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The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection.

PRENATAL OBSTETRICS

Perinatal depression and mortality (March 2024)

Perinatal depression is associated with an increased risk of death. An analysis of a national register from Sweden compared outcomes among individuals with and without a diagnosis of depression during pregnancy or postpartum, matched by age and year of delivery [ 1 ]. After controlling for potential confounding factors, all-cause mortality was greater in those with perinatal depression over 18 years of follow-up; the increased risk was largely driven by suicide. These results confirm previous data on the risks of perinatal depression and support our practice of screening for depression during pregnancy and postpartum. Services to ensure follow-up for diagnosis and treatment should accompany screening efforts. (See "Unipolar major depression during pregnancy: Epidemiology, clinical features, assessment, and diagnosis", section on 'All cause' .)

Noninsulin antidiabetic medications and pregnancy (February 2024)

Noninsulin antidiabetic medications such as glucagon-like peptide 1 (GLP-1) agonists, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and dipeptidyl peptidase 4 (DPP-4) inhibitors are commonly used in nonpregnant individuals but avoided in pregnancy because of lack of safety data in humans and harms observed in animal studies. However, in a multinational population-based cohort study including nearly 2000 individuals with preconception/first trimester exposure to these medications, the frequency of congenital anomalies was not increased compared with insulin [ 2 ]. A limitation of the study is that it did not adjust for potential differences in A1C, diabetes severity, or diabetes duration, which could obscure true effects on risk for congenital anomalies. We continue to avoid use of GLP-1 agonists, SGLT-2 inhibitors, and DPP-4 inhibitors in females planning to conceive and in pregnancy. (See "Pregestational (preexisting) diabetes: Preconception counseling, evaluation, and management", section on 'Patients on preconception noninsulin antihyperglycemic agents' .)

Updates to the United States perinatal HIV clinical guidelines (February 2024)

The United States Department of Health and Human Services has released updates to the perinatal HIV clinical guidelines [ 3 ]. Ritonavir-boosted darunavir is now a preferred agent only for treatment-naïve pregnant individuals who have used cabotegravir-based pre-exposure prophylaxis, because of the concern for integrase inhibitor-resistant mutations; for other pregnant individuals, it is now an alternative rather than preferred agent. Additionally, bictegravir, which was previously not recommended for initial therapy in pregnant individuals, is now an alternative agent based on new pharmacokinetic data that support its use during pregnancy. Our approach to treating HIV during pregnancy is consistent with these updated guidelines. (See "Antiretroviral selection and management in pregnant individuals with HIV in resource-rich settings", section on 'Selecting the third drug' .)

Combined use of metformin and insulin for treating diabetes in pregnancy (February 2024)

In patients with type 2 diabetes, insulin is the mainstay for managing hyperglycemia in pregnancy. The addition of metformin improves maternal glucose control and reduces the chances of a large for gestational age newborn, but a prior randomized trial reported an increased risk for birth of a small for gestational age (SGA) infant. A recent randomized trial comparing use of insulin alone with insulin plus metformin in nearly 800 adult pregnant patients with either preexisting type 2 diabetes or diabetes diagnosed in early pregnancy confirmed the previously reported benefits but found that both treatment groups had low and similar rates of SGA [ 4 ]. The discordancy in SGA risk needs to be explored further, as metformin cotreatment would be undesirable if this risk is real. (See "Pregestational (preexisting) diabetes mellitus: Antenatal glycemic control", section on 'Metformin' .)

Fetoplacental GDF15 linked to nausea and vomiting of pregnancy (February 2024)

Almost all pregnant people experience nausea with or without vomiting in early pregnancy; however, the pathogenesis of the disorder has been unclear. Previous studies have shown that GDF15 is expressed in a wide variety of cells, with the highest expression in placental trophoblast, and that its protein (GDF15) appears to regulate appetite. A recent study confirmed the fetoplacental unit as a major source of GDF15 and also found that higher GDF15 levels correlated with more severe nausea and vomiting of pregnancy [ 5 ]. In the future, drugs targeting the production or action of GDF15 are a potential novel pathway for treating nausea and vomiting of pregnancy, if safety and efficacy are established. (See "Nausea and vomiting of pregnancy: Clinical findings and evaluation", section on 'Pathogenesis' .)

Use of cerebroplacental ratio at term does not reduce perinatal mortality (February 2024)

Cerebral blood flow may increase in chronically hypoxemic fetuses to compensate for the decrease in available oxygen and can be assessed by the cerebroplacental ratio (CPR; middle cerebral artery pulsatility index divided by the umbilical artery pulsatility index). However, increasing evidence indicates that use of the CPR does not reduce perinatal mortality in low-risk pregnancies. In a randomized trial comparing fetal growth assessment plus revealed versus concealed CPR in over 11,000 low-risk pregnancies at term, knowledge of CPR combined with a recommendation for delivery if the CPR was <5th percentile did not reduce perinatal mortality compared with usual care (concealed group) [ 6 ]. We do not perform umbilical artery Doppler surveillance, including the CPR, in low-risk pregnancies. (See "Doppler ultrasound of the umbilical artery for fetal surveillance in singleton pregnancies", section on 'Low-risk and unselected pregnancies' .)

Low- versus high-dose calcium supplements and risk of preeclampsia (January 2024)

In populations with low baseline dietary calcium intake, the World Health Organization recommends 1500 to 2000 mg/day calcium supplementation for pregnant individuals to reduce their risk of developing preeclampsia. However, a recent randomized trial that evaluated low (500 mg) versus high (1500 mg) calcium supplementation in over 20,000 nulliparous pregnant people residing in two countries with low dietary calcium intake found low and similar rates of preeclampsia in both groups [ 7 ]. These findings suggest that a 500 mg supplement is sufficient for preeclampsia prophylaxis in these populations. For pregnant adults in the United States, we prescribe 1000 mg/day calcium supplementation, which is the recommended daily allowance to support maternal calcium demands without bone resorption. (See "Preeclampsia: Prevention", section on 'Calcium supplementation' .)

Respectful maternity care (January 2024)

Respectful maternity care is variably defined but broadly involves both absence of disrespectful conduct and promotion of respectful conduct toward pregnant individuals. A systematic review found that validated tools to measure respectful maternity care were available, but the optimal tool was unclear and high quality studies were lacking on the effectiveness of respectful maternity care for improving any maternal or infant health outcome [ 8 ]. Respectful maternal care is a basic human right, but how to best implement and monitor it and assess outcomes requires further study. (See "Prenatal care: Initial assessment", section on 'Effectiveness' .)

Outcome of a multifaceted intervention in patients with a prior cesarean birth (January 2024)

Patients with a pregnancy after a previous cesarean birth must choose between a trial of labor (TOLAC) and a planned repeat cesarean. The optimal care of such patients is unclear. In a multicenter, cluster-randomized trial including over 20,000 patients with one prior cesarean birth, a multifaceted intervention (patient decision support, use of a calculator to assess chances of a vaginal birth after cesarean [VBAC], sonographic measurement of myometrial thickness, clinician training in best intrapartum practices during TOLAC) reduced perinatal and major maternal morbidity composite outcomes compared with usual care [ 9 ]. VBAC and uterine rupture rates were similar for both groups. Further study is needed to identify the most useful component(s) of the intervention for reducing morbidity. (See "Choosing the route of delivery after cesarean birth", section on 'Person-centered decision-making model' .)

Serial amnioinfusions for bilateral renal agenesis (January 2024)

Bilateral renal agenesis (BRA) is incompatible with extrauterine life because prolonged oligohydramnios results in pulmonary hypoplasia, leading to postnatal respiratory failure. A prospective study (RAFT) assessed use of serial amnioinfusions to treat 18 cases of BRA diagnosed at <26 weeks of gestation [ 10 ]. Of the 17 live births, 14 survived ≥14 days and had placement of dialysis access, but only 6 survived to hospital discharge. Of the 4 children alive at 9 to 24 months of age, 3 had experienced a stroke and none had undergone transplant. These findings show that serial amnioinfusions for BRA mitigates pulmonary hypoplasia and increases short-term survival and access to dialysis; however, long-term outcome remains poor with no survival to transplantation. Serial amnioinfusions remain investigational and should be offered only as institutional review board-approved research. (See "Renal agenesis: Prenatal diagnosis", section on 'Investigative role of therapeutic amnioinfusion' .)

Prenatal genetic testing for monogenic diabetes due to glucokinase deficiency (December 2023)

In pregnant individuals with monogenic diabetes due to glucokinase (GCK) deficiency, management depends on the fetal genotype. If the fetus inherits the maternal GCK variant, maternal hyperglycemia will not cause fetal hyperinsulinemia and excessive growth, and maternal hyperglycemia does not require treatment. However, if the fetus does not inherit the pathogenic variant, maternal insulin therapy is indicated to prevent excessive fetal growth. Fetal ultrasound has been used to predict fetal genotype but has limited diagnostic utility. In a cohort of 38 pregnant individuals with GCK deficiency, fetal genetic testing using cell-free DNA in maternal blood had higher sensitivity (100 versus 53 percent) and specificity (96 versus 61 percent) for prenatal diagnosis of GCK deficiency compared with ultrasound measurement of fetal abdominal circumference [ 11 ]. When available, noninvasive prenatal genotyping should be used to guide management of GCK deficiency during pregnancy. (See "Classification of diabetes mellitus and genetic diabetic syndromes", section on 'Glucokinase' .)

Early metformin treatment of gestational diabetes mellitus (November 2023)

Usual initial gestational diabetes mellitus (GDM) care (ie, medical nutritional therapy, exercise) may result in a few weeks of hyperglycemia before a need for pharmacotherapy is established. In a randomized trial evaluating whether initiating metformin at the time of GDM diagnosis regardless of glycemic control improves clinical outcomes compared with usual care, the metformin group had a lower rate of insulin initiation and favorable trends in mean fasting glucose, gestational weight gain, and excessive fetal growth, but more births <2500 grams [ 12 ]. Rates of preeclampsia, neonatal intensive care unit admission, and neonatal hypoglycemia were similar for both groups. Given these mixed results, we recommend not initiating metformin at the time of GDM diagnosis except in a research setting. (See "Gestational diabetes mellitus: Glucose management and maternal prognosis", section on 'Does early metformin initiation improve glycemic control and reduce need for insulin?' .)

