Articles this week
Surgical techniques, Bartholin's abscess, thromboprophylaxis in gynaecology, PMS, antiphospholipid syndrome, endometriosis & IVF, COVID-19 vaccines, valvular heart disease & pregnancy & Fe-deficiency
How do you grip your needle holder? Several surgical articles of interest, starting with another surgical skill guide from Ronald Barbarosa from the March issue of the British Journal of Surgery and a review of the diagnosis and practical management of Bartholins cyst/abscess, published in TOG.
Thromboprophylaxis in gynaecology requires careful consideration for each patient, and this paper contains a succinct protocol to guide practice for gynaecological surgeries, including early pregnancy.
The utility of endometriosis-related surgery as an adjunct for improving IVF outcomes is a critically important issue to address because about 35% of women undergoing assisted reproductive treatment in Australia have endometriosis. Should we be treating the endometriomas before IVF?
Learning objectives for this review of valvular heart disease in pregnancy:
To understand the WHO classification of maternal cardiac disease and how this affects counselling regarding decisions around pregnancy for women with valve pathology.
To understand how valve disease affects pregnancy and vice versa.
To gain insight into the anaesthetic and haematological considerations for managing women with valvular disease.
During the omicron period, it remains crucial to convey that COVID-19 vaccination primarily prevents severe illness, including hospitalisation and death, in the general population; this is also true for pregnant women. COVID-19 vaccination among pregnant women are effective against severe illness and complications during the omicron period, but immunity wanes over time.
A recent 2022 study among the general US population showed that bivalent mRNA boosters (containing components both from the ancestral SARS-CoV-2 strain and omicron sublineages) provide significant additional protection against symptomatic SARS-CoV-2 infection compared with receipt of monovalent mRNA boosters. To prevent adverse outcomes associated with SARS-CoV-2 infection during pregnancy, pregnant women should be advised to receive recommended COVID-19 vaccines, including, if available, a bivalent mRNA booster when eligible.
On 20 January 2023, the Therapeutic Goods Administration of Australia provisionally approved the Pfizer bivalent BA.4/5 for use as a booster COVID-19 vaccine in people aged 12 years and older. Here’s a link to the ATAGI recommendations.
The continuing rise in the prevalence of obesity requires multifaceted, effective responses for its prevention and treatment. The growing understanding of obesity as a complex, chronic disease has led to rapid advances in treatment over the past decade. This Lancet Therapeutics Review summarises current and emerging pharmacological, endoscopic, and surgical approaches to obesity management for clinicians provides guidance on their use and highlights challenges in therapeutic decision-making.
Both heavy menstrual bleeding and iron deficiency, with or without anaemia, impact quality of life. These combined issues adversely affect the lives of reproductive-aged girls and women of all ages, from menarche to menopause, and their often-insidious nature frequently leads to normalisation. The effects on cognitive function and the related work and school absenteeism and presenteeism can undermine the efforts and function of women in all walks of life, be they students, educators, employers, or employees.
Thanks for following along, and until next time, take care.
Danny