Is the age of cervical cancer diagnosis changing over time?

Objectives: The objective of this study was to determine if there has been an increase in the age of diagnosis of cervical cancer over time, specifically in the proportion of patients over 65 years old, given decreasing rates of hysterectomy.

Materials And Methods: A retrospective review of a single institution was conducted including cervical cancer patients seen between 1986 and 2016. Data included demographic variables including age of diagnosis, last cervical cancer screening, and cancer information.

Effect of Obesity on Cervical Cancer Screening and Outcomes.

Objectives: The aims of the study were to identify whether obese women are less appropriately screened for cervical cancer before diagnosis and to explore related cancer outcomes.

Methods: We retrospectively reviewed all cervical cancer patients at a single institution between 1986 and 2016 and collected demographic information including age, cancer stage, body mass index (BMI), screening information, and cancer outcomes. Morbid obesity was defined as BMI of 40 kg/m or greater, obesity as BMI of 30 to less than 40 kg/m, and nonobese as BMI of less than 30 kg/m.

Efficacy-based Contraceptive Counseling for Women Experiencing Homelessness in Iowa City, Iowa.

This study evaluated homeless women's contraception knowledge and demonstrated improved knowledge following efficacy-based contraceptive counseling. Women were surveyed using a pre-test then post-test following standardized efficacy-based contraceptive counseling. 47 women participated.

Prevalence, attitudes and knowledge of misoprostol for self-induction of abortion in women presenting for abortion at Midwestern reproductive health clinics.

In the setting of increasing restrictions to legal abortion in the United States, reports have emerged of self-induced termination of pregnancies with misoprostol, obtained without a prescription or provider. This study seeks to describe the prevalence of women seeking or employing misoprostol for self-induced abortion, and how they access information. In a cross-sectional study of women immediately following their abortion at three reproductive health clinics in the Midwestern United States, an anonymous survey queried gestational age, barriers, online investigation about self-induction and opinions concerning the availability of medical abortion.

Abortion providers' experiences and views on self-managed medication abortion: an exploratory study.

Objective: Data on the practice of self-managed medication abortion are limited, in part because this practice takes place purposefully outside of established healthcare systems. Given this, we aimed to ascertain abortion providers' familiarity with self-managed medication abortion and associated complications, compare regional differences and evaluate provider attitudes.

Study Design: We distributed an online survey to members of Society for Family Planning, Association of Reproductive Health Providers and the Abortion Care Network between July and September 2017 querying experiences with and opinions about self-managed abortion.

Unintentionally Retained Foreign Objects: A Descriptive Study of 308 Sentinel Events and Contributing Factors.

Objective: Unintentionally retained foreign objects (URFOs) remain the sentinel events most frequently reported to The Joint Commission. The objective of this study was to describe reports of URFOs, including the types of objects, anatomic locations, contributing factors, and harm, in order to make recommendations to improve perioperative safety.

Methods: A retrospective review was undertaken of events involving URFOs reported to The Joint Commission from October 2012 through March 2018.

Retained surgical sponges: a descriptive study of 319 occurrences and contributing factors from 2012 to 2017.

Background: Unintended retention of foreign bodies remain the most frequently reported sentinel events. Surgical sponges account for the majority of these retained items. The purpose of this study was to describe reports of unintentionally retained surgical sponges (RSS): the types of sponges, anatomic locations, accuracy of sponge counts, contributing factors, and harm, in order to make recommendations to improve perioperative safety.

A randomized controlled trial comparing two types of retractors at caesarean delivery.

The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day.

Deep sedation without intubation during second trimester surgical termination in an inpatient hospital setting.

Objectives: Safety of outpatient dilation and evacuations with intravenous (iv) sedation without intubation has been demonstrated, but there is a paucity of data on deep iv sedation on an inpatient second trimester surgical termination population. The purpose of this study is to evaluate complications of deep sedation with propofol without the use of intubation during second trimester surgical terminations in an inpatient teaching institution.

Study Design: A retrospective chart review of all obstetrical and anesthetic data from inpatient dilation and evacuations between gestational ages 15 0/7 and 24 0/7 during the years 2002 to 2015.

Effect of Single-Use Negative Pressure Wound Therapy on Postcesarean Infections and Wound Complications for High-Risk Patients.

Objective: To evaluate the effect of a single-use negative pressure wound therapy (NPWT) system on postoperative complications after cesarean delivery.

Study Design: A historical control cohort of women was collected as part of a quality improvement project over a 6-month period. All women with at least 1 risk factor for postoperative complications were included in this control cohort.

Management of cesarean scar pregnancy in the second trimester: a report of three cases.

Background: A modern entity of the cesarean scar pregnancy with or without uterine dehiscence has been described and is increasing in incidence. Early diagnosis is difficult, and management in the second trimester poses a significant clinical challenge. The best options for management are unclear due to lack of data in this area.

Intensity and unpleasantness of pain following vaginal and cesarean delivery: a prospective evaluation.

Background: To date, most studies evaluating pain associated with cesarean birth have focused on delivery procedures or postoperative pain control methods rather than on the nature or severity of the pain experience of women, despite the increasing incidence and maternal requests for cesarean delivery. The objective in this study was to evaluate sensory, affective, and laterality aspects of pain after cesarean delivery and vaginal delivery.

Methods: A prospective cohort study using a seven-item visual analog scale assessed pain at rest and with activity, and the unpleasantness and location of pain on postpartum days 1 and 2.

Immune responses in infants whose mothers received Tdap vaccine during pregnancy.

Background: The effect of maternal Tdap vaccination on infant immunologic responses to routine pediatric vaccines is unknown.

Methods: This was a cohort study of infants whose mothers received or did not receive Tdap vaccine during pregnancy. Maternal and cord blood samples were collected at delivery; infant blood samples were collected before and after primary series and booster dose of diphtheria, tetanus, and acellular pertussis (DTaP) and other vaccines.

Vaginal misoprostol aids in difficult intrauterine contraceptive removal: a report of three cases.

Background: Intrauterine devices are the most used long-acting reversible contraceptive method worldwide. Under normal circumstances, removal of an intrauterine contraceptive (IUC) is an uncomplicated procedure requiring gentle traction on the string.

Study Design: We report three cases of nonvisible IUC strings where, following use of vaginal misoprostol, the IUC strings were visualized and the IUCs were removed intact with gentle traction.

Asthma in pregnancy: pathophysiology, diagnosis and management.

Asthma is a common, potentially serious, even life-threatening, chronic medical condition seen amongst nearly all groups of patients, regardless of ethnicity and socioeconomic circumstances. This article addresses the group of pregnant women with symptomatic asthma as well as those whose asthma is asymptomatic as a result of good control. The incidence, the pathophysiologic changes of pregnancy, and the interplay between these changes and asthma are reviewed in this article.