Rojana Tahil Pata BSN 2-1, group 3 Articles related to obstretics and gynecology

Some Ob.gyns. and other providers misuse low-risk HPV tests

by Heidi Splete

Approximately one-third of health care providers conduct unnecessary low-risk HPV testing, based on results of a survey of 376 office-based health care providers and 216 outpatient clinics. A high-risk human papillomavirus (HPV) DNA test, which detects cancercausing HPV types, is generally used for screening and managing women with abnormal Pap test results, but there are no clinical recommendations for use of a low-risk HPV DNA test that detects five nononcogenic HPV types, said Jennifer Wai-Yin Lee, R.N., and her colleagues at the Centers for Disease Control and Prevention (Obstet. Gynecol. 2011; 118:4-13). To assess the use of different types of HPVtesting, the researchers reviewed data from the 2006 Cervical Cancer ScreeningSupplement, a survey conducted by the CDC. Overall, 76% of the office-based providers and 77% of the outpatient clinics reported ever ordering an HPV test, and 35% of health care providers and 32% of clinics said they used low-risk HPV testing. Ob.gyns. were significantly more likely to report using the HPV test than family physicians and internists (99% compared with 77% and 45%, respectively). The finding on the use of low-risk HPV testing "is surprising," the researchers wrote. "The low-risk HPV DNA test screens for infection with nononcogenic HPV types and thus serves no purpose in the context of cervical cancer screening," they noted.
Reference: www.findarticles.com

FindArticles / Health / OB/GYN News / July, 2011

Dose selection key in picking antiepileptic drug in pregnancy

by Robert Finn

Dose selection is as critical as is the choice of antiepileptic drug for avoiding birth defects in women with epilepsy, according to a large observational cohort study. In a comparison of the four most commonly prescribed antiepileptic drugs, lamotrigine at a dose of less than 300 mg/day at the time of conception was the least likely to be associated with birth defects. Valproic acid at 1,500 mg/day or more was 16 times more likely to be associated with birth defects, according to the results of the multivariate analysis. Carbamazepine and phenobarbital carried intermediate levels of risk, depending on the dose. The results came from an observational cohort study of 3,909 pregnancies representing 3,521 women in 42 countries between 1999 and 2010. All the women had epilepsy and were taking one of the four drugs at conception. The investigators, led by Dr. Torbjorn Tomson of the Karolinska Institute, Stockholm, excluded pregnancies in women whose antiepilepsy prescription was changed during the first trimester, those who were exposed to antiepileptic polytherapy or to other potentially teratogenic medications, and women with comorbidities such as diabetes, toxoplasmosis, and HIV that are known to increase the risk of congenital malformations (Lancet Neurology 2011 [doi:10.1016/ S1474-4422(11)70107-7]). In their multivariate analysis, the investigators controlled for a host of potential confounders. These included maternal age, sex of child, parental history of major congenital malformations, geographical region, parity type of epilepsy, generalized tonic-clonic seizures during the first trimester, parental education, and the use of folic acid.

Reference: www.findarticles.com