Obstetrics and gynecology
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Obstetrics and gynecology · Jun 2015
ReviewEbola virus disease and Marburg disease in pregnancy: a review and management considerations for filovirus infection.
The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. As a result of the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus disease and Marburg disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of disease in nonpregnant individuals and pregnancy-specific data to inform management for pregnant women. ⋯ Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion as well as maintaining strict infection control to minimize transmission to others.
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Obstetrics and gynecology · Apr 2015
ReviewOral and intramuscular treatment options for early postpartum endometritis in low-resource settings: a systematic review.
To suggest options for oral and intramuscular antibiotic treatment of early postpartum endometritis in low-resource community settings where intravenous antibiotics are unavailable. ⋯ This review provides suggestions for oral, intramuscular, and combined antimicrobial regimens that may warrant additional study. Experimental trials should consider clinical effectiveness, safety and side effects profiles, and feasibility of community-based treatment.
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Obstetrics and gynecology · Apr 2015
ReviewOral and intramuscular treatment options for early postpartum endometritis in low-resource settings: a systematic review.
To suggest options for oral and intramuscular antibiotic treatment of early postpartum endometritis in low-resource community settings where intravenous antibiotics are unavailable. ⋯ This review provides suggestions for oral, intramuscular, and combined antimicrobial regimens that may warrant additional study. Experimental trials should consider clinical effectiveness, safety and side effects profiles, and feasibility of community-based treatment.
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Obstetrics and gynecology · Mar 2015
Editorial ReviewUnderrepresentation of women in clinical trials: why gynecologic oncologists are worried.
In gynecologic oncology, significant advances with improved patient outcomes have clearly and thankfully resulted from randomized clinical trials. The recent restructuring of cooperative groups and decreased funding for phase III clinical trials have unintentionally resulted in a 90% reduction of available trials and accrual in gynecologic oncology. ⋯ We suggest an opportunity for partnering with the U. S. government and the private sector to enhance research funding opportunities while increasing advocacy efforts to reinvigorate our clinical trials platform.
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This month we focus on current research in stillbirth. Dr. Andrews discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.