Ovarian cysts: presence and persistence with use of a 13.5mg levonorgestrel-releasing intrauterine system.

Objective: The aim of this study was to assess the presence of ovarian cysts in women using a new low-dose levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 13.5mg [total content]).

Study Design: A Phase 3 study assessed LNG-IUS 13.

Stopping menopausal hormone therapy: if breast cancer really decreased, why did colorectal cancer not increase?

Objective: The Women's Health Initiative (WHI) study of postmenopausal hormone therapy (HT) found that estrogen plus progestogen therapy (EPT) decreased colorectal cancer risk. Thus, the decline in EPT use from 2002 to 2003 should have precipitated an increase in the incidence of colorectal cancer. We tested this prediction using the SEER 9 epidemiologic database.

Burden of illness of hypertension among women using menopausal hormone therapy: a US perspective.

Objective: To estimate the burden of illness (BOI) of hypertension in a cohort of women receiving menopausal hormone therapy (HT).

Methods: Patients with at least one prescription for menopausal HT were selected from the PharMetrics database during the period July 1, 2003, to June 30, 2005. Hormone therapy patients were divided into those with and without hypertension.

The breast cancer "plunge" after initial publication of the WHI results: an alternative explanation.

From 2002 to 2003, the breast cancer incidence in the United States, as reported by the National Cancer Institute's Surveillance Epidemiology and End Results (SEER 9) database, appeared to decrease by 6.7%. This phenomenon has been attributed to a reduction in the use of menopausal hormone therapies after the initial publication of the Women's Health Initiative (WHI) study results in July of 2002.

Prevalence and opinions of hormone therapy prior to the Women's Health Initiative: a multinational survey on four continents.

Objective: Hormone therapy (HT) is a well-established form of treatment for menopausal symptoms worldwide. Since 2002 when the initial findings of the Women's Health Initiative (WHI) were published, the use of HT has decreased dramatically. This investigation was conducted immediately prior to the initial publication of the WHI and Million Women's Study results and quantifies menopausal women's prevalence of symptoms across nine countries on four continents.

A computerized method for accurately predicting fetal macrosomia up to 11 weeks before delivery.

Objective: To improve the prediction of birth weight and fetal macrosomia by combining sonographically derived fetal biometric data with routinely recorded pregnancy-specific information.

Study Design: Retrospective data were obtained for 218 normal gravidas who had obstetrical ultrasonography performed within 11 weeks of delivery. Multiple regression was employed to derive a set of equations for predicting birth weight that used different combinations of ultrasonographic and pregnancy-specific variables.

Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks.

Objective: Over ten million women are either pregnant or lactating in the United States at any time. The risks of medication use for these women are unique. In addition to normal physiologic changes that alter the pharmacokinetics of drugs, there is the concern of possible teratogenic and toxic effects on the developing fetus and newborn.

Evaluating medical student obstetrics and gynecology clerkship performance: which assessment tools are most reliable?

Objective: This study was undertaken to investigate medical student performance on an obstetrics and gynecology (Ob-Gyn) core clerkship to determine the most discriminating measures of student performance.

Study Design: Four-hundred twenty-one clinical clerks were assessed with the use of 46 performance indicators in 4 different categories. Final Scores were weighted: (1) Clinical Performance = 60%, (2) Formal Presentation = 10%, (3) Oral Examination = 10%, and (4) National Board of Medical Examiners (NBME) Subject Test score = 20%.

Preventing ectopic pregnancies: how often does transperitoneal transmigration of sperm occur in effecting human pregnancy?

Objective: Transperitoneal transmigration of sperm constitutes the mechanism by which ectopic pregnancies occur in unilaterally obstructed fallopian tubes. This study was undertaken to determine how often sperm transmigrate across the peritoneal cavity to effect human pregnancy.

Design: In women with non-communicating rudimentary uterine horn pregnancies, the ratio of total uterine horn pregnancies to prior contralateral hemi-uterine pregnancies was calculated to infer the overall transperitoneal sperm transmigration rate.

Hemoglobin, altitude and birth weight: does maternal anemia during pregnancy influence fetal growth?

Objective: To investigate the relationship between maternal hemoglobin concentration, altitude and birth weight.

Study Design: Birth weights in 235 term pregnancies were investigated for their dependence on maternal hemoglobin concentration after other maternal and pregnancy-specific influences on fetal weight were taken into account. The additional predictive value of hemoglobin concentration on birth weight was assessed using multiple regression.

