Ob/Gyn Information Center Feature Archive

Breast cancer screening: a review of current mammography guidelines

Breast cancer screening: a review of current mammography guidelines

Consensus regarding mammography screening varies, and conflicting guidelines from medical organizations can cause confusion for patients and providers.

Birth control leads to a blood clot

Birth control leads to a blood clot

A patient presents with chest pain 6 weeks after beginning use of a contraceptive device.

Genetic testing: an overview for clinicians

Genetic testing: an overview for clinicians

Understanding genetic testing allows providers to make the most of this resource in patient care.

Vulvar lichen sclerosus: breaking the silence

Vulvar lichen sclerosus: breaking the silence

Early diagnosis and treatment play a substantial role in a patient's prognosis and result in a decreased risk of malignancy and scarring.

Abnormal Pap test follow-up in a 30-year-old woman

Abnormal Pap test follow-up in a 30-year-old woman

A 30-year-old Caucasian woman reports a history of abnormal Pap test results with no other complaints.

Screening and treating pregnant women with asymptomatic bacteriuria may not be helpful

Screening and treating pregnant women with asymptomatic bacteriuria may not be helpful

Screening for asymptomatic bacteriuria may not lead to better outcomes among pregnant women and exposes them to unnecessary antibiotics.

Yeast infections in skinfolds

Yeast infections in skinfolds

Preventing yeast infections in skinfolds by using hand sanitizer.

In place of vaginal steroid cream

In place of vaginal steroid cream

Itching is a serious concern for patients with atrophic vaginitis, and alternative treatments can help.

Identifying cervical lesions

Identifying cervical lesions


One clinician took issue with the image published in a January 2016 Clinical Advisor article.

MRI after breast cancer diagnosis

MRI after breast cancer diagnosis

Despite the guideline, clinicians may choose to order MRI's for patients with dense breasts.

Flu vaccine in pregnant women

Flu vaccine in pregnant women

A clinician expresses concerns about potentially misleading flu vaccination information for pregnant women.

Contaminated water and cancer

Contaminated water and cancer

Contaminated water leads to high rates of birth defects, thyroid cancer, and spontaneous abortions.

More reader comments on ethical issues regarding use of IUDs

More reader comments on ethical issues regarding use of IUDs

More readers weigh in on the ethical issues surrounding the use of intrauterine devices.

Primary care clinician risk assessment for hereditary breast cancer

Primary care clinician risk assessment for hereditary breast cancer

Primary care clinicians should be proficient at assessing the potential for hereditary breast cancer risk in their patients.

Denosumab may reduce the risk of fracture in women with breast cancer on aromatase inhibitor therapy

Denosumab may reduce the risk of fracture in women with breast cancer on aromatase inhibitor therapy

Denosumab has been shown to reduce fracture risk in women with breast cancer with bone metastases.

Vitamin D supplementation does not improve functional outcomes in postmenopausal women

Vitamin D supplementation does not improve functional outcomes in postmenopausal women

Vitamin D deficiency is especially prevalent in postmenopausal women, and recommendations from current guidelines are inconsistent regarding vitamin D use.

Ethical concerns with IUDs

Ethical concerns with IUDs


For women who are pro-life advocates, copper IUD devices that prevent fertilization may be an acceptable alternative.

Pap smears, HPV, and screening
 for cervical cancer

Pap smears, HPV, and screening
 for cervical cancer


Confusion surrounds the current screening recommendations and guidelines.

Pap smear testing
 in a patient who is obese

Pap smear testing
 in a patient who is obese


Correctly position your patient to ensure a proper Pap smear.

Cervical cancer screening: Why less is best

Cervical cancer screening: Why less is best

ACOG's current recommendations regarding Pap smear testing for cervical cancer may be the best evidence-based practice for patients.

The IUD rumor mill: Common misconceptions

The IUD rumor mill: Common misconceptions

Disseminating accurate information can help women make informed decisions and potentially increase the overall use of intrauterine devices.

Monitoring pregnant women with nonsevere hypertensive disorders

Monitoring pregnant women with nonsevere hypertensive disorders 


Hypertensive disorders are the most common medical complications of pregnancy, affecting 5-8% of all pregnancies in the U.S.

Fetal macrosomia and shoulder dystocia

Fetal macrosomia and shoulder dystocia


Fetal macrosomia is associated with an increased risk of neonatal and maternal complications.

Effective management of opioid addiction in pregnancy

Effective management of opioid addiction in pregnancy

Caring for a woman who is pregnant and dependent on opioids is an opportunity to make life-changing interventions for the sake of her health and the health of her unborn child.

