SASGOG's Pearls of Exxcellence

SASGOG's Pearls of Exxcellence is a collection of documents that help Residents and Practicing ObGyn's stay up to date on common conditions and their management. The Editorial Board continuously reviews, reaffirms and/or revises the library of articles to maintain relevant and up to date content.

 

SASGOG Pearls of Excellence

Notice Regarding Use

** SASGOG is committed to accuracy and will review and validate all Pearls on an ongoing basis to reflect current practice.

These documents are designed to aid practitioners in providing appropriate obstetric and gynecologic care. Recommendations are derived from major society guidelines and high quality evidence when available, supplemented by the opinion of the author and editorial board when necessary. It should not be construed as dictating an exclusive course of treatment or procedure to be followed.

Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. SASGOG reviews the articles regularly; however, these publications may not reflect the most recent evidence. While we make every effort to present accurate and reliable information, the publications are provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. SASGOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither SASGOG nor their respective officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.

 

Pearls of Exxcellence articles
Log in now, or create a free account to access bonus Pearls features.

Contraception in Women with Cardiovascular Risk Factors

Cardiovascular risk factors include hypertension, diabetes, obesity, smoking and increasing age, and may limit options for contraception, particularly hormonal methods. Hypertension: Implants, intrauterine systems, and progestin-only pills do not...

Updated: 7/6/2021
Published: 1/18/2017
Category: Office Practice
Author: Margaret M. Boozer, MD

Download

Monochorionic Twins

In the United States, twin gestation is no longer a rare event due to the increase in maternal age at conception and the increase in use of assisted reproductive technology....

Updated: 1/5/2021
Published: 7/1/2016
Category: Obstetrics
Author: Sharon L. Seidel, MD

Download

Antepartum Management of Dichorionic/Diamniotic Twins

Chorionicity in twins is best determined by ultrasonography in the late first or early second trimester, with sensitivity of 90% or better. The twin peak sign (also called the...

Published: 5/4/2016
Category: Obstetrics
Author: Marygrace Elson, MD

Download

Management of Second Trimester Fetal Loss

Second trimester fetal loss occurs between 14 and 27 weeks’ gestation and may encompass spontaneous abortion, stillbirth, and early preterm labor. It complicates 1% to 2% of pregnancies. Stillbirth has...

Updated: 11/5/2019
Published: 3/1/2016
Category: Obstetrics
Author: Vanessa Torbenson, MD

Download

Evaluation of Stress Urinary Incontinence

Mentor: Christopher M. Zahn, MD Editor: Peter F. Schnatz, DO There are several different types of urinary incontinence: stress, urge, chronic urinary retention (overflow), mixed,...

Updated: 7/7/2020
Published: 1/1/2016
Category: Office Practice
Author: William D. Po, MD

Download Listen

Perioperative Management of Anticoagulation in Gynecologic Patients

Editor: Eduardo Lara-Torre, MD For patients using chronic antithrombotic therapy undergoing gynecologic surgery, interruption of therapy to reduce bleeding risk must be balanced against risk of...

Updated: 11/1/2018
Published: 12/1/2015
Category: Gynecology
Author: Christopher M. Zahn, MD

Download Listen

Metabolic Syndrome

The metabolic syndrome encompasses a cluster of risk factors including central obesity, dyslipidemia, elevated blood pressure, and hyperglycemia. Together these factors increase the risk of atherosclerotic cardiovascular disease and type...

Updated: 3/1/2020
Published: 10/1/2015
Category: Office Practice
Author: Anitra D. Beasley, MD

Download

Postmenopausal Vulvar Disorders

The postmenopausal vulva is characterized by a decline in skin barrier function associated with aging and estrogen deficiency that contributes to increased susceptibility to a variety of conditions. The most...

Updated: 3/1/2020
Published: 8/28/2015
Category: Office Practice
Author: Elizabeth A. Ferries-Rowe, MD

Download

Surgery in Morbidly Obese Patients

Surgical complications such as infection, venous thromboembolism (VTE), and wound complications are a major source of morbidity in obese women, but may be reduced with attention to preoperative, intraoperative and...