Automated insulin delivery in pregnant patients with type 1 diabetes (October 2023)

Hybrid closed-loop insulin therapy is associated with improved glucose control in nonpregnant adults and in children, but little information is available in pregnant people. In the first randomized trial in this population, hybrid closed-loop insulin delivery beginning at 11 weeks gestation improved glycemic control compared with standard insulin therapy in 124 patients with type 1 diabetes, without increasing their risk of severe hypoglycemia [ 13 ]. The system allowed customization of glycemic targets appropriate to pregnancy, in contrast to other commercially available systems in the United States. Additional study is needed to confirm these findings, evaluate the effects on obstetric and neonatal outcomes, and identify optimal candidates. (See "Pregestational (preexisting) diabetes mellitus: Antenatal glycemic control", section on 'Continuous subcutaneous insulin infusion (insulin pump)' .)

Valacyclovir for prevention of congenital cytomegalovirus infection (October 2023)

Emerging evidence suggests that maternal administration of valacyclovir for primary cytomegalovirus (CMV) infection substantially reduces the risk of congenital CMV infection, especially if begun prior to 14 weeks of gestation and within 8 weeks of the maternal infection. In a 2023 individual patient data meta-analysis (one randomized trial, two observational studies), maternal valacyclovir administration upon diagnosis of periconception or first-trimester primary CMV infection was associated with a 66 percent reduction in congenital CMV (11 versus 25 percent) [ 14 ]. We suggest high-dose oral valacyclovir (8g per day) for patients with a primary CMV infection in early pregnancy after a comprehensive discussion of the potential benefits and risks (eg, 2 percent risk of reversible maternal kidney failure). (See "Cytomegalovirus infection in pregnancy", section on 'Antiviral medication' .)

Respiratory syncytial virus vaccination in pregnancy (April 2023, Modified October 2023)

Respiratory syncytial virus (RSV) is a major cause of morbidity and mortality in infants. In October 2023, the United States Centers for Disease Control and Prevention, along with guidelines from other expert groups, endorsed RSV vaccination of pregnant individuals to reduce severe RSV infections in their infants [ 15-18 ]. Nirsevimab , a monoclonal antibody that can be given to infants postnatally to reduce the risk of severe RSV, has also been recently approved and endorsed by expert guidance panels. In settings where nirsevimab is not available, we suggest vaccination of pregnant individuals between 32 0/6 and 36 6/7 weeks of gestation in September through January (in the northern hemisphere) with inactivated nonadjuvanted recombinant RSV vaccine (RSVPreF; Abrysvo). In settings where both maternal vaccination and nirsevimab are available, the optimal preventive strategy remains uncertain, and, in most cases, it will not be possible to use both. For such patients, both options should be discussed and shared decision-making undertaken. (See "Immunizations during pregnancy", section on 'Choosing the optimal strategy' .)

INTRAPARTUM AND POSTPARTUM OBSTETRICS

Intrauterine postpartum hemorrhage control devices for managing postpartum hemorrhage (February 2024)

Intrauterine balloon tamponade and vacuum-induced uterine compression are the most common devices used for intrauterine postpartum hemorrhage (PPH) control in patients with atony, but it is unclear which device is superior as few comparative studies have been performed. In a retrospective study including nearly 380 patients with PPH, quantitative blood loss after placement, rate of blood transfusion, and discharge hematocrit were similar for both devices [ 19 ]. Based on these and other data, in the setting of ongoing uterine bleeding, rapid use of one of these devices is likely to be more important than the choice of device when both devices are available. (See "Postpartum hemorrhage: Use of an intrauterine hemorrhage-control device", section on 'Choice of method' .)

Labor epidural analgesia and risk of emergency delivery (December 2023)

It is well established that contemporary neuraxial labor analgesia does not increase the overall risk of cesarean or instrument-assisted vaginal delivery. However, a new retrospective database study of over 600,000 deliveries in the Netherlands reported that epidural labor analgesia was associated with an increased risk of emergency delivery (cesarean or instrument-assisted vaginal) compared with alternative analgesia (13 versus 7 percent) [ 20 ]. Because of potential confounders and lack of detail on epidural and obstetric management, we consider these data insufficient to avoid neuraxial analgesia or change the practice of early labor epidural placement to reduce the potential need for general anesthesia in patients at high risk for cesarean delivery. (See "Adverse effects of neuraxial analgesia and anesthesia for obstetrics", section on 'Effects on the progress and outcome of labor' .)

Delayed cord clamping in preterm births (December 2023)

Increasing evidence supports delaying cord clamping in preterm births. In an individual participant data meta-analysis of randomized trials of delayed versus immediate cord clamping at births <37 weeks (over 3200 infants), delaying cord clamping for >30 seconds reduced infant death before discharge (6 versus 8 percent) [ 21 ]. In a companion network meta-analysis evaluating the optimal duration of delay, a long delay (≥120 seconds) significantly reduced death before discharge compared with immediate clamping; reductions also occurred with delays of 15 to <120 seconds but were not statistically significant [ 22 ]. For preterm births that do not require resuscitation, we recommend delayed rather than immediate cord clamping. We delay cord clamping for at least 30 to 60 seconds as approximately 75 percent of blood available for placenta-to-fetus transfusion is transfused in the first minute after birth. (See "Labor and delivery: Management of the normal third stage after vaginal birth", section on 'Preterm infants' .)

Vacuum-induced intrauterine tamponade for postpartum hemorrhage (November 2023)

Intrauterine tamponade (with a balloon, packing, or vacuum) may be used to manage patients with postpartum hemorrhage (PPH) resulting from uterine atony that is not controlled by uterotonic medications and uterine massage. However, outcome data regarding vacuum-induced tamponade are limited. A study of data from a postmarketing registry of over 500 patients with PPH and isolated atony treated with vacuum-induced tamponade reported that the device controlled bleeding without treatment escalation or bleeding recurrence in 88 percent following cesarean birth and 96 percent following vaginal birth, typically within five minutes [ 23 ]. These data are consistent with previously published outcomes. Given its efficacy and ease of use, vacuum-induced tamponade is an important option for managing PPH in centers where this device is available. (See "Postpartum hemorrhage: Use of an intrauterine hemorrhage-control device", section on 'Vacuum-induced tamponade' .)

Risk of pregnancy-associated venous and arterial thrombosis in sickle cell disease (November 2023)

Sickle cell disease (SCD) and pregnancy both confer an increased risk of venous thromboembolism (VTE), but the magnitude of the risk is unclear. In a new administrative claims data study involving >6000 people with SCD and >17,000 age- and race-matched controls who were followed for one year postpartum, the risk of VTE was 11.3 percent in the patients with SCD, versus 1.2 percent in controls [ 24 ]. Arterial thromboembolism was also increased (5.2 percent, versus 0.6 percent in controls). This study emphasizes the value of postpartum VTE prophylaxis in people with SCD and the need for vigilance in evaluating suggestive symptoms. (See "Sickle cell disease: Obstetric considerations", section on 'Maternal risks' .)

Racial disparities in anemia during pregnancy (October 2023)

A new study has found that racial disparities in anemia during pregnancy persist and may be increasing. This analysis involved nearly four million births in the state of California from 2011 to 2020 [ 25 ]. Antepartum anemia was most common in Black individuals (22 percent), followed by Pacific Islanders (18 percent), Native American and Alaska Native peoples (14 percent), multiracial individuals (14 percent), Hispanic individuals (13 percent), Asian individuals (11 percent), and White individuals (10 percent). Antepartum anemia is associated with an increase in severe maternal morbidity. The reasons for disparities are multifactorial. (See "Anemia in pregnancy", section on 'Racial disparities' .)

Intrapartum magnesium sulfate before preterm birth and cerebral palsy (October 2023)

Magnesium sulfate is typically administered to pregnant women with impending preterm birth <32 weeks of gestation to decrease the incidence and severity of cerebral palsy in offspring. However, the recent MAGENTA trial comparing the effects of magnesium sulfate versus placebo administered before impending preterm birth between 30 and 34 weeks of gestation found that it did not prevent cerebral palsy among surviving infants [ 26 ]. These findings do not change our current practice because the trial used a single 4 g bolus of magnesium sulfate alone, whereas we also provide an ongoing 1 g/hour infusion until delivery and do not use the medication after 32 weeks; the trial was likely underpowered to find a significant difference. (See "Neuroprotective effects of in utero exposure to magnesium sulfate", section on 'Lower and upper gestational age' .)

OFFICE GYNECOLOGY

Infertility and autism spectrum disorder (December 2023)

Patients with infertility often ask about the impact of the disorder and its treatment on risk of autism spectrum disorder (ASD) in offspring. In a large population-based cohort study comparing ASD risk among children whose parents had subfertility (an infertility consultation without treatment), infertility treatment, or neither (unassisted conception), children in the subfertility and infertility treatment groups had a small increased risk of ASD compared with unassisted conception but the absolute risk was low (2.5 to 2.7 per 1000 person-years versus 1.9 per 1000 person-years with unassisted conception) [ 27 ]. The increased risk was similar in the subfertile and infertility treatment groups, suggesting that infertility treatment was not a major risk factor. Obstetrical and neonatal factors (eg, preterm birth) appeared to mediate a sizeable proportion of the increased risk for ASD. (See "Assisted reproductive technology: Infant and child outcomes", section on 'Confounders' .)

Macular changes related to pentosan polysulfate sodium (November 2023)

Macular eye disease has been reported in patients who have taken pentosan polysulfate sodium (PPS), which is used for the treatment of interstitial cystitis. In a prospective cohort study of 26 eyes with PPS maculopathy and >3000 g cumulative PPS exposure, progression of macular changes continued 13 to 30 months after drug cessation [ 28 ]. Median visual acuity decreased slightly; most patients reported progression of symptoms, including difficulty in low-light environments and blurry vision. These results indicate that PPS maculopathy progresses despite drug discontinuation, underscoring the importance of regular screening for maculopathy in patients with current or prior PPS exposure. (See "Interstitial cystitis/bladder pain syndrome: Management", section on 'Pentosan polysulfate sodium as alternative' .)