Vaginal discharge and odor 
resulting from tampon use

Vaginal discharge and odor 
resulting from tampon use


A tampon lodged between the cervix and vagina can be the cause of vaginal discharge and odor.

Inpatient management of pregnancy and type 1 diabetes

Inpatient management of pregnancy and type 1 diabetes

A patient, aged 33 years, with a history of type 1 diabetes for 10 years presented to the hospital.

Menopausal hormone replacement therapy recommendations

Menopausal hormone replacement therapy recommendations

The risks of HRT have received so much attention that its benefits have been largely overlooked.

Nonsterile glove use may reduce blood stream infections in premature infants

Nonsterile glove use may reduce blood stream infections in premature infants

Hand hygiene and glove use are simple measures that have been shown to reduce infections in cohort studies of preterm neonates and other pediatric populations.

Chronic vulvar itching and lichen sclerosus et atrophicus

Chronic vulvar itching and lichen sclerosus et atrophicus


A 51-year-old woman with chronic vulvar itching was diagnosed with lichen sclerosus et atrophicus.

Mammogram referral
 results not conveyed

Mammogram referral
 results not conveyed

A patient was referred 
for a mammogram, but 
clinicians fail to follow up on the report.

Breaking the silence about congenital cytomegalovirus

Breaking the silence about congenital cytomegalovirus

Congenital cytomegalovirus is a very common cause of birth defects, yet many primary-care providers are not well-informed about this infection.

Biotin supplements for prenatal care and more

Biotin supplements for prenatal care and more

Increasing biotin levels by supplement or by ingesting more biotin-rich foods may result in important benefits.

Breast cancer risk falls with NSAIDs

Breast cancer risk falls with NSAIDs

One study of 6,459 U.S. women aged 55 years to 81 years revealed that the use of alendronate or placebo did not affect the proportion of women who developed breast cancer (1.8% and 1.5%, respectively).

An update on long-term 
contraception methods

An update on long-term 
contraception methods

With increased insurance for contraceptives, more providers will be called upon to guide women toward the most suitable extended-use options.

Thinking through a diagnosis

Thinking through a diagnosis

After reviewing a patient's history, this clinician prevented a potentially fatal mistake.

Easing a female patient into her first pelvic exam

Easing a female patient into her first pelvic exam


Always, always hand the speculum to a woman who has come in for her first pelvic exam, and allow her to check it out.

'My gynecologist saved my life'

'My gynecologist saved my life'

A second look at nodules in the thyroid found cancer.

Giving breath to a child

Giving breath to a child

A clinician helped save his son and gave him his first breath.

Motivational interviewing helped a teen practice safe sex

Motivational interviewing helped a teen practice safe sex

Sometimes patients just need to hear their own stories out loud to help make better choices.

Addressing teen pregnancy in a school-based health center

Addressing teen pregnancy in a school-based health center

A new program that focused on education both male and female patients about contraception decreased pregnancy rates in an inner-city school.

High cholesterol may spell low fertility

High cholesterol may spell low fertility

The longest time to achieve pregnancy occurred in couples in which both partners had high cholesterol levels.

Unusual use of radiation therapy for pelvic pain

Unusual use of radiation therapy for pelvic pain

A woman suffers cyclic pain after multiple abdominal and pelvic surgeries.

Improving outcomes for infants with NAS

Improving outcomes for infants with NAS

Newborns who were exposed to certain substances in utero face unique challenges during their first months of life.

Heavy bleeding common during menopause

Heavy bleeding common during menopause

Gel reduces NICU hypoglycemia
 admissions

Gel reduces NICU hypoglycemia
 admissions

Buccal dextrose gel minimizes the need for unnecessary interventions that separate newborns with low blood glucose levels from their mothers.

Infant immunization after a 
blood transfusion

Infant immunization after a 
blood transfusion


Do blood transfusions affect implementation of the routine immunization schedule?

Is low amniotic fluid preventable?

Is low amniotic fluid preventable?

Why does low amniotic fluid occur so late in pregnancy despite regular prenatal visits and good prenatal care?

Diagnosing diseases
 of the vulva

Diagnosing diseases
 of the vulva

Vulvar biopsy is a helpful tool that should be utilized to diagnose 
and to guide the management of vulvar abnormalities.

Folic acid during pregnancy

Folic acid during pregnancy


Folic acid supplementation at least one month prior to conception is recommended.

Is estrogen plus progesterone necessary for vaginal atrophy?

