Low-risk moms face fewer complications with midwives

Pregnant patients with a low risk of birth problems who are cared for by a midwife will likely leave the hospital maternity unit having experienced fewer interventions and complications than if attended by an obstetrician, a new study has concluded.

Researchers reviewed data from the medical records of more than 20,000 women with no known medical or obstetric complications. The data involved 11 Pacific Northwest hospitals and spanned 2014 to 2018. Their findings indicated that women who were attended by midwives during labor had fewer interventions such as cesarean delivery or use of an epidural. The data was collected as part of the a perinatal quality-improvement effort to gather birth data for analysis and improvement of maternal and newborn outcomes.

The UW Medicine hospitals participating in the program include the University of Washington Medical Center and Northwest Hospital & Medical Center in Seattle and Valley Medical Center in Renton. The researchers included obstetricians, certified nurse-midwives, and epidemiologists from Washington, Oregon and Canadian hospitals and universities.

The study covered 23,100 births, of which 3,816 (14%) had labor managed by midwives and 19,284  who had labor management by obstetricians. The study involved singleton births between 37 and 42 weeks with no significant medical complications. Most of the mothers (53%) were 30 to 34 years old.

“Compared with obstetricians, midwifery patients had significantly lower intervention rates,” the authors. These patients wre less likely to have artificial rupture of membranes, labor induction, episiotomy, and use of vacuum or forceps. 

The midwife patients who were giving birth for the first time had an approximately 30% lower risk of cesarean delivery, the paper said. For mothers who had previously given birth, the midwife group had a 40% lower rate of cesareans compared with the obstetrician group. There was, however.  a higher incidence of shoulder dystocia, a complication of vaginal birth, in the midwife-attended group.

For more information regarding the session on Gynecology Congress 2020 during April 27-29, 2020 at San Francisco, USA.

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Gynecologic oncology

Gynecologic oncologists offer an integrated approach to the diagnosis and surgical management of women's cancers and complex benign gynecologic diseases. These include cervical cancer, endometriosis, fibroids, ovarian cancer, pelvic masses, uterine cancer, vaginal cancer and vulvar cancer.

When you visit Mayo Clinic in Arizona, Florida or Minnesota for one of these conditions, you will benefit from the collaborative care of an integrated team of specialists. Your gynecologic oncologist works with the Mayo Clinic Cancer Center to provide leading-edge care to people who have not had success with an approved treatment. The Mayo Clinic Cancer Center is one of only 41 National Cancer Institute-designated comprehensive cancer centers in the United States and the only such program in Arizona. You will have access to the knowledge and skills of physicians and researchers in every medical specialty and, where appropriate, to clinical trials for promising treatments under investigation.

Innovative treatment options

Your doctor will talk with you about a full range of effective, innovative treatment options. Mayo Clinic gynecologic oncology surgeons are expert in complex laparoscopic and robotic approaches, fertility-sparing surgery, and risk reduction procedures for inherited cancer syndromes:

·        Advanced laparoscopic surgery. This is an effective minimally invasive technique that has been shown to result in shorter hospital stays, less discomfort and a shorter recovery period.

·        Robotic surgery. This approach has the same advantages as advanced laparoscopy, and it allows surgeons to operate with increased precision and accuracy while minimizing trauma to surrounding tissues.

·        Intraoperative radiation therapy (IORT). This radiation technique is used to treat advanced cancers that are localized but have spread from the original tumor site in people who might otherwise have no treatment options. In IORT, the equipment is brought directly into the operating room, and a high dose of radiation is administered directly to the cancer site during surgery. Mayo Clinic is one of only about 10 medical centers in the world offering this treatment option.

Intraperitonealchemotherapy. This technique involves the direct delivery of chemotherapy into the abdomen for treatment of ovarian cancer. National Cancer 
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MATERNAL-FETAL MEDICINE

The Society for Maternal-Fetal (SMFM) released the following statement in response to the published results of "Progestin's Role in Optimizing Neonatal Gestation," more commonly referred to as the PROLONG trial, which was recently published in the American Journal of Perinatology.