Vaginal laser therapy not effective for genitourinary syndrome of menopause (November 2023)

Laser devices, including the fractional microablative CO 2 laser, have been marketed for treatment of patients with genitourinary syndrome of menopause (GSM), but data regarding their safety and efficacy are limited. In a randomized trial including nearly 50 postmenopausal patients with GSM, treatment with CO 2 laser did not improve symptom severity compared with sham therapy [ 29 ]. Change in vaginal histology, which is a common surrogate determinant of treatment success, was similar in both groups at six months postprocedure. In addition, histologic features associated with a hypoestrogenic state correlated poorly with the severity of vaginal symptoms. Although the trial had limitations, these findings are consistent with other data and support our practice of not using laser treatment for patients with GSM. (See "Genitourinary syndrome of menopause (vulvovaginal atrophy): Treatment", section on 'Laser or radiofrequency devices' .)

Use of vaginal estrogen in breast cancer patients taking aromatase inhibitors (October 2023)

Use of vaginal estrogen to manage symptoms of genitourinary syndrome of menopause (GSM) may be harmful in patients with breast cancer on aromatase inhibitors (AIs). In a subgroup analysis of a claims-based analysis, vaginal estrogen therapy was associated with a higher rate of breast cancer recurrence in patients taking versus not taking an AI [ 30 ]. Time to recurrence in the AI group was approximately 140 days. While this study had many limitations, these data support our general practice of avoiding vaginal estrogen for the management of GSM in most patients with breast cancer taking AIs. (See "Genitourinary syndrome of menopause (vulvovaginal atrophy): Treatment", section on 'Patients with breast cancer' .)

GYNECOLOGIC SURGERY

Risk of unplanned hysterectomy at time of myomectomy (February 2024)

Myomectomy is an option for patients with bothersome fibroid symptoms (eg, bleeding, bulk); however, data are limited regarding the risk of unplanned hysterectomy at the time of myomectomy. In a retrospective study of the American College of Surgeons' National Surgical Quality Improvement Program database from 2010 to 2021 including over 13,000 patients undergoing myomectomy, the risk of unplanned hysterectomy was higher in those undergoing laparoscopic myomectomy compared with an open abdominal or hysteroscopic approach (7.1, 3.2, and 1.9 percent respectively) [ 31 ]. While much lower risks have been reported (<0.4 percent), and expert surgeons at high-volume centers may have fewer conversions to hysterectomy, this study highlights the importance of discussing the risk of unplanned hysterectomy during the informed consent process. (See "Uterine fibroids (leiomyomas): Laparoscopic myomectomy and other laparoscopic treatments", section on 'Unplanned hysterectomy' and "Uterine fibroids (leiomyomas): Open abdominal myomectomy procedure", section on 'Unplanned hysterectomy' and "Uterine fibroids (leiomyomas): Hysteroscopic myomectomy", section on 'Unplanned hysterectomy' .)

Risk of subsequent hysterectomy after endometrial ablation (January 2024)

Endometrial ablation is an alternative to hysterectomy in selected premenopausal patients with heavy menstrual bleeding. Most ablations are performed using a non-resectoscopic technique; however, the long-term efficacy of this approach is unclear. In a meta-analysis of 53 studies including over 48,000 patients managed with non-resectoscopic endometrial ablation (NREA), the rates of subsequent hysterectomy were 4 percent at 12 months, 8 to 12 percent at 18 to 60 months, and 21 percent at 120 months [ 32 ]. Hysterectomy rates were similar for the different NREA devices (eg, thermal balloon, microwave, radiofrequency). These findings are useful for counseling patients about the long-term risk for hysterectomy after NREA. (See "Endometrial ablation: Non-resectoscopic techniques", section on 'Efficacy' .)

Pregnancy and childbirth after urinary incontinence surgery (January 2024)

Patients with stress urinary incontinence (SUI) have historically been advised to delay midurethral sling (MUS) surgery until after childbearing because of concerns for worsening SUI symptoms following delivery. In a meta-analysis of patients with MUS surgery who were followed for a mean of nearly 10 years, similar low SUI recurrence and reoperation rates were reported for the 381 patients with and the 860 patients without subsequent childbirth [ 33 ]. Birth route did not affect the findings. Although the total number of recurrences and reoperations was small, this study adds to the body of evidence suggesting that subsequent childbirth does not worsen SUI outcomes for patients who have undergone MUS. (See "Surgical management of stress urinary incontinence in females: Retropubic midurethral slings", section on 'Subsequent pregnancy' .)

GYNECOLOGIC ONCOLOGY

Types of hysterectomy in patients with stage IB1 cervical cancer (March 2024)

Patients with stage IB1 cervical cancer (ie, >5 mm depth of stromal invasion and ≤2 cm in greatest dimension) are typically treated with radical hysterectomy; however, less extensive surgery is being evaluated. In a randomized trial including over 640 patients with stage IB1 cervical cancer, radical hysterectomy and simple hysterectomy plus lymph node assessment resulted in similar rates of recurrence at three years (2.2 and 2.5 percent, respectively) [ 34 ]. Although the study has limitations, including a short follow-up period, simple hysterectomy with lymph node assessment may be an acceptable alternative to radical hysterectomy in patients with IB1 cervical cancer. (See "Management of early-stage cervical cancer", section on 'Type of surgery' .)

Increasing incidence of cervical and uterine corpus cancer in the United States (February 2024)

In January 2024, the American Cancer Society published their annual report of cancer statistics in the United States [ 35 ]. Notable trends in regard to gynecologic cancers include a 1.7 percent increase in the annual incidence of cervical cancer from 2012 to 2019 in individuals aged 30 to 44 years, after decades of decline. Cancer of the uterine corpus (all ages) continued to increase by approximately 1 percent annually and was the only cancer in the report in which survival decreased. These and other data emphasize the continued importance of both early detection and prevention (eg, for cervical cancer: human papillomavirus vaccination and screening for precursor lesions; for endometrial cancer: achieving and maintaining a normal body mass index). (See "Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis", section on 'Incidence and mortality' and "Endometrial carcinoma: Epidemiology, risk factors, and prevention", section on 'Epidemiology' and "Endometrial carcinoma: Clinical features, diagnosis, prognosis, and screening", section on 'Prognosis' .)

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• Cesta CE, Rotem R, Bateman BT, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med 2024; 184:144.
• Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States. https://clinicalinfo.hiv.gov/en/guidelines/perinatal/whats-new-guidelines (Accessed on February 08, 2023).
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• Lee TTM, Collett C, Bergford S, et al. Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes. N Engl J Med 2023; 389:1566.
• Chatzakis C, Shahar-Nissan K, Faure-Bardon V, et al. The effect of valacyclovir on secondary prevention of congenital cytomegalovirus infection, following primary maternal infection acquired periconceptionally or in the first trimester of pregnancy. An individual patient data meta-analysis. Am J Obstet Gynecol 2024; 230:109.
• CDC recommends new vaccine to help protect babies against severe respiratory syncytial virus (RSV) illness after birth. Centers for Disease Control and Prevention, 2023. https://www.cdc.gov/media/releases/2023/p0922-RSV-maternal-vaccine.html#:~:text=On%20September%2022%2C%202023%2C%20members,respiratory%20tract%20infection%20in%20infants (Accessed on September 25, 2023).
• ACIP Recommendations. Centers for Disease Control and Prevention, 2023. https://www.cdc.gov/vaccines/acip/recommendations.html (Accessed on September 25, 2023).
• ACOG Unequivocally Supports ACIP’s Recommendation Approving Use of Maternal RSV Vaccine in Pregnancy. American College of Obstetricians and Gynecologists, 2023. https://www.acog.org/news/news-releases/2023/09/acog-supports-acip-recommendation-approving-use-maternal-rsv-vaccine-in-pregnancy (Accessed on September 25, 2023).
• Clinical considerations for the prevention of respiratory syncytial virus disease in infants. Society for Material-Fetal Medicine. Available at: https://www.smfm.org/publications/546-smfm-statement-clinical-considerations-for-the-prevention-of-respiratory-syncytial-virus-disease-in-infants (Accessed on November 02, 2023).
• Shields LE, Foster M, Klein C, et al. 68 Prospective multicenter trial comparing balloon versus suction hemorrhage control devices for postpartum hemorrhage. Am J Obstet Gynecol 2024; 230:S51.
• Damhuis SE, Groen H, Thilaganathan B, et al. Effect of intrapartum epidural analgesia on rate of emergency delivery for presumed fetal compromise: nationwide registry-based cohort study. Ultrasound Obstet Gynecol 2023; 62:668.
• Seidler AL, Aberoumand M, Hunter KE, et al. Deferred cord clamping, cord milking, and immediate cord clamping at preterm birth: a systematic review and individual participant data meta-analysis. Lancet 2023; 402:2209.
• Seidler AL, Libesman S, Hunter KE, et al. Short, medium, and long deferral of umbilical cord clamping compared with umbilical cord milking and immediate clamping at preterm birth: a systematic review and network meta-analysis with individual participant data. Lancet 2023; 402:2223.
• Goffman D, Rood KM, Bianco A, et al. Real-World Utilization of an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device. Obstet Gynecol 2023; 142:1006.
• Agarwal S, Stanek JR, Vesely SK, et al. Pregnancy-related thromboembolism in women with sickle cell disease: An analysis of National Medicaid Data. Am J Hematol 2023; 98:1677.
• Igbinosa II, Leonard SA, Noelette F, et al. Racial and Ethnic Disparities in Anemia and Severe Maternal Morbidity. Obstet Gynecol 2023; 142:845.
• Crowther CA, Ashwood P, Middleton PF, et al. Prenatal Intravenous Magnesium at 30-34 Weeks' Gestation and Neurodevelopmental Outcomes in Offspring: The MAGENTA Randomized Clinical Trial. JAMA 2023; 330:603.
• Velez MP, Dayan N, Shellenberger J, et al. Infertility and Risk of Autism Spectrum Disorder in Children. JAMA Netw Open 2023; 6:e2343954.
• Somisetty S, Santina A, Au A, et al. Progression of Pentosan Polysulfate Sodium Maculopathy in a Prospective Cohort. Am J Ophthalmol 2023; 255:57.
• Li FG, Fuchs T, Deans R, et al. Vaginal epithelial histology before and after fractional CO2 laser in postmenopausal women: a double-blind, sham-controlled randomized trial. Am J Obstet Gynecol 2023; 229:278.e1.
• Agrawal P, Singh SM, Able C, et al. Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer. Obstet Gynecol 2023; 142:660.
• Coyne K, Purdy MP, Bews KA, et al. Risk of hysterectomy at the time of myomectomy: an underestimated surgical risk. Fertil Steril 2024; 121:107.
• Oderkerk TJ, Beelen P, Bukkems ALA, et al. Risk of Hysterectomy After Endometrial Ablation: A Systematic Review and Meta-analysis. Obstet Gynecol 2023; 142:51.
• Nahshon C, Abramov Y, Kugelman N, et al. The effect of subsequent pregnancy and childbirth on stress urinary incontinence recurrence following midurethral sling procedure: a meta-analysis. Am J Obstet Gynecol 2024; 230:308.
• Plante M, Kwon JS, Ferguson S, et al. Simple versus Radical Hysterectomy in Women with Low-Risk Cervical Cancer. N Engl J Med 2024; 390:819.
• Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin 2024; 74:12.

