American College of Obstetricians and Gynecologists, May 4-8, 2013

The 61st Annual Clinical Meeting of the American College of Obstetricians and Gynecologists

The annual meeting of the American College of Obstetricians and Gynecologists was held from May 4 to 8 in New Orleans and attracted approximately 3,200 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in obstetrics and gynecology. The conference highlighted recent advances in the prevention, detection, and treatment of conditions impacting women, with presentations focusing on the advancement of health care services for women worldwide.

In a retrospective study, Dorothea J. Mostello, M.D., of Saint Louis University, and colleagues found that the combination of metoclopramide administered with diphenhydramine was effective in reducing headaches in women during pregnancy.

"The combination of metoclopramide and diphenhydramine is effective headache treatment for obstetric patients, especially when acetaminophen fails to provide relief," said Mostello. "Physicians who care for pregnant women will have another tool in their armamentarium for treating headache."

The investigators only studied intravenous administration of the drug combination, so the effects of an orally administered combination remain unknown.

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In an effort to evaluate the effects of oxytocin on newborns, Michael S. Tsimis, M.D., of the Beth Israel Medical Center in New York City, and colleagues evaluated more than 3,000 women delivering full-term infants from 2009 to 2011 who were induced or augmented with oxytocin (Pitocin).

"After controlling for confounding factors, we see that neonatal intensive care unit admissions beyond 24 hours and Apgar scores <7 at five minutes are significantly elevated with the use of Pitocin for induction or augmentation," said Tsimis. "Pitocin has become inextricably linked to obstetric management but its safety with regards to neonatal outcomes should not go unacknowledged."

Tsimis recommends that practitioners who more routinely use Pitocin should be more cautious in the use of the drug due to the neonatal outcomes at risk.

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Sue Park, M.D., of the University of California at Los Angeles/Cedars-Sinai Medical Center, and colleagues found that there is no increased risk of complications with performing salpingectomy at time of hysterectomy with ovarian preservation compared to hysterectomy alone.

"By implementing routine salpingectomy into standard practice at our institution, we saw a marked rise in provider incorporation of bilateral salpingectomy at time of hysterectomy with ovarian preservation, from 3 to 73 percent. Patient acceptance approached 100 percent," said Park. "Moreover, when we carried out a 2:1 case control trial, there were no significant increases in surgical morbidities when comparing EBL, operating room time, complications, length of stay, and readmission rates."

Park suggests that clinicians can be confident when counseling patients that salpingectomy at time of hysterectomy does not add any additional surgical morbidity.

"Previous studies have suggested a potential role of salpingectomy as a risk-reducing strategy for certain serous carcinomas and post-hysterectomy adnexal masses. This study assures the safety of performing routine salpingectomy at time of hysterectomy, regardless of route (abdominal, laparoscopic, vaginal)," said Park.

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ACOG: Better Outcomes for IVF by Single-Embryo Transfer

THURSDAY, May 9 (HealthDay News) -- Women who undergo in vitro fertilization by transfer of a single embryo that has undergone screening for genetic abnormalities have significantly better obstetric and neonatal outcomes than women who receive two embryos, according to a study presented at the annual meeting of the American College of Obstetricians and Gynecologists, held from May 4 to 8 in New Orleans.

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ACOG: Most Hospitals Have Implemented Induction Policies

MONDAY, May 6 (HealthDay News) -- Policies addressing non-medically-indicated induction before 39 weeks of gestation have been implemented by many hospitals and they are having a positive impact, according to two studies presented at the annual meeting of the American College of Obstetricians and Gynecologists, held from May 4 to 8 in New Orleans.

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ACOG: Nutritional Components of Diet Impact Fertility

MONDAY, May 6 (HealthDay News) -- Fecundity seems to be related to the nutritional components of diet, with high protein intake linked to improved blastocyst development and pregnancy rates, according to a study presented at the annual meeting of the American College of Obstetricians and Gynecologists, held from May 4 to 8 in New Orleans.

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