Updated: 5/1/2021
Published: 3/1/2018
Category: Gynecology
Author: Bani M. Ratan, MD

Download

Amniotic Fluid Embolism

Editor: Elizabeth Ferris-Rowe, MD Amniotic Fluid Embolism (AFE) is an uncommon, catastrophic obstetric emergency. The frequency of AFE is 2-7 cases per 100,000 births. It is responsible for approximately...

Updated: 11/1/2018
Published: 4/1/2013
Category: Obstetrics
Author: Mari-Paule Thiet, MD

Download Listen

Primary Amenorrhea in a Teenager

Primary amenorrhea (PA) has traditionally been defined as failure to menstruate by age 15. An evaluation should be initiated if a 15-year-old with normal secondary sexual characteristics or a 13-year-old...

Updated: 5/5/2021
Published: 3/1/2011
Category: Office Practice
Author: Priya B. Maseelall, MD

Download

Elevated Maternal Serum AFP (MSAFP) During the Second Trimester

Alpha-fetoprotein (AFP) is produced by the fetal liver. Levels rise during the second trimester. Values are expressed as MoMs (multiples of the median) for each specific week of gestation, and...

Updated: 5/5/2021
Published: 6/1/2010
Category: Obstetrics
Author: Michael T. Mennuti, MD

Download

Management of Symptomatic Polyhydramnios

Polyhydramnios (or hydramnios) is an excessive amount of amniotic fluid relative to gestational age. It is thought to result from either increased production or decreased clearance of...

Updated: 9/1/2019
Published: 10/1/2016
Category: Obstetrics
Author: Jane S. Limmer, MD

Download

Surgical Management of Women with Hypertension

Approximately one in three adults in the United States has a diagnosis of systemic hypertension and almost half of them have uncontrolled blood pressure. Hypertension is the most common cause...

Updated: 7/6/2021
Published: 1/1/2017
Category: Gynecology
Author: Mostafa Borahay, MBBS

Download

Contraception for Women with Diabetes

The prevalence of diabetes mellitus is increasing worldwide, including among women of childbearing age, with an additional 150 million adult cases projected by 2030. Diabetes poses significant...

Updated: 1/1/2020
Published: 5/1/2017
Category: Office Practice
Author: Jane S. Limmer, MD

Download Listen

Glycemic Control in Diabetic Patients Undergoing Gynecologic Surgery

Patients with diabetes undergoing surgery are at increased risk of morbidity and mortality from their hypermetabolic stress response, preoperative catabolic state, altered nutritional status, changes in circulation, immobility, and glucose...

Updated: 7/1/2019
Published: 4/1/2018
Category: Gynecology
Author: Joseph Peterson, MD

Download

Prevention of Complications in Women with Diabetes Undergoing Surgery

Diabetes mellitus (DM) is a common and increasingly prevalent chronic medical condition with an incidence of one in 11 persons worldwide. Approximately half of these cases are undiagnosed. ...

Published: 1/2/2018
Category: Gynecology
Author: Tara E. Kelly, MD

Download

Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disease. The incidence is between 0.2%-2% and is higher in South American and Northern European...

Updated: 7/7/2020
Published: 1/1/2019
Category: Obstetrics
Author: Shelby Dickison, MD

Download

Evaluation of Sexual Dysfunction

Female sexual dysfunction is defined as any sexual complaint or problem that results from disorders of desire, arousal, orgasm, or sexual pain and causes marked distress or interpersonal difficulty. ...

Updated: 1/5/2021
Published: 6/1/2019
Category: Office Practice
Author: Amy Markese. MD

Download

Persistant Postpartum Endometritis

When patients with postpartum endometritis do not respond to initial broad-spectrum antibiotic therapy and either demonstrate persistent temperatures over 38° Celsius after 48 hours or who are critically...

Updated: 5/1/2021
Published: 9/1/2019
Category: Obstetrics
Author: Taimur Chaudhry, MD

Download Listen

Medical Management of Menopausal Symptoms

Menopausal symptoms vary for each woman. Symptoms can arise in the perimenopausal period and last throughout the rest of a woman’s lifetime. Vasomotor symptoms occur in 75% of women...

Published: 11/3/2020
Category: Gynecology
Author: Kathryn I. Marko, MD, NCMP, FACOG

Download