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A List of the Best Dissertation Topics in Obstetrics and Gynecology

Before students can graduate, they may have to create a dissertation on gynecology and obstetrics. In addition to requiring a significant amount of research, this research paper will necessitate hours of time spent writing and proofreading. To get started on the essay, students need to pick a topic. The best topics are completely original and contain an interesting subject. If the student truly cares about their topic, they will find it easier to research and write the paper. For some dissertation ideas, read through the following list.

Topic Ideas for Obstetrics and Gynecology

• Effectiveness of Cloposcopic Cervical Screenings
• Do Patients With frequent Miscarriages Have Higher Anticardiolip Antibodies?
• Acute Liver Failure During Pregnancy: Different Prognostic Techniques and Medical Treatments
• Prevalence of Thyroid Disorders in Obstetrics Patients
• Comparison of the Efficacy of Different Techniques for Estimating Fetal Weight Throughout Pregnancy
• Techniques for Managing Hypertension During Pregnancy
• Dealing With Insulin Resistance Among Women Who Have Polycystic Ovarian Syndrome
• How Does Vitamin D Supplementation During Pregnancy Change the Outcomes for Mother and Child?
• Gestational Diabetes and Medical Interventions
• Hepatitis-B in Pregnant Women and Their Neonatal Outcome: Do Vaccines Effectively Reduce Transmission?
• Gestational Weight Gain's Effect on Delivery and Neonatal Health
• Are Lowered Blood Platelet Counts an Indication of Hypertension Among Pregnant Women?
• Study of Human Chimeras and Their Pregnancy Outcomes
• Techniques for Treating Malignant Ovarian Tumors During Pregnancy
• Dynsfunctional Uterine Bleeding: The Efficacy of an Ultrasound Diagnosis
• What Enzymes Are Linked to Gestational Diabetes?
• Can Ultrasounds be Used as a Pelvimetric Tool?
• The Efficacy of Hormone Therapy in Early Menopause
• Comparative Study for Different Preventive Methods for Postpartum Hemorrhage
• Neonatal Outcome of Third Trimester Confinement Versus Non-Confinement
• High Risk Pregnancies and the Implications of Color Doppler
• Will an Amnio-Infusion Reduce Fetal Distress in Cases of Thick Meconoium Amniotic Fluid?
• What are the Predictors for Pregnancy-Induced Hypertension?
• Uterine Bleeding: Is Bleeding Due to Histopathological Differences in the Endometrium?
• Physical Activity Levels and Perinatal Mortality Rates
• Comparative Study of Cesarean Sections in the United States and the United Kingdom
• The Implications of Different Volumes of Amniotic Fluid in Predicting Perinatal Outcomes
• Does the Consumption of Sugar-Sweetened Beverages in Childhood Change the Age of Menarchy?
• Study of Maternal Health Services Available in Rural Peru
• Boosting Fertility Rates in Women With Polycystic Ovarian Syndrome
• Comparison of Neonatal and Maternal Outcomes for Hospital Deliveries Versus Midwifery Deliveries
• Comparison of Side Effects of Different Contraceptive Methods
• Management of Ovarian Cancer in HNPCC Carrier Families

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Obstetrics and Gynaecology - Theses

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Dissertations at the division of Obstetrics and Gynaecology

2023 Ylva Crona Guterstam Immune cell composition and cytokine expression in the pregnant and non-pregnant uterus

2022 Emilia Rotstein Pelvic Floor Dysfunction after Childbirth - symptoms, diagnosis, treatment

2022 Beata Molin Chronic pain related to childbirth. Prevalence, characteristics, women’s experiences about its impact and support from healthcare

2022 Stefhanie Romero Traction force and long-term outcome in children born after a vacuum assisted delivery

2022 Nerges Winblad Exploring Early Development and Regenerative Medicine Using CRISPR/Cas9

2021 Richelle Duque Björnvangn Fewer Kids: Not Always By Choice.The link between endocrine-disrupting chemicals and female reproductive health

2011 - 2020

2020 Magdalena Wagner The human ovary: a characterization of cell types and adverse ovarian side effects of chemotherapy

2020 Alvaro Playa Reyes Developmental insights and biomedical potential of human embryonic stem cells: modelling trophoblast differentiation and establishing novel cell therapies for age-related macular degeneration

2020 John Paul Schell Exploring mammalian preimplantation development and pluripotency

2019 Lars Thurn Massive transfusion in relation to obstetric hemorrhage: with special attention to placenta accreta

2018 Fawaz Abomaray Exploring the Role of Mesenchymal Stromal Cells in Endometriosis

2015 Boel Niklasson Pain relief following cesarean section: short and long term perspectives

2015 Ingrid Norman Human papillomavirus and cervical cancer : detection of potential markers of disease progression using liquid-based cytology.

2015 Sarita Panula Modeling human germ cell development with pluripotent stem cells and characterizing the putative oogonial stem cells

2014 Shahla Hamza Al-Saqi New approaches to treat women’s urogenital problems

2014 Fredwell Hambiliki Culture and vitrification of human preembryos

2013 Liv Ahlborg Go with the flow : to facilitate learning in laparoscopic gynecology

2013 Anna-Maria Kanold Maternal Microchimerism

2013 Mona Sheikhi Clinical grade vitrification of human ovarian tissue for fertility preservation

2013 Mohammed Saliem Cellular replacement therapy for liver disease

2012 Eleonor Tiblad New strategies to prevent fetal and neonatal complications in Rhesus D immunization

2012 Natalia Luksha Small artery dysfunction : focus on preeclampsia and end-stage renal disease

2011 Signe Altmäe Human endometrial receptivity and embryo-endometrium interactions

2001 - 2010

2010 Susanne Ström Optimisation of Human Embryonic Stem Cell Derivation and Culture - Towards Clinical Quality

2009 Lena Edwall Female stress incontinence and uterovaginal prolapse : Collagen turnover and hormone sensitivity in urogenital tissue

2009 Michael Algovik Genetic and epidemiological studies of Dystocia : Difficult labour

2009 Sophia Brismar Wendel HPV genotyping and potential progression markers in cervical intraepithelial neoplasia : Clinical and diagnostic impact

2008 Inger Britt Carlsson Regulation of human ovarian folliculogenesis in vitro

2008 Maria Lindeberg Molecular and morphological studies of folliculogenesis, oocyte maturation and embryogenesis in humans.

2006 Maria-Natalia Cruz Gender-related small artery function: implications for estrogenic compounds .

2006 Ingrid Bergström Effects of gonadal hormone deficiency on bone mineral density: can physical activity increase bone mineral density in women?

2006 Karin Petersson Diagnostic evaluation of fetal death with special reference to intrauterine infections

2006 Lusine Aghajanova Endometrial, embryonic and ovarian aspects of human implantation.

2005 Pu Zhang Human ovarian follicles and oocytes: collection, cryopreservation, culture and gene expression.  

2004 Christine Bruse Invasion promoting factors in endometriotic and endometrial tissue.

2004 Jennifer E. Scott Human ovarian follicle recruitment: an in vitro approach.

2003 José Inzunza New micromanipulative techniques in reproductive biology.

2003 Julius Hreinsson Preservation of fertility through cryopreservation and in vitro maturation of human ovarian follicles and oocytes.

2003 Miriam Mints Idiopathic menorrhagia.

2003 Kristina Elfgren Longitudinal studies of human papillomavirus infection with special reference to screening for cervical cancer and treatment of cin.

2003 Ingvar Ek Polycystic ovary syndrome.

2002 Josefine Nasiell Expression and regulation of vasoactive substances, sex steroids and their receptors in placenta during normal pregnancy and preeclampsia.

2002 Bim Lindton Experimental studies of human fetal liver cells-in regard to in utero hematopoietic stem cell transplantation.

2001 Katarina Englund Hormonal regulation of sex steroid receptors and growth related genes in human myometrium and leiomyomas.

1991 - 2000

1998 Margareta Fridström Endocrine and therapeutic aspects of infertile women with the polycystic ovary syndrome.

1998 Björn Rosenlund Management of severe male infertility with special reference to IVF and ICSI.

1997 Karolina Kublickiene Regulation of vascular tone in myometrial resistance arteries in normal pregnancy and preeclampsia.

1996 Marius Kublickas Maternal renal artery Doppler velocimetry in normal and hypertensive pregnancies.

1996 Susanne Lindgren HIV and pregnancy an epidemiological, clinical and virological study of HIV-infected pregnant women and their offspring .

1995 Lennart Nordström Fetal lactate levels during labour and at delivery.- determined with test strip methods

1995 Sverker Ek Fetal hematopoietic cells in early gestation: Aspects in view of fetal transplantation.

1994 Owe Gustafson Endocrine factors and the outcome of in vitro fertilization.

1994 Charlotta Grunewald Circulatory effects of plasma volume expansion and blood pressure reduction in hypertensive disorders of pregnancy.

