American College of Obstetricians and Gynecologists, May 3-6
The annual meeting of the American College of Obstetricians and Gynecologists was held from May 3 to 6 in Nashville, Tennessee, and attracted more than 3,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in obstetrics and gynecology. The conference highlighted recent advances in the prevention, detection, and treatment of conditions impacting women, with presentations focusing on the advancement of health care services for women worldwide.
In one study, Annelise Marie Wilhite, M.D., of the University of Minnesota in Minneapolis, and colleagues found that almost one-third of patients who have a BRCA mutation are not receiving full guideline-based care when they undergo risk-reducing salpingo-oophorectomy.
"Gynecologic oncologists were more likely to follow all aspects of the surgical guidelines compared to obstetrician-gynecologists (91 versus 41 percent), which could have contributed to the higher detection rates of occult neoplasm in this group (6.3 versus 0.8 percent). Given similar patient populations, we expected to see a similar rate of occult malignancy in the two groups," Wilhite said. "Our results highlight a need for improved education regarding the guidelines, as well as the importance of communication between the surgeon and pathologist to ensure the pathologist is aware of the indication for the procedure to ensure that microsectioning of the specimen and comprehensive pathology review is done."
In another study, Emily Staudenmaier, D.O., of the Good Samaritan Hospital Medical Center in West Islip, New York, and colleagues performed a retrospective chart review comparing mode of delivery between obese women who presented for elective induction of labor after 39 weeks and those presenting in spontaneous labor.
The investigators found that obese women who undergo elective induction are at higher risk for cesarean delivery (43.3 percent) compared with obese women who presented in spontaneous labor (27.8 percent). This increased risk for cesarean delivery was most pronounced in primiparous obese women presenting for elective induction, with a cesarean delivery rate of 66.1 percent in this population.
"It is well known that obese women are at a greater risk of stillbirth and that this risk increases with increasing obesity class and with advancing gestational age. Currently, there is no recommendation regarding timing of delivery in this population or demonstrated value in increased antepartum surveillance. Obese women are also more at risk of adverse surgical outcomes, including venous thromboembolism, aspiration, and wound infection," Staudenmaier said. "Therefore, when considering elective induction of labor for an obese woman, especially an obese primiparous woman, the risk of stillbirth must be weighed carefully against the risk of postoperative complications, considering that our study found this population to be at an increased risk of cesarean delivery. This impacts counseling between physicians and their patients when considering elective induction for the obese patient."
Marika Toscano, M.D., of the University of Rochester Medical Center in New York, and colleagues evaluated whether gynecologist-performed point-of-care ultrasound (PoCUS) can accurately and sensitively identify gynecologic pathology. The investigators performed a pilot field study of a handheld PoCUS in Haiti to investigate whether PoCUS can identify and triage gynecologic pathology.
"When compared to a conventional diagnostic ultrasound, handheld physician-operated ultrasound devices are accurate, sensitive, and specific in a point-of-care context for female pelvic ultrasound and may be useful to advance women's health in low-resource settings," Toscano said. "As a result of its ease of use, portability, and low cost, PoCUS has the potential to be very influential in low-resource settings, particularly for global health application. In this setting, patients often must travel long distances to access medical care and may not be able to afford these travel and health care costs. PoCUS testing can more easily triage patients who are high risk or require a higher level of care."
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Posted: May 2019