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American College of Obstetricians and Gynecologists, May 2-6, 2009

Last Updated: May 11, 2009.


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American College of Obstetricians and Gynecologists 57th Annual Clinical Meeting

The American College of Obstetricians and Gynecologists' 57th Annual Clinical Meeting took place May 2 to 6 in Chicago and attracted more than 7,000 attendees from around the world, including more than 3,000 medical registrants. The meeting addressed issues such as patient safety, robotic surgery and postpartum depression, and presented breaking research on contraception, reproductive endocrinology and infertility, infectious diseases, gynecologic oncology, menopause, primary care, and urogynecology.

"Our President's Plenary Program highlighted patient safety and included an excellent keynote address by Robert M. Wachter, M.D., of the University of California in San Francisco," said Scientific Program Chair Manju Monga, M.D., of the University of Texas Medical School in Houston.

Wachter discussed the challenges of implementing patient safety programs in private practices. "In a practice, you can't really have specialized jobs -- there's no patient safety officer, no information technology technician," Wachter said in a statement. "And, in a hospital, the patient is a captive population. When risky things happen, the patient is still in the building."

In a private practice, Wachter said it's more difficult to manage patients because they often move in and out of a practice, change doctors, receive care from other specialists, and undergo tests at remote locations. To prevent medical errors, he suggested adopting lessons from the aviation industry. "In health care, there is no tradition of using simulation and teamwork training to help prepare for the unexpected but potentially catastrophic failure, but there should be," he said in a statement.

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"Another well-received speech at the President's Plenary Program was delivered by actress Fran Drescher, who is president of the Cancer Schmancer Movement and a survivor of endometrial cancer," Monga said. "Her message was that we should really be aiming for early detection of cancer and early initiation of treatment, and getting women to play a greater role in their health care decisions."

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A session entitled "Robotic Surgery in Gynecology: Use and Abuse" addressed robotic surgery for hysterectomies, myomectomies, vaginal prolapse repair, cancer removal, and other gynecologic procedures. "The point-counterpoint discussion revolved around the obstacles to learning these procedures and whether or not these advances have improved patient outcomes," Monga said.

During the session, Arnold P. Advincula, M.D., from the University of Michigan, and Javier F. Magrina, M.D., from the Mayo Clinic in Arizona, identified obstacles such as the $1.6 million cost of a robotic system, the need for company-sponsored training, and the need for a proctor for the first several surgeries. They identified benefits such as reduced blood loss and shorter hospital stays and recovery times, but acknowledged a need for more definitive outcomes data.

"What we really need to know is if this holds up long term," Advincula said in a statement. "In cancer surgery, studies show that you can obtain a better surgical dissection, particularly for lymph nodes, but we don't know the five-year survival rates. For myomectomies, we need to know what the long-term impact is on fertility."

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During his inaugural speech, incoming ACOG President Gerald F. Joseph Jr., M.D., of the Ochsner Health Center in Covington, La., announced that postpartum depression will be the theme of his presidential initiative and said it is important to determine the condition's true incidence and prevalence, and develop more accurate screening tools.

"We also need to know how ACOG Fellows screen and identify patients suffering from postpartum depression," Joseph said in a statement. "When do they counsel? How do they treat? Do they refer to other specialists for treatment? What kind of local programs are available for education and support? These are all questions that we need answers to."

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Among the 189 oral presentations were studies by the 2008 to 2009 Donald F. Richardson Memorial Prize winners: Sharai C. Amaya, M.D., for "Dietary Impact on Endometriosis: A Closer Look at the Active Ingredients of Red Wine and Soy," and Anthony N. Imudia, M.D., for "Retrieval of Trophoblast Cells from the Cervical Canal for Prediction of Abnormal Pregnancy."

Imudia, a third-year OB/GYN resident at Wayne State University in Detroit, and colleagues collected fetal trophoblastic cells from 37 women with a normal intrauterine pregnancy, 10 women with symptoms of ectopic pregnancy, and five women with blighted ovum. They found that women with normal pregnancies had a four- to five-fold higher concentration of HLA-G positive cells as women with abnormal pregnancies.

"We reliably distinguished normal pregnancy from abnormal pregnancy very early, and this is a new scientific discovery," Imudia said in a statement. "The information needs to be validated by a clinical trial, but it would mean that very early in the pregnancy, by doing a simple test like a Pap smear, we'll be able to know which pregnancies would need to be followed more closely or not."

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Other oral poster presentations included a study by Sunania Sehwani, M.D., and colleagues at St. Luke's Hospital and Health Network in Bethlehem, Pa., who compared the accuracy and usability of dollar-store pregnancy tests with a more expensive urinary pregnancy test. They found that both tests accurately detected hCG at the same low levels, and that four of the five independent observers concluded that the cheaper test was easier to read.

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ACOG: Donor-Egg Outcomes Poorer in Black Women

FRIDAY, May 8 (HealthDay News) -- Even after adjustment for potential confounders such as uterine or tubal disease, blacks have poorer outcomes after IVF cycles using donor eggs than other racial and ethnic groups, according to research presented this week at the American College of Obstetricians and Gynecologists' Annual Clinical Meeting, held from May 2 to 6 in Chicago.

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ACOG: Soy, Red Wine Have Anti-Estrogenic Effects

THURSDAY, May 7 (HealthDay News) -- Compounds in soy and red wine may positively affect gynecologic health and help prevent endometriosis, according to a prize-winning paper presented this week at the American College of Obstetricians and Gynecologists' Annual Clinical Meeting, held from May 2 to 6 in Chicago.

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ACOG: 24-Day Contraceptive Regimen May Be More Effective

THURSDAY, May 7 (HealthDay News) -- A 24-day regimen of 3 mg drospirenone and 20 mcg ethinylestradiol may provide more effective protection against unwanted pregnancy than either a 21-day regimen of the same hormones or a 21-day regimen of contraceptives containing other progestins, according to research presented this week at the American College of Obstetricians and Gynecologists' Annual Clinical Meeting, held from May 2 to 6 in Chicago.

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ACOG: Medical Liability Climate Linked with C-Section Rates

THURSDAY, May 7 (HealthDay News) -- Cesarean section rates are significantly higher in states that show either a current or brewing medical liability crisis even after adjustments are made for other known cesarean section risks, according to research presented this week at the American College of Obstetricians and Gynecologists' Annual Clinical Meeting, held from May 2 to 6 in Chicago.

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ACOG: Clinicians Appear Accepting of Black Cohosh

WEDNESDAY, May 6 (HealthDay News) -- Perimenopausal and menopausal women who use Remifemin® black cohosh extract therapy are likely to report support from their health care providers, according to research presented this week at the American College of Obstetricians and Gynecologists' Annual Clinical Meeting, held from May 2 to 6 in Chicago.

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