1993 Gunnar Möllerström Altered adrenal steroid profile and bone characteristics in women with endometrial cancer.

1991 Gunny Röckner Reconsideration of the use of episiotomy in primiparas. A study in obstetric care.

1991 Märta Silber Hormonal influences in women, as reflected in cognitive function, libido, sexual behavior and premenstrual symptoms.

1980 - 1990

1990 Lennart Rosenborg Human sperm characteristics before and after preparation for in vitro fertilization.

1988 Aino Johansson The effect of cervical dilatation by Laminaria tent on fibrinolytic, collagenolytic and contractile activity in the uterus and on postabortal pelvic inflammatory diseases.

1985 Helmus Pschera Amniotic fluid studies in diabetic and intrauterine growth retarded pregnancies with special reference to fetal beta cell function.

1985 Henry Nisell Studies of cardiovascular and sympatho-adrenal function in normal pregnancy and pregnancy induced hypertension.

1984 Anders Kjaeldgaard Influence of contraceptive steroids and cigarette smoke on tissue plasminogen activator. - A clinical, experimental and immunological study.

1983 Peter Bistoletti Plasma catecholamines in the human fetus and newborn.

1982 Lars Nylund Uteroplacental blood flow studies with functional placental scintigraphy.

1982 Ulf Rosing Serum lecithin fatty acids in normal and pre-eclamptic pregnancy and in the puerperium.

1981 George Evaldson Premature rupture of the membranes and ascending infection.

1980 Anders Ölund Rivanol for induction of late abortion. Clinical and biochemical aspects.

1980 Jan Wager Metabolic, circulatory and hormonal effects of the BETA2-adrenoceptor stimulating drug salbutamol in late pregnancy.

1980 Anders Lagrelius Aspects on treatment of the climacteric. A prospective study with special reference to blood coagulation, lipid, endocrinological and bone mineral metabolic changes during treatment with oral piperazine estrone sulphate in the perimenopaus.

Obstetrics & Gynaecology

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Find obstetrics and gynaecology books, keywords and subject headings, ebook collections, aap neonatal resuscitation collection, searching the ubc library catalogue.

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Most obstetrics and gyneacology books are classed in WP and WQ and are located on Level 3 of the Woodward Science Library . You can also find obstetric and gynaecology collections at the Biomedical Branch Library at Vancouver General Hospital and the Study and Learning Commons at BC Children's and Women's Hospitals.  Ebooks are accessible through the UBC Library Catalogue . 

Listed below is a selection of obstetrics and gynaecology subject headings that can be used to search the UBC Library Catalogue . Click on the links to find all UBC Library books on that specific subject.

• Genital Diseases, Female
• Pregnancy Complications
• Pregnancy in Adolescence
• Ultrasonics in obstetrics
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Please find links below to both online and print copies of the NRP (Neonatal Resuscitation Program) texts from the American Academy of Pediatrics.

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The Epidemiology of Gynecologic Health: Contemporary Opportunities and Challenges

Sarah r. hoffman.

1 Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA

Leslie V. Farland

2 Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

Kemi M. Doll

3 Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA

Wanda K. Nicholson

4 Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill, NC, USA

5 Center for Women’s Health Research, University of North Carolina, Chapel Hill, NC, USA

6 Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA

Maya A. Wright

Whitney r. robinson.

7 Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA

Non-cancerous gynecologic conditions have long been neglected in epidemiologic research. The field of reproductive epidemiology has primarily focused on reproduction and life-threatening gynecologic cancers, thereby marginalizing the suffering associated with non-malignant gynecologic conditions. This narrow focus downplays the common and life-altering impacts that non-malignant gynecologic conditions have on quality of life, economic well-being, as well as physiologic, psychosocial and sexual health. We argue that women’s bodies should be studied for their own sakes and not just for their reproductive function. Then we identify and illustrate three critical research complexities to address to advance the epidemiology of non-malignant gynecologic conditions. With greater investment and a patient-centered approach, epidemiology can advance knowledge about this critical area of health.

Condensation

Epidemiology has neglected gynecologic conditions that do not involve pregnancy, childbirth, or cancer. To advance the epidemiology of non-malignant gynecology, we recommend three methodological issues to prioritize.

Introduction

In this commentary, we argue that the epidemiology of non-malignant gynecologic conditions is under-resourced. Non-malignant gynecologic conditions of the vagina, uterus, and ovaries are deleterious to physical health and the sufferer’s quality of life. These non-cancerous conditions include uterine fibroids, abnormal uterine bleeding, endometriosis, adenomyosis, adnexal masses, pelvic inflammatory disease, polycystic ovarian syndrome (PCOS), and vulvar pain conditions, among other conditions [ 1 ][ 2 ], Non-malignant gynecologic conditions diminish psychosocial health, increase psychologic distress, impair sexual function, and harm economic well-being by, for instance, increasing days missed from work.[ 3 ]

We argue that there is relatively little investment in the epidemiology of non-malignant gynecologic conditions because most societies devalue the pain, time, and well-being of women.[ 4 , 5 ] For instance, when it comes to the limited pool of resources devoted to reproductive epidemiology, the field has prioritized topics related to birth and death: on the birth side, the ability to conceive and birth children;[ 6 ] on the death side, life-threatening gynecological cancers, such as ovarian or endometrial cancer.[ 4 ] This focus neglects the high prevalence of non-cancerous gynecological diseases that impair quality of life for many non-pregnant cis-gendered women, trans-gendered men, and non-binary people; those not trying to conceive; and many post-reproductive-aged cis-gendered women. For instance, a gynecologically related condition like anemia places a huge burden on women in both wealthy nations and low and middle income ones. [ 7 ]

The Reproductive Epidemiology chapter of the Handbook of Epidemiology illustrates the shunting of non-reproductive-related gynecologic issues to other fields:

“Many diseases of the reproductive organs, like cancer or infections, may have an effect on reproduction if the diseases appear before or during reproductive age. In most cases, studying the determinants of these diseases will be similar to studying determinants of other diseases and, as such, they are not pertinent to the analysis in this chapter.”[ 8 ]

Indeed, gynecologic cancers and infections may find disciplinary homes in cancer and infectious disease epidemiology. But where does such a narrow focus of reproductive epidemiology leave the epidemiology of non-malignant gynecologic conditions? The neglect of the epidemiology of non-malignant gynecologic conditions leaves these conditions without the funding and research infrastructure to advance knowledge about their etiology, prevention, and treatment.

In the United States, funding for gynecologic conditions has been disproportionately low. For instance, the National Institutes of Health (NIH) is expected to award endometriosis, uterine fibroid, and vulvodynia research $12 million, $16 million, and $2 million, respectively, in fiscal year 2021.[ 9 ] In comparison, for this same time period, chronic obstructive pulmonary disease, which affects 6.2% of the U.S. population, is expected to receive $107 million; Crohn’s disease, which affects <1% of the population, will receive $74 million; and inflammatory bowel disease will receive $158 million.[ 9 ] A recent NIH study supports the contention that gynecologic conditions, and the larger field of women’s reproductive health, is under-resourced. The study identified 150 topical clusters funded by the NIH in 2011–2015. The cluster with the absolute lowest likelihood of funding was the one characterized “by the [gendered] words ‘ovary,’ ‘fertility,’ and ‘reproductive’.[ 10 ] This area’s funding likelihood was 7.5%, compared to 28.7% for the cluster most likely to be funded. This funding discrepancy shows that even reproduction-focused reproductive health is underfunded in the U.S. A sub-field like gynecologic health is even less likely to receive funding. Globally, there is also limited funding dedicated to gynecologic research in other high-income countries [ 11 ] [ 12 ], And there is anecdotal evidence that, in many low and middle-income countries (LMICs), there is little dedicated funding at all [ 13 ].

While there are productive and dedicated researchers who work in gynecologic epidemiology, they often do so with limited resources. The only NIH entity to focus on this area, the Gynecologic Health and Disease Branch (GHDB), was established less than 10 years ago and has a small budget relative to the burden of gynecologic conditions.[ 14 ] As a result, there are few institutions today with centers focused on non-malignant gynecologic epidemiology.[ 15 ] Moreover, many of the limited training programs, like the NIH’s “Women’s reproductive Health Research Career Development Program,” are exclusively for physician-scientists and exclude PhD-trained epidemiologists.

Besides the discounting of the well-being of women, gynecologic epidemiology may be under-resourced because there is a perception that its issues are not urgent. One might ask, “Why study diseases that are not fatal and can be treated?” While there are treatment options for these conditions, many of these treatments either fail overtime, are invasive, require long-term medication use, or are incompatible with people’s desires for fertility. Moreover, the eventual remission of symptoms after decades of suffering does not remove the onus from the public health community to prevent these conditions and provide effective, non-invasive, long-term treatments that are compatible with people’s possible desires for fertility and to avoid long-term medication use.

In this commentary, we argue that the epidemiology of gynecologic health is characterized by a unique set of methodologic complexities that warrant further attention. By devoting resources to address these methodological challenges, the field of gynecologic epidemiology can accelerate the growth of knowledge. Further, the development of richer data infrastructure, epidemiologic methods, and expertise will have positive spillover effects for other fields. Below we describe three key methodologic complexities salient to gynecologic epidemiology.

Methodologic complexities to address to catalyze the advance of epidemiologic studies of non-malignant gynecologic disorders

Missing cases.

Difficulty in identifying cases is a major challenge of research studies of gynecologic conditions. Non-malignant gynecologic conditions are often subclinical. When symptoms of gynecologic conditions like uterine fibroids or endometriosis develop, they are often self-managed. For instance, heavy menstrual bleeding and pain may not be discussed with a health care provider because a woman considers it “normal.”[ 16 – 18 ]. This self-management may be especially common if the disease runs in the family and is normalized within the familial and community networks. The sociocultural context may also impart a stigma that affects patients’ reports of their own symptoms. Even if patients are in contact with the healthcare system, stigma and embarrassment about discussing menstruation and sex with health care providers may impair a person’s ability to articulate symptoms.[ 12 ] Moreover, even when patients do complain of gynecologic pain or symptoms, providers may minimize or deny these complaints (“medical gaslighting”) .[ 19 ], causing the patient to doubt his or her own perceptions and minimize symptoms. For example, it is estimated that globally, on average, there is a seven year delay between symptom onset and diagnosis for women with endometriosis.[ 19 ] Additionally, anomalies such as decidual casts (i.e., shedding of the uterine lining in one piece, in the shape of the uterine cavity)[ 20 ] or galactorrhea (e.g., spontaneous lactation)[ 21 ] may manifest as transient episodes that may resolve before the person seeks treatment, rendering their measurement and study difficult.

