California and Oregon will soon allow pharmacists to screen patients and prescribed birth control pills. While the American College of Obstetricians and Gynecologists considers this a step in right direction, they believe they should be available over-the-counter, plain and simple. While it is true that low dose combination birth control pills can have medical complications in a very small percent of people, by and large their health benefits far outweigh their risks.
As most of you probably are already aware, hepatitis C has a new medical treatment which provides a cure in a very high percentage of people. However, hepatitis B has remained a challenge, and in particular, we have had to deal with the problem of vertical passage of the virus from mother to baby during pregnancy, labor and delivery. However recently at the meetings of the American Association for the Study of Liver Diseases, new research was presented. In the course of a randomized controlled trial, a drug called Tenofovir was shown to be able to reduce vertical transmission.
Yet another encouraging recommendation about exercise in pregnancy has been released. According to the American College of Obstetricians and Gynecologists, nearly half of US women gain too much weight while they're pregnant. We all know that women who gain too much weight in pregnancy are very uncomfortable. However they also have higher rates of miscarriage, premature birth, stillbirth, and babies with birth defects. They’re also more likely to have heart problems, sleep apnea, gestational or pregnancy associated diabetes, preeclampsia also known as toxemia, and abnormal blood clots. They are at higher risk for cesarean section. So there are ample reasons to find ways to control this weight gain.
The new memo released by ACOG advises pregnant women to exercise regularly and more often than they currently do. The memo states that while walking is the best exercise, jogging, Pilates, yoga, cycling, swimming, and other forms of exercise are perfectly acceptable. ACOG cautions against contact sports such as skiing, and other specialized sports such as scuba diving.
More good news: it appears that breast-feeding for two months or more reduces a gestational diabetic’s risk of developing type II diabetes later in life by 50 %. Moreover, the risk of diabetes lessens as the patients breast-fed longer.
Finally, here is some good news that initially sounds a lot like bad news. Since 2010, there has been a significant increase in the number of women under age 26 who have received a diagnosis of early-stage cervical cancer. In the next age group, 26-34, the numbers were unchanged. What changed for the younger age group? The answer is the availability of insurance. One of the features of the ACA, The affordable care act, was to allow children to stay on their parents insurance plans through the age of 26. Most likely the increase in diagnoses came from increased compliance with recommended screening, i.e. pap smears. Once again, we are reminded that appropriate screening leads to early diagnosis, which leads to less invasive treatments, fewer complications, and higher rates of cure.
Stay tuned for more breaking news from the world of OB/GYN next week on Medical Monday.
