- Email: [email protected]
Hormone replacement practice patterns among Oklahoma physicians
Anticardiolipin Antibodies in First- and Second-Trimester Pregnancy Loss Carlos W. Benito, MD UMDNJ–Robert Wood Johnson Medical School/Saint Peter’s University Hospital, New Brunswick, NJ
Elaine T. Vostrovsky, RN, BS, Debra L. Day-Salvatore, MD, PhD, Susan Trout, MD, and Susan Shen-Schwarz, MD Objective: To determine whether a difference exists in the prevalence of anticardiolipin antibodies in patients with a history of recurrent first- versus second-trimester pregnancy loss. Methods: Patients presenting to the Pregnancy Loss Evaluation Service (PLES) from June 1994 to December 1999 were tested for the presence of anticardiolipin IgG, IgM, and IgA antibodies. Levels were measured by a single reference laboratory test. Patients were eligible for the service if they had experienced recurrent first-trimester losses (RFTLs) or at least one second-trimester loss (STL). Comparisons based on the presence of the anticardiolipin antibody were made between patients with RFTL versus STL. Significance was set at P less than 0.05. Results: Anticardiolipin antibody levels were obtained in 93% (243/261) of patients during PLES evaluations. There were 132 patients with RFTL and 129 patients with a STL.
Anticardiolipin IgG Anticardiolipin IgM Anticardiolipin IgA
1st-trimester loss
2nd-trimester loss
6.1% (8/130) 7.1% (9/126) 2.2% (2/88)
4.4% (5/113) 1.7% (2/115) 0% (0/78)
P value 0.49 0.08 0.18
Conclusion: Although the prevalence of anticardiolipin antibodies is greater in patients with first-trimester losses, testing is justified in both first-trimester and second-trimester loss evaluations.
Hormone Replacement Practice Patterns Among Oklahoma Physicians Todd D. Tillmanns, MD University of Oklahoma Health Sciences Center, Oklahoma City, OK
Michael A. Gold, MD, Natalie S. Gould, MD, Scott Kamelle, MD, D. Scott McMeekin, MD, and Joan L. Walker, MD Objective: To determine hormone replacement (HRT) patterns among ob-gyns (OBs), family practitioners (FPs), and internists (IMs).
32S Monday Posters
Methods: Anonymous written surveys were sent to OBs, FPs, and IMs within the state of Oklahoma. Practice patterns were compared using X2 tests. A P value of 0.05 was considered significant. Results: Five hundred twenty-five of 1,341 surveys were returned, and 42.1% of OBs, 25.2% of FPs, and 16.3% of IMs stated that they prescribe HRT to 90% of their postmenopausal patients (OBs versus FPs P ⫽ 9⫻10-4; OBs versus IMs P ⫽ 1⫻10-6). Urban physicians prescribed HRT to ⬎ 90% of their postmenopausal patients (urban 38.8%, rural 19.9%, P ⫽ 5⫻10-4). A trend towards increased HRT prescribing was seen for physicians in practice 5 years or less compared with those in practice longer (P⫽ 0.06). Multiple logistics regression found specialty (P ⫽ 0.02), urban practice (P ⫽ 0.01), and years in practice (P ⫽ 0.05) as independent predictors for prescribing HRT to 91–100% of postmenopausal patients. Unopposed estrogen was the favored HRT for all specialties in postmenopausal women with prior hysterectomies. Women with a history of endometriosis who received a hysterectomy were more likely to receive unopposed estrogen for HRT if they were postmenopausal (77.6%) than if they were premenopausal (68.4%). Finally, differences were seen between specialties in requiring a mammogram before starting HRT (OBs 66.9%; FPs 84.7%; IMs 91.7%; OBs versus FPs P ⫽ 1⫻10-4; OBs versus IMs P ⫽ 3⫻10-7; FPs versus IMs (P ⫽ 0.05). Conclusions: Significant differences exist between the practice patterns of OBs, FPs, and IMs. This indicates a need for OBs to promote the benefits of HRT to physicians who are not ob-gyns.