Moreover, many women may not receive a diagnosis because of limited access to appropriate health care. Financial, geographic, or time constraints can all restrict health care access. These barriers access are present in many countries but may be especially common in LMICs.

Finally, these barriers to diagnosis within clinical settings affect epidemiologic research conducted outside of clinical settings. Because gynecologic conditions are underdiagnosed and frequently dismissed by authority figures, they may not be identified with high sensitivity by self-reports. All the factors described above lead to disease under-ascertainment in gynecologic epidemiology research. Without addressing this under-ascertainment, the field can be hampered by biases such as outcome misclassification bias and selection bias.

Clinical Case Definitions

Another barrier facing gynecologic epidemiology is the clinical challenge of differential diagnosis. This challenge manifests as outcome misclassification in epidemiologic studies. The incidence and prevalence of gynecologic conditions will remain challenging to study as long as diagnostic tests are non-specific, relatively invasive, and expensive. For example, a woman may present with primary dysmenorrhea and heavy menstrual bleeding. However, these are symptoms of a number of gynecologic conditions including uterine fibroids, endometriosis, and adenomyosis. Further, many gynecologic conditions share symptoms with non-gynecologic conditions, such as abdominal pain, which is a symptom of irritable bowel syndrome, Crohn’s disease, and some cancers.

Currently, definitive diagnoses of many gynecologic conditions require invasive surgical procedures. For example, diagnosing endometriosis involves laparoscopy, a surgical procedure in which endometriosis is visualized and often removed for pathological examination.[ 22 ] Thus, diagnosing endometriosis requires a patient’s time, logistical ability, and sufficient health status to undergo a potentially expensive surgical procedure under anesthesia that may not even result in a definitive diagnosis. Diagnosis of adenomyosis relies on an even more invasive surgery: hysterectomy and pathology of the uterine tissue.[ 22 ] While imaging methods like MRI and transvaginal ultrasound are emerging as alternative diagnostic methods, these techniques provide less definitive and sensitive detection of adenomyosis than a pathology report after hysterectomy.[ 23 ] One example of how difficulty in diagnosis can effect gynecologic epidemiology is the relationship between childbearing and adenomyosis. Because diagnosis for this disease relies on hysterectomy, adenomyosis is more likely to be diagnosed in women who have already completed childbearing. As a result, a relationship between parity and adenomyosis may be biased by disproportionately greater likelihood of definitive diagnosis among parous versus nulliparous patients. Lack of sensitive and specific diagnostic criteria that are relatively non-invasive complicates research on the descriptive (e.g., incidence) and mechanistic epidemiology of many gynecologic conditions.[ 23 , 24 ]

On the other extreme, incidental diagnosis of non-symptomatic gynecologic conditions is common and may lead to etiologically heterogenous categories of gynecologic conditions. For example, an incidentally diagnosed case of endometriosis during a work-up for infertility may be etiologically and phenotypically distinct from symptomatic cases of endometriosis that present with pain.[ 25 ] Patients detected during an infertility evaluation recognized their difficulty conceiving and had access to infertility care, which is expensive and relatively inaccessible in many parts of the world.[ 26 ] Therefore, studying a case series in which these incidentally detected cases are overrepresented may result in spurious associations with socioeconomic status, health literacy, and access to care. The potential for spurious associations with factors that predict greater likelihood of incidental diagnosis instead reflecting true underlying incidence reinforces the need for population-based studies of gynecologic conditions and attention to case definitions and diagnosis modes.

Finally, we acknowledge that the needs of clinical practice and epidemiologic research differ when it comes to case definitions for non-malignant gynecologic conditions. In accordance with the American College of Obstetrics & Gynecology (ACOG) guidelines, many providers will presumptively diagnose conditions based upon symptoms alone. The alternative is subjecting patients to expensive and invasive diagnostic procedures whose results might not change providers’ treatment recommendations.[ 22 ] For some mild to moderate cases, medications such as hormonal contraceptives may be used to reduce pain and bleeding even in the absence of diagnosis.[ 3 , 27 ] Forgoing definitive diagnosis is an optimal decision for many patients. However, lack of specific, non-invasive case definitions prevents epidemiologists from identifying phenotypically homogenous, population-based samples of those with disease. Population-based samples would enable epidemiology to conduct high-quality etiologic research to calculate incidence of each condition and identify causes of these conditions.

Measuring and analyzing dynamic exposures, outcomes, and covariates

The final complexity of the epidemiology of gynecologic conditions is the measurement and analysis of key time-varying variables. One salient issue if the cyclical nature of the menstrual cycle. For instance, gonadal and hypothalamic hormones, which are important in research on gynecologic conditions, vary over the menstrual cycle. Even non-hormones, such as iron are known to vary across the menstrual cycle. In gynecologic-related etiologic research involving biomarkers, blood must be drawn at a consistent time in the menstrual cycle in order for the lab values to be comparable, whether within or between women.[ 25 ] However, collecting high-quality, comparable, data is not as simple as asking women to present for blood collection on the n th day of their cycles, because not all cycles are the same length and not all people are willing to track their cycles. This issue interacts with the social stigma against menstruation and female reproductive body parts. This stigma may cause some people to avoid paying attention to their own cycles and bodies out of shame or disgust. Similarly, use of health care data is often not a feasible solution: clinicians are unlikely to obtain laboratory values on the same day of the menstrual cycle for most patients. The dynamic nature of gynecologic systems requires specialized expertise in data collection and advanced approaches to data analysis.

In addition to the cyclical nature of key biological variables in gynecologic epidemiology, many other key covariates (e.g., pregnancy, lactation, and hormonal contraceptive use) difficult to measure or vary over time. For example, hormonal contraceptives are an important potential mediator, effect modifier, and confounder in many studies of gynecologic health. However, recall is challenging,[ 28 ] given that women report using a median of five hormonal contraceptive types across their lifetimes.[ 29 ]

Other key covariates are not routinely captured. For instance, a person’s desire to maintain the possibility of future fertility is missing from many studies. This time-varying preference is a strong determinant of type of gynecologic health care chosen. Unfortunately, it is not uniformly reported in claims data or electronic health records nor always measured by cohort studies. Moreover, social correlates of gynecologic health and health care such as race/ethnicity, individual-level socioeconomic status, stress pathways, and aspects of place and health care systems are often unmeasured in gynecologic epidemiology studies. Finally, as noted throughout this paper, the sociocultural context in which people experience their menstrual cycles (or lack thereof) and organs of the gynecologic system affects observation of and communication about gynecologic health. Sociocultural contexts remain deeply influential but largely unmeasured forces in gynecologic epidemiology.

Conclusion and recommendations for researchers

Reproductive health, as defined by the World Health Organization, concerns the reproductive system at all stages of life.[ 30 ] Unfortunately, the emphasis of reproductive epidemiology as a field has been on reproductive capacity and function, rather than on the health of the reproductive system and its effects on quality of life across the life course.[ 4 , 8 ] The totality of reproductive health will remain obscured if critical research challenges in gynecologic health are not addressed. The methodologic complexities described above - difficulty identifying people with subclinical disease; the need for more sensitive and specific case definitions that can be applied in population-based research; and measurement of key variables - are challenging but can be overcome. Knowledge about the population-level epidemiology of gynecologic health can advance if biomedical funding invests in validating self-report measures of gynecologic conditions; developing accurate, scalable case definitions that do not rely on invasive or expensive medical procedures; nuanced, high quality data collection incorporating the cyclical and time-varying nature of key variables; and the incorporation of study designs and data analysis techniques that can address missing data and time-varying variables and identify mediation and modification.

We urge a patient-centered approach in all gynecologic research. Women’s and transgender and non-binary people’s bodies have long been heavily politicized. [ 4 , 5 ] Further, gynecologic conditions and their treatments may have long-term consequences for self-concept, sense of agency, and achievement of life goals. Interactions around gynecologic health often implicate and complicate personal identity more than treatment for other conditions. When health researchers design their research in a patient-centered manner, not only are the causal inferences stronger, but the work will be more valuable for the end users of the research.

In conclusion, we have argued that more resources and research should be focused on gynecologic epidemiology. Non-malignant gynecologic conditions affect tens of millions of people and can severely impact quality of life. Therefore, a well-funded, methodologically rigorous, and person-centered gynecologic epidemiology has the potential to improve the health and well-being of tens of millions. Gynecologic epidemiology is a field that has made remarkable strides with relatively low levels of sustained investment. With more resources to understand these conditions and tackle these methodological complexities, the field can be a scientific leader and improve the health and wellbeing for people around the world.

Competing Interest: None declared.

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Obstetrics and Gynaecology Thesis Topics for MD/DNB.

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1 The Maternal and Foetal outcome in premature rupture of membranes.

2.      Coagulation disorder in abruptio placentae and maternal and fetal outcome.

3.      Study of Incidental HPV infection in PAP smear.

4.      Doppler USG OBS and mean arterial pressure studies at 19-24 weeks and their outcome in pregnancy related to PIH.

5.      Carcinoma of Cervix and its Management.

6.      Pregnancy induced Hypertension : a prospective study of Fetomaternal outcome and its corelation to USG Doppler study and Histopathological changes of placenta.

7.      Ectopic Pregnancy : Diagnosis & Management.

8.      A prospective study of etiology, investigations, management and pregnancy outcome in Ist trimester abortions and its correlation with TORCH infection.

9.      Safe simple and method of termination of early pregnancy MVA syringe.

10.  A Study of ovarian malignancies; with special reference to management protocols.

11.  Clinical and Sonographic correlation of IUGR.

12.  To study Maternal & Neonatal outcome in vaginal birth after Caesarean section (VBAC) Vs Elective lower segment Caesarean section in patients with previous lower segment Caesarean section due to non recurrent cause.