Prediction of term birth weight in Hispanic women using an equation based on maternal characteristics.

Objective: To test the accuracy of a birth weight prediction equation based on maternal characteristics in Hispanic women.

Study Design: A previously published birth weight prediction equation based on maternal and pregnancy-specific characteristics was used to predict birth weights for 283 normal Caucasian women of Hispanic ethnicity. The accuracy of these birth weight estimates was compared to a similarly selected group of 233 non-Hispanic Caucasian gravidas who were located 2500 miles away.

Relationship of paternal factors to birth weight.

Objective: To investigate the relationship between paternal characteristics and birth weight.

Study Design: A total of 241 gravidas with uncomplicated, singleton, term pregnancies were studied. Maternal demographic and pregnancy-specific characteristics were used to calculate the expected birth weight for each fetus using a previously validated birth weight prediction equation.

Ultrasonic prediction of term birth weight in Hispanic women. Accuracy in an outpatient clinic.

Objective: To investigate the accuracy of ultrasonic fetal biometric algorithms for estimating term fetal weight.

Study Design: Ultrasonographic fetal biometric assessments were made in 74 Hispanic women who delivered at 37-42 weeks of gestation. Measurements were taken of the fetal biparietal diameter, head circumference, abdominal circumference and femur length.

Ultrasonographic prediction of term birth weight: how accurate is it?

Objective: The purpose of this study was to investigate the accuracy of 25 ultrasonic algorithms for the estimation of term fetal weight and to compare these results to an equation that is based on maternal and pregnancy-specific characteristics alone.

Study Design: Ultrasonography was performed in 82 nondiabetic gravid women at 35 to 41 weeks of gestation. Fetal biparietal diameter, abdominal circumference, head circumference, and femur length were measured.

Validation of a birth weight prediction equation based on maternal characteristics.

Objective: To validate the accuracy of a birth weight prediction equation based on maternal and pregnancy-specific characteristics and to assess its value in predicting fetal macrosomia.

Study Design: A previously published birth weight prediction equation based on maternal and pregnancy-specific characteristics was used to predict birth weight in 244 Caucasian gravidas with uncomplicated, singleton, term pregnancies. Results were assessed by calculating the mean absolute error, the mean absolute percentage error and the percentage of birth weights correctly predicted to within +/- 10% and +/- 15% of actual birth weight.

Early-pregnancy glucose screening for gestational diabetes mellitus.

Objective: To determine the accuracy of the 50-g, one-hour glucose screening test administered at 16 weeks of pregnancy for identifying women with gestational diabetes mellitus.

Study Design: Two hundred fifty-five women underwent 50-g, one-hour glucose screening tests at 16 weeks of pregnancy. Those with results > or = 135 mg/dL underwent 100-g, three-hour glucose tolerance tests.

Correlation between one-hour, 50-g glucose screening values in successive pregnancies.

Objective: To investigate the relationship between one-hour, 50-g oral glucose screening test results in successive pregnancies and to assess the risk of gestational diabetes in women who had a previously negative glucose screening test during a prior pregnancy.

Study Design: Sixty-nine women were studied who had successive pregnancies delivered at intervals ranging from one to four years. All had glucose screening tests performed at 24-32 weeks of gestation during both pregnancies.

Predicting fetal weight. Are Leopold's maneuvers still worth teaching to medical students and house staff?

Objective: To assess the value of teaching Leopold's maneuvers to medical students and house staff physicians for the purpose of estimating term fetal weight.

Study Design: Forty-four patients between 37 and 42 weeks of gestation were asked to estimate their fetus's weight upon presentation for delivery. A medical student or house staff physician then performed Leopold's maneuvers to assess fetal weight manually.

Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases.

Objective: To investigate the outcomes of rudimentary uterine horn pregnancies and to identify trends and opportunities for improvement in patient care.

Study Design: During the period 1900-1999, 588 cases of rudimentary uterine horn pregnancy were identified using both manual and computerized searches of Index Medicus, Excerpta Medica and the Index-Catalogue of the Library of the Surgeon-General's Office of the United States Army as well as standard reference tracing. Nine characteristics of each case were evaluated: (1) fetal status at birth, (2) maternal survival, (3) neonatal survival, (4) gestational age at delivery, (5) whether the rudimentary horn ruptured, (6) communication status of the horn with the contralateral hemiuterus, (7) gravidity and parity, (8) side of the horn, and (9) order of the gestation.