The PROLONG trial assessed the effectiveness of weekly injections of 17-alpha-hydroxyprogesterone caproate (17-OHPC) in reducing the incidence of recurrent preterm birth and neonatal morbidity. Between 2009 and 2018, this study enrolled more than 1,700 pregnant patients from nine countries and ultimately concluded that 17-OHPC does not decrease recurrent preterm birth or neonatal morbidity.

A previous large randomized control trial (Meis, 2003) also examined the effectiveness of 17-OHPC. Unlike PROLONG, this study found a 34% reduction in the incidence of recurrent preterm birth and significant reductions in several neonatal complications.

In comparing the conflicting results of the PROLONG and Meis trials, one important consideration is the different populations studied. The Meis trial included a larger proportion of patients with additional risk factors for preterm birth. For example, 20% of the patients in the Meis trial reported smoking, compared to 8% in the PROLONG Trial. Other meaningful differences in the populations included:

• Race/Ethnicity
• Number of previous preterm births
• Marital status
• Reported substance use

·        SMFM has reviewed the results of the PROLONG trial and has released the SMFM Statement: Use of 17-alpha hydroxyprogesterone caproate for prevention of recurrent preterm birth, which recommends that obstetric care providers use an individualized approach as they council patients regarding the use of 17-OHPC. It is reasonable for providers to continue to use 17-OHPC in the context of a shared decision-making model that includes consideration of risk level for recurrent PTB. Important factors to discuss include: uncertainly regarding the benefit, the lack of short-term safety concerns, the possibility of injection site pain, extra patient visits, and substantial costs.

·        Further, SMFM recommends additional research on 17-OHPC to identify populations in whom it is likely to be effective.

·        SMFM's complete, updated clinical guidance will be published in the American Journal of Obstetrics and Gynecology, can be found on the SMFM website, and will be addressed on Tuesday, October 29, 2019 at meeting of the Food and Drug Administration's Bone, Reproductive and Urologic Drugs Advisory Committee.

Source: News Medical Life Sciences

For more information about the Gynecology Congress 2020 at San Francisco,USA during April 27-29, 2020

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PREGNANCY

Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. A pregnancy may end in a live birth, abortion, or miscarriage, though access to safe abortion care varies globally. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP). This is just over nine months, where each month averages 31 days. When measured from fertilization it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following fertilization, after which, the term fetus is used until birth. Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.

Pregnancy is divided into three trimesters. The first trimester is from week one through 12 and includes conception, which is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus, where it begins to form the embryo and placenta. During the first trimester, the possibility of miscarriage (natural death of embryo or fetus) is at its highest. The second trimester is from week 13 through 28. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided with high-quality medical care. The third trimester is from 29 weeks through 40 weeks.

Prenatal care improves pregnancy outcomes. Prenatal care may include taking extra folic acid, avoiding drugs and alcohol, regular exercise, blood tests, and regular physical examinations. Complications of pregnancy may include disorders of high blood pressure, gestational diabetes, iron-deficiency anemia, and severe nausea and vomiting among others. In the ideal childbirth labor begins on its own when a woman is "at term".Babies born before 37 weeks are "preterm" and at higher risk of health problems such as cerebral palsy. Babies born between weeks 37 and 39 are considered "early term" while those born between weeks 39 and 41 are considered "full term". Babies born between weeks 41 and 42 weeks are considered "late term" while after 42 week they are considered "post term". Delivery before 39 weeks by labor induction or caesarean section is not recommended unless required for other medical reasons.

For more information regarding the session on Gynecology Congress 2020 at San Francisco, USA During April 27-29, 2020

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Vaginal infections during pregnancy

The surge in hormones during pregnancy make moms-to-be more susceptible to a host of vaginal infections. A woman’s body transforms in many ways during pregnancy and an increase in vaginal discharge is one of the common changes.

If the discharge is white or clear and odour-free, it means it is caused by the pregnancy hormones and your vagina is healthy. But if the discharge is excessive, red or yellow and smells, it can be a sign of an infection. Vaginal infection happens when the natural balance of the bacteria that live in the vagina is disrupted.

Bacterial Vaginosis (BV)

Almost 1 in every 5 pregnant women develop this itchy infection, according to the National Institutes of Health. BV occurs when there is an overgrowth of bacteria in the vagina due to the shifting of hormones. If left untreated, it can lead to premature birth or low birth weight of the baby.