Is estrogen plus progesterone necessary for vaginal atrophy?

Should oral progesterone be prescribed in combination with vaginal estrogen?

Testing for multiple STDs

Testing for multiple STDs

How do you explain to a patient when a positive test results is likely, but inconclusive due to insufficient specimen quality?

An unexpected finding during a routine Pap smear

An unexpected finding during a routine Pap smear

I tried to keep my voice steady, as I described what looked like an inch-long piece of cooked linguine attached to the patient's buttock.

A patient's bruises prompt closer attention

A patient's bruises prompt closer attention

Sometimes it is hard to ask our patients personal questions. But if we don't, who is?

Postmenopausal vulvovaginal atrophy: Communication and care

Postmenopausal vulvovaginal atrophy: Communication and care

Guidance for the primary-care clinician to identify and treat this chronic and highly prevalent condition.

Severe hemorrhaging after eclampsia and stroke

Severe hemorrhaging after eclampsia and stroke

A family faces a life and death decision when a patient is given a poor prognosis after experiencing a major stroke from eclampsia.

HPV recurrence risk in monogamous relationships

HPV recurrence risk in monogamous relationships

What is the likelihood of HPV-caused cervical cancer recurrence after loop electrosurgical excision procedure?

An unexpected source of acute onset rectal pain

An unexpected source of acute onset rectal pain

An embarrassed teenager obscures the truth until a healthcare provider identifies the source of pain upon exam.

Heavy menses and uterine bleeding signal a greater problem

Heavy menses and uterine bleeding signal a greater problem

A thorough work-up helps a clinician make an unusual diagnosis in a young patient.

Options for pelvic congestion syndrome

Options for pelvic congestion syndrome

This challenging diagnosis presents as a dull, throbbing and achy pain in 
the vulvar region and may require referral to an interventional radiologist.

Safety first in infant feeding

Safety first in infant feeding

Counseling parents on the avoidance of feeding-associated infections.

Breast CA radiation Tx associated with CV risk

Breast CA radiation Tx associated with CV risk

Incidental exposure of the heart to radiation is a common unintended consequence of radiation therapy for breast cancer.

Craving ice may signal anemia

Craving ice may signal anemia

Ask patients who present with fatigue about abnormal cravings for ice.

Does red wine ease menstrual cramps?

Does red wine ease menstrual cramps?

Does evidence support red wine for menstrual cramp prevention?

Vaginal bleeding in the early stages of pregnancy

Vaginal bleeding in the early stages of pregnancy

A number of potential causes of vaginal bleeding in early pregnancy must be considered when deciding what type of management is required.

Surfactant cuts ventilation needs in preterm infants

Surfactant cuts ventilation needs in preterm infants

Minimally invasive surfactant treatment reduces need for ventilation in spontaneously breathing preterm infants requiring increased oxygen.

Primary-care prevention of cervical cancer

Primary-care prevention of cervical cancer

To reduce the mortality and incidence of this disease, clinicians must be aware of the most recent vaccination and screening guidelines.

Ease constipation caused by calcium supplements

Ease constipation caused by calcium supplements

Omega-3 supplements can help constipation in postmenopausal women taking calcium and vitamin D supplements.

Fenugreek aids weight-loss, and promotes lactation, healthy glucose and lipids

Fenugreek aids weight-loss, and promotes lactation, healthy glucose and lipids

The seeds of the fenugreek plant, which are used for medicinal purposes, contain saponins, alkaloids and other antioxidants.

The ABCs of shaving

The ABCs of shaving

Advice for preventing shaving-related chafing, itching, bumps and lesions.

Gassing up at the gynecologic exam

Gassing up at the gynecologic exam

A nurse practitioner shares a tip for teaching students how to insert a speculum and locate the cervix.

When to do an endometrial biopsy

When to do an endometrial biopsy

A patient continues to have breakthrough bleeding while taking oral contraceptives, despite changing pills. What could be the cause?

Postpartum depression in a primary-care setting

Postpartum depression in a primary-care setting

Experienced by up to one in five mothers, postpartum depression often goes untreated. Learn what risk factors to be alert for.

CCHD screening guidelines: Implementation of standardized protocols, Part 2

CCHD screening guidelines: Implementation of standardized protocols, Part 2

Taking the pulse of neonatal screening for critical congenital heart disease.

Thyroid hormone and bone density

Thyroid hormone and bone density

Can thyroid hormone replacement therapy affect bone density?

