J Reprod Med
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Upon completion of this article, the reader should be able to: 1. Identify the dermatologic drugs with the highest risk of teratogenicity. 2. List the essential information to be obtained from a woman with childbearing potential being considered for treatment with a teratogenic dermatologic agent. 3. ⋯ Dermatologic agents can be highly teratogenic, and the gynecologist must be aware of the issues involved in prescribing them. Prescribers should be aware of the risks and ensure that patients taking teratogens do not become pregnant during the course of therapy (or until the drug has been cleared from the body). This can involve taking menstrual and sexual histories and counseling the patient about sexual behavior and contraception.
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Review
"Be smart, be safe, be sure". The revised Pregnancy Prevention Program for women on isotretinoin.
After studying the information in this article, the reader should be able to: 1. Describe the purpose of the pregnancy prevention program. 2. Discuss the five most common reasons for unintended pregnancy. 3. ⋯ One such program is the Pregnancy Prevention Program, for use when prescribing isotretinoin to women with childbearing potential. Isotretinoin is a known teratogen and is prescribed disproportionately to teens, who are at higher risk of unintended pregnancy. The program has shown impressive effectiveness despite these handicaps, but since exposure to isotretinoin is so harmful to the fetus and some women still become pregnant while taking the drug, the program has been revised to reduce the failure rate further.
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Review Case Reports
Hemorrhagic ascites associated with endometriosis. A case report.
Endometriosis associated with massive, bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis, with the description of a case and a review of 31 others. ⋯ Bloody ascites should be considered a complication of endometriosis, especially in nulliparous women of childbearing age with abdominal distention, a pelvic mass, dysmenorrhea, abdominal pain, weight loss and eventual pleural effusion, suggesting a diagnosis of ovarian malignancy.
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Review
Evaluating chronic pelvic pain. A consensus recommendation. Pelvic Pain Expert Working Group.
To identify a comprehensive approach to evaluating women with chronic pelvic pain based on findings in the literature. ⋯ A comprehensive approach to chronic pelvic pain includes consideration of multiple organ systems, with empiric therapy appropriate after a thorough history and physical examination, to further delineate the pain problem.
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Postmenopausal bleeding is more prevalent than was previously thought, occurring in women regardless of whether or not they are on hormone replacement therapy. While estrogen-only regimens have been used for several beneficial effects, bleeding patterns associated with these regimens can be irregular and unpredictable, causing discomfort to the patient as well as increasing the risk of both endometrial hyperplasia and carcinoma. Studies in recent years have examined the effects of estrogen-only regimens as compared to different estrogen-plus-progestogen combination therapies to help regulate and minimize postmenopausal bleeding while providing endometrial protection.