the opening session of the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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ACOG: Lawsuits Can Result from Poor Communication

WEDNESDAY, May 7 (HealthDay News) -- Solutions to the medical malpractice crisis should focus on the root cause of why patients sue doctors in the first place, argues a legal expert who delivered a symposium on medical malpractice reform at the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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ACOG: Caesarean Rate Rises As Malpractice Premiums Soar

TUESDAY, May 6 (HealthDay News) -- Rising medical malpractice premiums may be related to increasing rates of Caesarean delivery and declining rates of operative vaginal delivery at a Connecticut hospital between 1991 and 2005, according to research findings presented at the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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ACOG: Breast-Feeding Content of Ob-Gyn Textbooks Lacking

TUESDAY, May 6 (HealthDay News) -- Popular obstetrics and gynecology textbooks lack the most current information on breast-feeding, and often omit key content such as normal breast-feeding patterns and strategies to improve breast-feeding rates, according to research findings presented at the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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ACOG: Rising Health Care Costs Top Reform Agenda

TUESDAY, May 6 (HealthDay News) -- The spiraling cost of health care should be the number-one priority of health care reform in the United States, according to a leading health care economist who delivered the Samuel A. Cosgrove Memorial Lecture, "The Future of Health Care," during the opening session of the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held this week in New Orleans.

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