Spontaneous Ectopic Pregnancy and Ectopic Pregnancy Associated With Fertility Treatment: Clinical Findings Manuel Lopez-Iglesias, MD Hospital Angeles de las Lomas, Mexico
Jesus Barron-Vallejo, MD, Herminia Licona-Suarez, MD, Julio Cesar Mondrago´n-Mendoza, MD, Roberto Almanza-Marquez, MD, and Alejandra Sa´nchez-De Leon, MD Objective: The purpose of the study was to investigate the clinical manifestations of patients with spontaneous ectopic pregnancy and patients with the same diagnosis secondary to fertility treatments. Methods: The study included a total of 40 cases. Patients were divided into two groups according to the manner of presentation of ectopic pregnancy. In Group 1, ectopic pregnancy was spontaneous; in Group 2, it was associated with fertility treatments (ovulation induction and IVF). Results: Mean age of all patients was 32.6 ⫾ 5.5 years. In patients with previous ovulation induction, symptoms of
Obstetrics & Gynecology
Elaine T. Vostrovsky, RN, BS, Debra L. Day-Salvatore, MD, PhD, Susan Trout, MD, and Susan Shen-Schwarz, MD Objective: To determine whether a difference exists in the prevalence of anticardiolipin antibodies in patients with a history of recurrent first- versus second-trimester pregnancy loss. Methods: Patients presenting to the Pregnancy Loss Evaluation Service (PLES) from June 1994 to December 1999 were tested for the presence of anticardiolipin IgG, IgM, and IgA antibodies. Levels were measured by a single reference laboratory test. Patients were eligible for the service if they had experienced recurrent first-trimester losses (RFTLs) or at least one second-trimester loss (STL). Comparisons based on the presence of the anticardiolipin antibody were made between patients with RFTL versus STL. Significance was set at P less than 0.05. Results: Anticardiolipin antibody levels were obtained in 93% (243/261) of patients during PLES evaluations. There were 132 patients with RFTL and 129 patients with a STL.
Anticardiolipin IgG Anticardiolipin IgM Anticardiolipin IgA
1st-trimester loss
2nd-trimester loss
6.1% (8/130) 7.1% (9/126) 2.2% (2/88)
4.4% (5/113) 1.7% (2/115) 0% (0/78)
P value 0.49 0.08 0.18
Conclusion: Although the prevalence of anticardiolipin antibodies is greater in patients with first-trimester losses, testing is justified in both first-trimester and second-trimester loss evaluations.
Hormone Replacement Practice Patterns Among Oklahoma Physicians Todd D. Tillmanns, MD University of Oklahoma Health Sciences Center, Oklahoma City, OK
Michael A. Gold, MD, Natalie S. Gould, MD, Scott Kamelle, MD, D. Scott McMeekin, MD, and Joan L. Walker, MD Objective: To determine hormone replacement (HRT) patterns among ob-gyns (OBs), family practitioners (FPs), and internists (IMs).
32S Monday Posters
Methods: Anonymous written surveys were sent to OBs, FPs, and IMs within the state of Oklahoma. Practice patterns were compared using X2 tests. A P value of 0.05 was considered significant. Results: Five hundred twenty-five of 1,341 surveys were returned, and 42.1% of OBs, 25.2% of FPs, and 16.3% of IMs stated that they prescribe HRT to 90% of their postmenopausal patients (OBs versus FPs P ⫽ 9⫻10-4; OBs versus IMs P ⫽ 1⫻10-6). Urban physicians prescribed HRT to ⬎ 90% of their postmenopausal patients (urban 38.8%, rural 19.9%, P ⫽ 5⫻10-4). A trend towards increased HRT prescribing was seen for physicians in practice 5 years or less compared with those in practice longer (P⫽ 0.06). Multiple logistics regression found specialty (P ⫽ 0.02), urban practice (P ⫽ 0.01), and years in practice (P ⫽ 0.05) as independent predictors for prescribing HRT to 91–100% of postmenopausal patients. Unopposed estrogen was the favored HRT for all specialties in postmenopausal women with prior hysterectomies. Women with a history of endometriosis who received a hysterectomy were more likely to receive unopposed estrogen for HRT if they were postmenopausal (77.6%) than if they were premenopausal (68.4%). Finally, differences were seen between specialties in requiring a mammogram before starting HRT (OBs 66.9%; FPs 84.7%; IMs 91.7%; OBs versus FPs P ⫽ 1⫻10-4; OBs versus IMs P ⫽ 3⫻10-7; FPs versus IMs (P ⫽ 0.05). Conclusions: Significant differences exist between the practice patterns of OBs, FPs, and IMs. This indicates a need for OBs to promote the benefits of HRT to physicians who are not ob-gyns.
Spontaneous Ectopic Pregnancy and Ectopic Pregnancy Associated With Fertility Treatment: Clinical Findings Manuel Lopez-Iglesias, MD Hospital Angeles de las Lomas, Mexico
Jesus Barron-Vallejo, MD, Herminia Licona-Suarez, MD, Julio Cesar Mondrago´n-Mendoza, MD, Roberto Almanza-Marquez, MD, and Alejandra Sa´nchez-De Leon, MD Objective: The purpose of the study was to investigate the clinical manifestations of patients with spontaneous ectopic pregnancy and patients with the same diagnosis secondary to fertility treatments. Methods: The study included a total of 40 cases. Patients were divided into two groups according to the manner of presentation of ectopic pregnancy. In Group 1, ectopic pregnancy was spontaneous; in Group 2, it was associated with fertility treatments (ovulation induction and IVF). Results: Mean age of all patients was 32.6 ⫾ 5.5 years. In patients with previous ovulation induction, symptoms of
Obstetrics & Gynecology