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Objectives. The purpose of this study was to determine prospectively whether unplanned pregnancies are associated with adverse pregnancy outcomes among users of natural family planning. Methods. Women who became pregnant while using natural family planning were identified in five centers worldwide: there were 373 unplanned and 367 planned pregnancies in this cohort. The subjects were followed up at 16 and 32 weeks' gestation and after delivery. The risks of spontaneous abortion, low birthweight, and preterm birth were estimated after adjustment by logistic regression. Results. The women with unplanned pregnancies were more likely to be at the extremes of age, to report more medical problems before and during the index pregnancy, and to seek antenatal care later in gestation than the women with planned pregnancies. However, women with planned pregnancies reported a higher rate of spontaneous abortion in previous pregnancies (28.8%) than did women with unplanned pregnancies (12.9%). There were no significant differences in the rates of spontaneous abortion, low birthweight, or preterm birth between the two groups. Conclusions. No increased risk of adverse pregnancy outcomes was observed among women who experienced an unplanned pregnancy while using natural family planning. (Am J Public Health. 1997;87:338-343)

Breast-feeding is today the major form of infant nutrition in the immediate postpartum period. Despite this, recent trends in modern life-styles have raised obstacles to successful lactation. These include infant illness and maternal responsibilities outside the home, both requiring separation from the mother. While the hormonal dynamics of infant suckling are understood, little is known about the effects of artificial methods of milk expression. A variety of breast pumps exist in the current US market which vary considerably in price and effectiveness. To understand better the ability of these pumps to assist women in the maintenance of lactation, the current study was undertaken to evaluate their effects on milk yield and prolactin and oxytocin release when compared to natural infant suckling. Twenty-three women who were exclusively breast-feeding their infants were randomly assigned to serially use several pumping methods, as well as infant suckling, with blood being taken at 10-minute intervals to determine the hormonal responses. The results reveal variability in the proclatin responses to the artificial pumping methods, with the greatest responses found with an electric pulsatile pump; these responses compare favorably with those of natural infant suckling. Other methods were less successful in causing prolactin elevations. No differences were seen among the methods in the oxytocin response. The results of this study demonstrate striking differences in the ability of breast-pumping methods to produce an acute and sustained prolactin rise in breast-feeding mothers. The large discrepancies found suggest the need for further studies to enable women and health care providers to choose the most appropriate method for milk expression. Pediatrics 1992; 89:437-440; breast-feeding, nutrition, milk expression, lactation.

ABBREVIATIONS ACOG American College of Obstetricians and Gynecologists RhIG Rh immune globulin In 2015, the AABB and the College of American Pathologists sponsored an Interorganizational Work Group on I RHD i Genotyping,[1] inviting the American College of Obstetricians and Gynecologists (ACOG), American Red Cross, America's Blood Centers, and Armed Services Blood Program to recommend organizational representatives. As cost-effective and quicker methods for managing serologic weak D phenotypes become available, the focus should turn to developing protocols for managing patients with I RHD i alleles, who do not have a serologic weak D phenotype, but who are at risk for developing anti-D, such as I RHD*DIIIa i and I RHD*DIVa i . Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype. [Extracted from the article]

The author reflects on the creation of the "Contemporary OB/GYN" medical journal as it celebrates its 41st anniversary in 2014. Topics discussed include the concept behind the creation of the journal which debuted in 1973, the formation of the editorial board that included doctors Hervy Averette, Ron Chez and Paula Hillard as well as the changes made to the formats of the magazine over the years.

The article highlights the views and predictions of experts about the future of the field of obstetrics and gynecology. Physician Kenneth L. Noller expects several changes in the field's office practice by 2022. Doctor Mary E. D'Alton, however, predicts the potential of genetics in the specialty of maternal-fetal medicine (MFM).

The article discusses the compensation systems for patients injured due to adverse medical outcomes. It explores several systems including Binding Early Offers, the Recognize, Respond, Resolve (3Rs) Program, and the ones from Denmark and Sweden. It states that health care provider defines the compensable event in Binding Early Offers. It says that 3Rs Program promotes complete and early adverse outcome report. It notes that fault is not a condition to receive compensation in Sweden and Denmark.

This was a multicentred, prospective study of pregnancies among women using natural family planning. The women maintained natural family planning charts of the conception cycle, recording acts of intercourse and signs of ovulation (cervical mucus changes, including peak day and basal body temperature). Charts were used to assess the most probable day of insemination relative to the day of ovulation and length of the follicular phase of the cycle. The sex ratio (males per 100 females) for 947 singleton births was 101.5, not significantly different from the expected value of 105. The sex ratio did not vary consistently or significantly with the estimated timing of insemination relative to the day of ovulation, with the estimated length of the follicular phase or with the planned or unplanned status of the pregnancy. Although these findings may be affected by imprecision of the data, the study suggests that manipulation of the timing of insemination during the cycle cannot be used to affect the sex of offspring. [ABSTRACT FROM AUTHOR]

Recent studies have suggested that the presence of hydro-salpinx has a negative effect on in-vitro fertilization (IVF) outcome, with markedly diminished implantation and pregnancy rates, and increased early pregnancy loss. We evaluated the impact of hydrosalpinx on IVF outcome in a large population with tubal factor infertility: 63 patients with hydrosalpinx and 60 without hydrosalpinx (no hydro-salpinx) underwent 103 and 89 IVF cycles respectively. Hydrosalpinx was diagnosed by hysterosalpingography and/or laparoscopy prior to IVF. Patients were further subdivided into those with or without elevated quantitative serum Chlamydia trachomatis IgG antibody (Ab) titres. All couples with elevated serum Ab titres (I: 16 or more) were treated with doxycycline (100 mg bid.) 10 days prior to the first IVF cycle. In all, 88 women (71.5%) had elevated C. trachomatis Ab: 47 women (74.6%) with hydrosalpinx had elevated titres, compared to 41 (683%) in the no hydrosalpinx group. There were no significant differences in mean age, number of mature oocytes obtained, and number of embryos transferred between the two groups. There was a trend for a higher implantation rate and ongoing pregnancy rate in the no hydrosalpinx group compared to the hydrosalpinx group (12.6 versus 9.8%, and 33.7 versus 24.8% respectively); however, this did not reach statistical significance. The incidence of early pregnancy loss was similar in the two groups. Two ectopic pregnancies were noted in the hydrosalpinx group compared to none in the no hydrosalpinx group. As expected, the prevalence of elevated titres of C. trachomatis IgG Ab in patients with tubal factor infertility presenting for assisted reproductive treatment was high. In contrast to recently published reports, our study did not confirm a negative effect of hydrosalpinx on IVF outcome when antibiotic treatment was given prior to assisted reproductive treatment. Prospective multicentre studies evaluating the effect of hydrosalpinx and its treatment on IVF outcome are needed. [ABSTRACT FROM PUBLISHER]