13.  Seroprevalence of Rubella virus in Preconceptional and Infertile women.

14.  Comparative study of efficacy of Valethamate Bromide and Drotaverine in normal labor.

15.  Cord blood nucleated red blood cell count- A marker of foetal Asphyxia.

16.  Hysterectomy morbidity and mortality.

17.  Comparative study of the Effect of different parenteral Iron preparation in pregnant anaemic women.

18.  Nuchal cord & perinatal outcome.

19.  Modified extraperitoneal Cesarean section -A study of 30 cases

20.  Comparative analysis between PGE1 and PGE2 analogues for medical induction of labour.

21.  Correlation of Pelvic findings, Ultrasound with Doppler and Tumor Marker (CA125) with Histopathological nature of ovarian tumors in women of 40 to 60 years of age.

22.  Maternal and Perinatal outcome in Placenta Previa.

23.  Effect of Progestrone in Management of Threatened preterm labour.

24.  To Study the Effect of Omega 3 fatty acids on Pregnancy outcome.

25.  Combined use of Serum Inhibin and CA 125 assays as Tumour Marker For Ovarian Cancer.

26.  To Study the Correlation between Maternal Body Mass Index & Obstetric outcome.

27.  To Study incidence of immediate postoperative complications of obstetrical and Gynaecological surgery.

28.  Screening for preeclampsia and fetal growth restriction by uterine artery doppler at 11-14 weeks Gestation.

29.  A study of Trans Obturator sling surgery in Management of Stress Urinary incontinence.

30.  A study of correlation between maternal body mass index in pregnancy and its perinatal outcome.

31.  Study of Multiple Pregnancy.

32.  Role of Intrapartum fetal monitoring in predicting perinatal outcome.

33.  Ultrasound evaluation of congenital anomalies in at risk Pregnacies.

34.  Study of Perinatal Mortality.

35.  Clinico-Microbiological Correlation of White Per Vaginal Discharge.

36.  Placental Localisation by Ultrasound & its role in prediction of Pregnancy induced Hypertension.

37.  Walking Epidural for painless labour.

38.  Comparative Study of Various Methods of Fetal Weight Estimation at Term Pregnancy.

39.  Comparison Study of various Oxytocics in management of third stage of labour.

40.  Study of Socio-Demographic factors contributing to Eclampsia and their correlation with perinatal and Maternal outcome.

41.  Control study on birth defects and risk factors at tertiary care centre.

42.  Prospective clinical study of cases of Abruptio Placentae.

43.  Study of safety & efficacy of low dose magnesium sulphate (MgSo4) regimen in controlling convulsion in Eclampsia.

44.  Clinical study of PPH in rural population.

45.  Effect of Maternal Haemoglobin % on Birth Weight and Apgar Score of baby.

46.  Correlation of Clinical Features and Hormonal assays in Women having Polysistic Ovaries on Ultrasonography.

47.  Intravenous Versus Oral Iron for Treatment of Anaemia in Pregnancy.

48.  Borderline AFI in Last Trimester and Perinatal Outcome.

49.  Extra-Amniotic Normal saline Instillation in 2nd trimester abortion.

50.  A Study of Fetal outcome in Twin pregnancy at Government medical college , Nagpur.

51.  Syndromic Diagnosis in RTI/STI among women of reproductive age group.

52.  An Observational (Longitudinal) study of Amniotic Fluid index & perinatal (Fetal)outcome.

53.  Prevalence & clinico pathological profile of endometriosis in Perimenopausal Women.

54.  Perinatal outcome in cases of Term & Preterm Prelabour rupture of membranes with special reference to Body mass index, Hemoglobin status, Amniotic fluid index, Cervical score & Cervical and Vaginal colonization.

55.  Study of Incidence of Hypothyroidism in Neonates.

56.  Emergency Contraception – Public Awareness.

57.  To study the effect of per-rectal Buscopan suppository (10 mg)on duration of active stage of labour, from ‘3’ cms – cervical dilatation to delivery of baby.

58.  To compare the effects of intravaginal prostaglandin E1 and intracervical prostraglandin E2 for prelabour ripening of unfavourable uterine cervix in nulliparous women.

59.  To study the efficacy of prophylactic IV methyl- Ergometrine, IM Prostaglanding -F2α, and oral prostaglandin -E1 in prevention of postpartum haemorrhage.

60.  Complications and outcome in teenage pregnancy.

61.  Study of risk factors and outcome in cases with postpartum hemorrhage.

62.  Pregnancy outcomes in the in vitro fertilization conceived polycystic ovary syndrome patients: a retrospective study

63.  The study of maternal factors and perinatal outcome in meconium-stained liquor in full term pregnancies.

64.  A retrospective study on postmenopausal bleeding-causes and its diagnosis using transvaginal ultrasound and hysteroscopy.

65.  A study of effect of vitamin D supplementation in vitamin D deficient females having polycystic ovarian syndrome.

66.  Study of sublingual misoprostol versus interavaginal misoprostol in induction of labor.

67.   Maternal and perinatal outcome in cases of oligohydramnios.

68.  The role of dignostic hystero-laparoscopy in the evaluation of infertility and the diagnostic accuracy of hysterosalpingography in early detection of causes of infertility over hystoero-laparoscopy.

69.  The study of maternal factors and perinatal outcome in Gestational Diabetes Mellitus

70.  Ultrasound evaluation of cause of vaginal bleeding in first trimester of pregnancy.

71.  Evaluation of factors leading to blood transfusion in antenatal & postnatal patients.

72.  A prospective study to assess compliance safety and expulsion rate of CU-T 380 A in immediate post partum period.

73.  A prospective comparative study to evaluate the efficacy and acceptability of intravenous iron sucrose and oral ferrous fumarate for the prevention of iron deficiency anemia during pregnancy.

74.  Early neonatal outcome in meconium stained amniotic fluid in uncomplicated pregnancies.

75.  Prostaglandin E1 in prevention of post partum bleeding: route of administration.

76.  Prospective study to evaluate the safety,efficacy and acceptance of intra-venous iron sucrose complex in pregnant women with iron deficiency anaemia.

77.  Non stress test as an admission test to assess the outcome of high risk pregnancy.

78.  Study of indications of caesarean section and related maternal and fetal complications in teaching institute.

79.  Study of maternal and neonatak outcome in cases of abruptio placenta.

80.  Combination of foley bulb and vaginal misoproostol compared with vaginal misoprostol alone for cervical ripening and labor induction.

81.  Prevalence of gestational diabetes mellitus with its maternal and fetal outcome.

82.  Study of obstetric and fetal outcome of post caesarean section pregnancy at tertiary health care centre.

83.  Study of complications of medical termination of pregnancy in first trimester.

84.  A clinical study of ectopic pregnancy.

85.   Prevalence of bacterial vaginosis in pregnancy after 20 weeks of gestation.

86.   Prospective study of ultrasound imaging of ovaries with its clinical implication and management.

87.  Role of encirclage operation in primigrivida patient with short cervical length.

88.  Umbilical cord coiling index and perinatal outcome.

89.  Relationship of the findings of colour doppler and non-stress test with the perinatal outcome among the cases of intra-uterine growth restriction.

90.  The role of external pelvimetry and maternal height in the prediction of mode of delivery among nulliparous women.

91.  A clinical study to correlate perinatal outcome of newborns with intrapartum diagnosis of fetal distress.

92.  A comparative study of clinicosurgical outcome between total abdominal hysterectomy and vaginal hysterectomy in non proplapse and non oncological uterine conditions.

93.  Comparison of sperm vitality of fresh semen before and after sperm preparation using two different methods in subfertile

94.  Asthenozoospermic males attending the infertility OPD at a tertiary care centre.

95.  Prospective study of socio demographic characteristics,maternal disorders & foetal risk factors responsible for early and late stillbirth in a rural tertiary care hospital.

96.  A clinico -pathological study of women with complex and/or atypical endometrial hyperplasia and endometrial carcinoma with special refernce to risk factors including lifestyle diseases and polycystic ovarian syndrome.

97.   Foetal and maternal outcome in eclampsia.

98.   Study of non-descent vaginal hysterectomy.         

99. Evaluation of high risk mothers by a screening system and its co-relation with perinatal outcome.

100. Study of maternal and neonatak outcome in cases of post partum hemorrhage.

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There are many methods of sample size determination. It is one of the first hurdle when someone starts writing a thesis. I have tried to give simplest way of determination of sample size. You need to show the method to your PG teacher before you include this method in your thesis. First confirm from your PG teacher and then only proceed.

74 Gynecology Essay Topic Ideas & Examples

🏆 best gynecology topic ideas & essay examples, 👍 good essay topics on gynecology, ⭐ simple & easy gynecology essay titles, ❓ essay questions in obstetrics and gynecology.