Yeast infection

The overgrowth of candida can lead to burning and itching in the vagina, which can be suspected as a yeast infection. The increased estrogen and progesterone help create the environment in which yeast can thrive. Some antibiotics can also disrupt the pH balance of your vagina.

Common steps to prevents vaginal infections:

- Wear comfortable cotton underwear. Avoid wearing tight pants that can cause bacteria inducing sweat.

- Never sit around in swimsuit or wet panty after swimming. Change immediately into a clean cotton panty.

- Sleep without underwear to reduce the risk of infections.

- Wipe front to back when you go to the bathroom.

- Skip bathing oils as they can trap bacteria.

- Stay hydrated to help flush out toxins.

- Eat complex carbohydrates and whole grains instead of refined sugar.

- Consume yogurt often.

- Stick to one partner to decrease your chances.

- Use a condom to prevent the spreading of the infection.

For more details regarding the session in Gynecology Congress 2020 at San Francisco, USA during April 27-29, 2020

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Polycystic Ovarian Syndrome 

Polycystic ovarian syndrome (PCOS, polycystic ovary syndrome) is a relatively common hormonal disorder that causes a number of different symptoms in women of reproductive age. Common to all women with PCOS is an irregularity in the menstrual cycle and the presence of excess male hormones (androgens).

The condition was named because of the finding of enlarged ovaries containing multiple small cysts (polycystic ovaries). Although most women with PCOS have polycystic ovaries, some affected women do not. PCOS has also been referred to as Stein-Leventhal syndrome and polycystic ovarian disease (PCOD).

Symptoms

PCOS leads to disruptions in the menstrual cycle that typically begin around the onset of puberty. The menstrual irregularities of PCOS are accompanied by a lack of ovulation, so affected women may experience infertility.

An increase in the production of androgens (male hormones) by the ovaries in PCOS may lead to excess hair growth in areas suggesting a male pattern, known as hirsutism. Thick, pigmented hair growth occurs on the upper lip, chin, around the nipples, and on the lower abdomen.

Because of the absence or reduction in ovulation, women with PCOS have reduced levels of the hormone progesterone. This can result in growth stimulation of the endometrium,  leading to dysfunctional uterine bleeding and breakthrough bleeding. Increased stimulation of the endometrium in the absence of progesterone production is a risk factor for the development of endometrial hyperplasia and uterine cancer.

Insulin resistance, weight gain, and obesity are also common in PCOS. Observers have suggested that about one-half of women with PCOS are obese. Insulin resistance, accompanied by elevated blood levels of insulin, occurs in most women with PCOS, independent of the presence of obesity.

For more information regarding the session on Gynecology Congress 2020 at San Francisco during April 27-29, 2020

PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

Surgical Equipment Market

Surgical equipment are tools that are designed to view internal body organs or modify biological tissues. They are used for various surgical procedures such as neurosurgery, urology, laparoscopic, plastic surgery, cardiovascular, and others. Surge in prevalence of chronic disorders among geriatric population, increase in number of surgical procedures, and increase in demand for surgical procedures such as minimally invasive surgeries and laparoscopic surgeries act as the major drivers of the global surgical equipment market.

Key Findings of the Surgical Equipment Market:

Closure devices was the major contributor to the revenue of surgical auxiliary instruments in 2016 and is anticipated to maintain this trend throughout the forecast period. Lancets/Scalpels registered highest growth in the surgical cutter instruments market during the forecast period. Retractors is anticipated to grow at the fastest pace in the handheld surgical instruments market during the forecast period. Europe accounted for one-third of total market share in 2016 and is expected to maintain this trend throughout the forecast period. UK is anticipated to grow at the fastest pace in the European surgical equipment market during the forecast period.

Geographically, the surgical equipment market is studies across North America, Europe, Asia-Pacific, and LAMEA. North America dominated the surgical equipment market in 2016, accounting for three-sevenths of the total market. This was attributed to well-established healthcare system in North America, high adoption of innovative minimal invasive & laparoscopic surgical procedures, rise in prevalence of chronic diseases & related surgical procedures, and surge in demand for plastic & reconstructive & bariatric surgeries.

For more details regarding the session on Gynecology Congress 2020 at San Francisco, USA during April 27-29, 2020

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Email: gynecologycongress@frontierscongress.com