Treating psychiatric illness during pregnancy

Treating psychiatric illness during pregnancy

What considerations exist regarding the safety of using aripiprazole during pregnancy?

Sudden neurologic symptom onset 
in an adolescent

Sudden neurologic symptom onset 
in an adolescent

Dizziness, photophobia, nausea and 
an unsteady gait develop following a 
routine annual check up.

File away anxiety over trimming infant fingernails

File away anxiety over trimming infant fingernails

Many parents are anxious about cutting their infant's fingernails.

Group B strep treatment during pregnancy

Group B strep treatment during pregnancy

What treatment regimen would have the least adverse effect on the fetus?

What does inflammation on a Pap smear mean?

What does inflammation on a Pap smear mean?

How should patients whose Pap smear results show inflammation and no other abnormalities be managed?

Getting the cervix in view

Getting the cervix in view

A nurse practitioner offers tips to get patients in the proper position for a cervical exam.

Causes of thinning hair in a postmenopausal woman

Causes of thinning hair in a postmenopausal woman

Could a vegetarian diet be contributing to an older woman's alopecia?

Breastfeeding with a positive thyroid peroxidase

Breastfeeding with a positive thyroid peroxidase

Could positive thyroid peroxidase adversely affect a mother's milk supply?

Help for a young adult with anorexia and bulimia

Are there other treatment options for eating disorders after therapy, acupuncture, nutrition counseling and in-patient hospital stays have failed?

Contraception options for women older than age 50 years

If follicle-stimulating hormone is >20 mIU/mL, most clinicians counsel patients against contraception, as the risk of pregnancy is virtually nil.

The benefits of oral contraceptives with folate

What is the rationale behind the new combined oral contraceptive that adds folate to the estrogen and progestin?

Contraception choices and breast cancer

Are certain oral contraceptive pills better for women with a family history of breast cancer?

A patient ignores a suspicious breast lump

A patient ignores a suspicious breast lump

When a patient does 
not comply with medical 
recommendations, how 
do you protect yourself?

Wild Yam: An herbal remedy for menstrual pain and menopause

Wild Yam: An herbal remedy for menstrual pain and menopause

Wild yam is an herbal remedy for menstrual discomfort and menopausal symptoms, and has also been suggested as an alternative to hormone replacement therapy (HRT).

"Alarming" teen contraceptive-pill compliance

Teens often tell me they forget to take their birth-control pills (BCPs), sometimes as often as three or more times per cycle.

Next step for endometrial hyperplasia

How would you proceed with a 64-year-old woman who has complex endometrial hyperplasia and secretory changes?

Alternative therapy for gestational diabetes

Alternative therapy for gestational diabetes

Insulin is the only agent recommended to lower glucose levels in pregnant 
women, but a second-generation sulfonylurea may provide another option.

Making contraceptive vaginal-ring insertion easy

A nurse offers advice for patients that are unsure how to properly place the contraceptive vaginal ring.

Treating atrial fibrillation during pregnancy

How often should follow-up ECG be performed on a pregnant patient with atrial fibrillation (AF) that resolves with medication that is then discontinued?

An algorithm for managing breast pain

An algorithm for managing breast pain

Breast pain can be an frightening experience, but the primary-care provider can often allay the patient's fears and capably manage the condition.

Stat Consult: Breastfeeding

Stat Consult: Breastfeeding

A quick review of breastfeeding recommendations, including timelines for infant weaning, guidelines for appropriate supplementation and contraindications.

Antibiotics have no effect on oral contraceptives

While it is true that lower serum ethinyl estradiol and progestin levels have been found in women using combination OCs and antibiotics, these women remain well within the therapeutic window.

Differentiating between types of intertriginious warts

Which type of human papillomavirus (HPV) is associated with nonmucosal, condyloma acuminatum-appearing warts found under the pannus in intertriginous areas?

When is it appropriate to repeat a Pap smear?

When is it appropriate to repeat a Pap smear?

When reviewing Pap smear results with absent endocervical cells, what is the recommended next step?

Stat Consult: Polycystic ovary syndrome

Stat Consult: Polycystic ovary syndrome

A quick review of polycystic ovary syndrome, a heterogeneous androgen excess syndrome that can cause hirsutism, secondary amenorrhea, obesity, hyperinsulinemia and infertility, providing the latest global evidence for diagnosis and treatment.

Does hematuria during a Pap smear warrant further evaluation?

Should all patients with hematuria during routine Pap smear undergo full urologic evaluation, even if there is only trace amounts of blood?

Sign Up for Free e-newsletters