• The Difference Between Male and Female Gynecologist This was later, when women have come to the profession and the consideration appeared that men are not those, who should be the gynecologist and that women were the first, and men has entered it […]
• The Gynecologic Health History and Its Importance The reaction of gynecologic health history is necessary to provide or enhance the healthcare of the gynecologic patient. Therefore, they require special coverage within the framework of gynecologic health history. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
• Business Proposal for Gynecologist in the Campus Women need to make regular visits to a gynecologist for professional advice on how to maintain the health of their reproductive system.
• Protein in Modern Obstetric and Gynecological Practice It also elucidates on inflammatory markers and infertility in the context of STDs and briefly discusses anemia types and splenectomy in ITP.
• Medical Diagnostics in Gynecology and Dermatology The presence of similar skin defects at the patient’s recent sexual partners and the previous existence of similar skin defects on the patient’s skin and mucosae can define the duration of the disease and the […]
• Gynecological Conditions: Diagnosis and Management The combination of excessive exercise, stress, and weight loss leads to the reduction in the release of gonadotropin-releasing hormone and amenorrhea.
• Screenings for Women’s Gynecologic Health A significant part of health care for women is devoted to disease prevention and timely diagnosis. Moreover, cholesterol and blood pressure checks are added for women to detect any cardiovascular issues.
• Chlamydial Infections: Gynecological Conditions The diagnosis will have a short-term effect on SL’s life as she will have to have a discussion about STIs with her partner, which may be challenging for her.
• Diagnosing and Managing Gynecologic Conditions This report discusses the primary and differential diagnoses for the condition and suggests possible treatment methods. Differential diagnoses include the following conditions: Polycystic ovarian syndrome, which is a common endocrine disorder that affects up to […]
• Complete Gynecology Services in a Community College
• Hemostasis in Obstetrics and Gynecology
• The Use of Herbs and Dietary Supplements in Gynecology
• Facial and Body Blood Contamination in Major Gynecological Surgeries
• Transvaginal Ultrasound Practice in a General Gynecology Clinic
• New Applications of the co2laser in Gynecology
• A Scientific Effort to Combat COVID-19 in Gynecology
• Preoperative Hypnosis in Gynecology
• Effectiveness of the Gynecology Teaching Associate in Teaching Pelvic Examination Skills
• Role of Gynecologists in Reproductive Education of Adolescent Girls
• Impact of the Availability of Sonography in the Acute Gynecology Unit
• Fluorescence Diagnostics in Oncological Gynecology
• Manpower Planning in Obstetrics and Gynecology
• Gynecological Care of the Transgender Man
• Molecular Targets in Gynecological Cancers
• Gender Gap Between Male and Female Obstetrics and Gynecology
• Three-Dimensional Ultrasound in Gynecology
• Cost and Robotic Surgery in Gynecology
• Evidence-Based Indications for Treatment of Uterine Fibroids in Gynecology
• Obstetric and Gynecological Problems Associated With Eating Disorders
• Hospital Infections in Obstetrics and Gynecology
• The Outcome of Short-Stay Surgery in Conventional Gynecological Operations
• Selected Hormonal Agents in Gynecology
• Distress and Mental Health in Patients With Gynecological Cancer
• The Level of Loneliness of Patients With Gynecological Cancer
• The Teaching Diagnostic Skills in Gynecology
• Sensitivity Measurement in Gynecological Cytology
• Screening Methods for Gynecological Cancers
• Nutrition in Gynecological Disease
• Psychiatric Morbidity in Gynecological Outpatients
• Social Responsibility of Gynecology and Obstetrics
• Computer System for Gynecological Health Control
• Prevalence of Gynecological Disorders
• Use of Complementary and Alternative Medicine by Gynecologists
• Use of Metronidazole in Obstetrics and Gynecology
• The Use of Nurse Practitioners in Ambulatory Gynecology
• Gynecology and Obstetrics of the Present: Perspectives and Challenges
• Possibilities of Electrical Impedance Tomography in Gynecology
• The Link Between Adolescent Gynecology and Endocrinology
• The Future of Lasers in Gynecology
• What Does Hemostasis Mean in Gynecology?
• What Can the Use of Herbs and Nutritional Supplements in Gynecology Bring?
• What Is the Difference Between Gynecology and OB-GYN?
• What Problems Does a Gynecologist Treat?
• What Are Serious Gynecological Problems?
• What Are the Basics of Gynecology?
• What Are the Benefits of Being a Gynaecologist?
• What Are the Disadvantages of Being a Gynecologist?
• Who Was the First Gynecologist?
• What Causes Gynecological Disorders?
• What Is a Gynaecological Assessment?
• What Are Gynecologic Emergencies?
• What Are the Prospects and Problems of Gynecology and Obstetrics?
• What Are the Primary Subspecialty Fellowships in Gynecology?
• How to Prepare for a Gynecologist Appointment?
• How Does a Gynecologist Check Up Go?
• How Many Times Should a Woman See a Gynecologist?
• Should Every Woman See a Gynecologist?
• At What Age Should a Female Start Seeing a Gynecologist?
• What Is Difference Between Gynecologist and Obstetrician?
• Is Gynecology Medical or Surgical?
• What Are the Challenges of Being a Gynecologist?
• What Is Human Resource Planning in Obstetrics and Gynecology?
• What Is the Gender Gap Between Male and Female Obstetrics and Gynecology?
• What Does Robotic Surgery Mean in Gynecology?
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Dissertation Topics For MD Obstetrics And Gynecology Dissertation & Thesis Writing Service & Help

There are some subjects that are more suited to certain aspects of the profession. For example, those who are currently training to become an OB/GYN will have a much different set of topics to those who are studying to become an endocrinologist. If you are interested in becoming an OB/GYN but do not know which area of the medical field you want to pursue, you can choose the thesis topics for MD obstetrics and gynaecology that will help you get a good education in this area.

You will be given a large amount of homework when choosing the thesis topic for MD obstetrics and gynaecology. You will need to write an essay or report based on your findings. This will require research, writing, editing and proofreading. It will also require research on the subject matter. Some of the topics include:

General obstetrics and gynaecology – One of the most common areas in MD obstetrics and gynaecology is the treatment of female problems such as infertility , ovarian cysts, fibroids, etc. The topics of infertility, ovarian cysts, fibroids, etc. are usually covered in this area.

Birth control pills – If you want to work towards becoming an OB/GYN, but do not want to take up advanced courses in this field, you may want to choose the thesis topic for MD obstetrics and gynaecology that address the use of birth control pills. This topic deals primarily with the effects of birth control on women’s health. The main focus is on the risks associated with taking birth control and how they affect women’s health.

Gynecological disorders – These include reproductive problems such as uterine cancer , endometriosis, ovulation disorders, etc. These topics will cover gynecological conditions that affect both males and females. In addition, there are also topics that address disorders of the reproductive system such as cervical cancer, pelvic inflammatory disease and the treatment of pelvic inflammatory disease. In these topics, you will learn about infertility treatments, cervical cancer, pelvic inflammatory disease and the methods used to treat it.

Miscarriage – One of the more controversial topics in this type of field is the treatment of miscarriage. While miscarriage is considered a normal part of pregnancy, some physicians believe that there is a link between miscarriage and infertility issues and believe that medical interventions may lead to this condition. Some of the topics include early miscarriages, miscarriage due to stress or trauma and miscarriage due to genetic defects.

Obstetric and gynaecological disorders are just a few of the topics that are presented in a thesis for MD obstetrics and gynaecology. You can choose to write an essay on any of them. You can choose to complete the thesis on your own or you can choose a thesis advisor to help you through your writing process.

As you can see, the list of topics can be overwhelming. However, if you choose wisely, you should have no problem completing your thesis. You should plan your research well and follow through with the written work after completing the assigned topics.

A thesis is an important paper that needs to be completed with thorough research and analysis of the subject matter presented in it. It is important that you get all your facts right so that you can present a well-researched thesis. document that will be helpful for your prospective employer.

Writing a thesis is an important part of earning your PhD. In order to successfully complete your thesis, you need to know the subject matter very well so that you can write a well researched dissertation that will be well worth your time and effort. Once you have completed your research, you should have no trouble writing the paper.

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Sunday 12 July 2015

Md obstetrics and gynaecology thesis topics mmc, 19 comments:.

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Thesis Topics In Obstetrics And Gynecology In AIIMS

For all the medical science students here we are with the Thesis Topics In Obstetrics And Gynecology In AIIMS.

Your doctoral thesis’s process could be very difficult, long, and stressful for most of it.

So you will need time and patience to make it perfect and you’ll love every minute spent on making your Doctoral thesis perfect.

All India Institutes of Medical Sciences (AIIMS) ,  is a group of autonomous government Medical Research Public University and Medical College.

AIIMS New Delhi is the predecessor institute established in 1956. After that, 22 more institutes were opened.

Obstetrics and gynecology are focused on the care of a pregnant lady, her unborn child, and manages the diseases specific to women. The specialty of medical science combines medicine and surgery.

To write your doctoral thesis a significant amount of research is needed, and for writing and proofreading, this research paper will necessitate hours.

To get started on the thesis, students need to select a topic. The best topic should be completely original and contain an interesting subject.

If a student selects a topic that is interesting to him/her, it will be easier to write the thesis. Following is the List of Thesis Topics In Obstetrics And Gynecology In AIIMS from which he/she can select :

Also Read: SBI PO Descriptive Material, Letter Writing SBI PO

List of Thesis Topics In Obstetrics And Gynecology In AIIMS:

• Evaluation of Intrapartum Fetal Pulse Oximetry for Fetal Monitoring in Labour.

Evaluation of Uterine Artery Embolization in the management of Uterine Fibroids in comparison with Medical (GnRH Agonist) and Surgical (Hysterectomy) treatment.

Evaluation of Transdermal Nitroglycerine as a Tocolytic Agent in Preterm Labour.

Role of Hormone Replacement Therapy and Antioxidants on Levels of Lipid Peroxidation in Postmenopausal Women.

To evaluate the effects of Metformin in terms of Clinical, Biochemical, Hormonal Radiological Profile in Women with Polycystic Ovary syndrome.

The effect of Nitroglycerine Patch in Lowering Blood Pressure in women with PIH.

Visualization of Fetal Anatomy in First Trimester of Pregnancy by Different Modes of Ultrasonography.

• The Haematological and bacteriological Assessment of Umbilical Cord Blood for use of Autologous Neonatal Transfusion.
• Evaluate the Immune Status of Rubella in Adolescent Unmarried Girls and Pregnant Women.
• Screening for Rh-Negative Blood Group and Rh Isoimmunization in Indian Population, Critical Evaluation of the Practice of Anti D Prophylaxis and Cause of Sensitization in Rh Isoimmunization Women.
• Clinical and Biochemical Changes after Bipolar Vs Unipolar Laparoscopic Ovarian Electro Cautery in Cases of Polycystic Ovary Syndrome.
• Detection of Feto Maternal Haemorrhage Following Chorionic Villus Sampling by Kleihanser Betke and Rise in maternal serum Alpha Protein.
• Vulvar Vestibulitis: A Study of the Magnitude of the Problem and Management Outcome.
• A Comparative Study of Daily Vs Weekly Iron Therapy in Pregnant women.
• Assessment of Fimbro – Ovarian Relation by Laparoscopy in Case of Unexplained Infertility.
• Evaluation of Serum CA-125 and Sr Estradiol Levels after conservative Surgical management of Advanced (Moderate and Severe) Endometrium in Infertility.
• Assessment p53 and Telomerase as Prognostic Factors in carcinoma Ovary Stage III and IV.

So above we have provided the topics to help you decide your desirable topic.

All The Best 🙂

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