Temporal availability of obstetrics and gynecology clinics in Taiwan: A nationwide survey

Objective

Obstetrician–gynecologists are the main providers of women's healthcare. However, workforce shortages and excessive workloads among these providers have been encountered in many countries. While most past studies on this subject have investigated the spatial distribution of obstetrics–gynecology clinics, few have focused on their temporal availability, especially on the national level.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: A questionnaire study

Objective

Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics.

Study design

We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's χ² test were used for statistical analysis.

Results

About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives’ belief in the methods’ effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners’ perceptions of the methods’ therapeutic effectiveness.

Conclusions

CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.     

The use of electro-analgesia in obstetrics and gynecology. A survey by invitation.

The newly-developed method of electroanalgesia is based on the employment of low-intensity impulse currents with extended frequency range and electrode application in the region of the forehead and mastoid processes. Electro-analgesia has been successfully used in preparing the pregnant woman for labour, in controlling abnormal uterine contractility, in preventing and treating toxaemia of pregnancy. It produces favourable effects on the mother and the fetus. Electro-analgesia has also been successfully used in labour anaesthesia, and as part of a combined method of general anaesthesia in 200 obstetrical and gynaecologic operations and the postoperative period.     

The use of prostaglandin gel in obstetrics and gynecology.

The use of prostaglandin gel for therapeutic termination of second trimester pregnancy, the management of intrauterine fetal death, ripening of the cervix and induction of labour is reviewed. For these indications, prostaglandin gel is acceptable to patients, effective, and has low incidence of side effects and complications.     

Present relation of obstetrics and gynecology between the USA and Germany

After World War II there was a blooming association between German and American Obstetricians-Gynecologists. When young German scientists began Fellowships in the US, they found German Professors of all ranks teaching in the various medical schools. At present there is no connection between the Deutsche Gesellschaft für Gyn?kologie und Geburtshilfe (DGGG) and the American College of Obstetricians and Gynecologists ACOG. There is however a close cooperation between ACOG and the Berufsverband der Frauen?rzte (BVF) who invite their presidents on a yearly basis. An advanced formalization of the affilitiation between the two German Societies and ACOG is expected to benefit all Societies while not interfering with European connections.     

数字医学发展趋势及在妇产科的应用

由于信息科学特别是计算机科学与技术的快速发展,推动人类社会进入了数字化时代。纵观科学发展史,科学技术的最新研究成果往往都是最先应用于医学和军事。数字医学就是人类社会进入数字化时代应运而生的新生事物,它是以现代医学和数字化高新技术相结合、涵盖了医     

The use of once-daily dosing of gentamicin in obstetrics and gynecology.

Gentamicin is a widely-used antimicrobial agent for obstetric and gynecologic infections. Renewed excitement in this antibiotic has arisen from recent information supporting less frequent dosing. In this symposium, we will describe the pharmacokinetics of gentamicin and review new information advocating the use of once-daily administration of gentamicin.     

A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients

Abstract. Von Gruenigen VE, White LJ, Kirven MS, Showalter DO, Hopkins MP, Jenison EL. A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients.
Our objective was to describe and compare the use of complementary and alternative medicine (CAM) in gynecology and gynecological oncology patients. Five hundred and twenty-nine gynecology and gynecological oncology patients completed a questionnaire regarding CAM use. Overall, 56.3% of gynecology and gynecological oncology patients reported current use of CAM. Therapies used included nutritional supplements (20%), prayer as medical therapy (17%), exercise as medical therapy (12%), megavitamins (10%), and green tea (10%). While 69.5% believed CAM to be beneficial, only 31.6% discussed these therapies with their physician. The women spent a mean of $656.22 on CAM (range $0–$7,000), with 31.7% receiving some insurance reimbursement. Gynecologic oncology patients ( n =161) used CAM significantly more than gynecology patients ( n =368) (66% vs. 52%, 95% CI=0.046–0.230, P =0.004). Gynecological oncology patients also spent more for CAM, with a mean expenditure of $711 versus $622 by gynecology patients. Within the gynecological oncology patient group, there were 69 patients currently receiving modern medical treatments for cancer; among these patients, 58% reported using CAM; of these, 39.3% communicated their use of CAM to their physician. Patients in this group spent an average of $1,178 on CAM during their illness, with only 6.3% receiving insurance reimbursement. Benefits from CAM were perceived by 54.5% in this group. We concluded that cancer patients have a higher usage rate and expenditure for CAM, particularly while they are receiving medical therapy, and are more likely to discuss the use of alternative therapies with their physicians. CAM was perceived as helpful by patients despite the lack of scientific data about its effect.     

The use of barbed sutures in obstetrics and gynecology

Despite the multitude of different procedures performed with a host of different wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations. In recent years, a new class of suture material-barbed suture-has been introduced into the surgeon's armamentarium. This review focuses on barbed suture to better understand the role of this newer material in obstetrics and gynecology.     

SHBG--new possibilities of diagnostic use in obstetrics and gynecology

Recent literature review is suggesting the need to renew the traditional concept of SHBG as only a transport protein. The new role of SHBG relates to the evidence of its specific receptor on the cell membrane and an alternative signal pathway for sexual steroids. This review points to the importance of simultaneous measurements of SHBG along with determinations of the total sexual steroid concentration and informs of some new areas where SHBG can be used in laboratory diagnostics. In obstetrics the low levels of SHBG in the first half of pregnancy were reported as a promising early risk marker of the later development of preeclampsia.