Research programs in maternal-fetal medicine, reproductive endocrinology, gynecologic oncology, female reproductive endocrinology and minimally-invasive gynecologic surgery at Penn State Health Milton S. Hershey Medical Center continue to advance the understanding of women’s health and garner placement in peer-reviewed clinical journals. This new knowledge translates from bench-to-bedside into improved diagnosis, treatment and prevention.
Reduction in the rate of Cesarean delivery following Consensus guidelines1
This before-after retrospective cohort study examined 200 consecutive nulliparous women managed prior to the Consensus for the Prevention of the Primary Cesarean Delivery guidelines were adopted, and then 200 similar patients after the guidelines were implemented. In one year, the Cesarean delivery rate among women delivering after induction or augmentation decreased from 35.5 percent to 24.5 percent; the overall rate decreased from 26.9 percent to 18.8 percent. Continue reading
A 42 year-old woman presents in the outpatient obstetrics and gynecology clinic with severe, uncontrolled pelvic pain, painful bowel movements, and constipation. The patient has a history of stage IV endometriosis and had conceived via in-vitro fertilization (IVF). The patient now desires definitive therapy; she has completed childbearing and she had unsuccessful medical management of her symptoms with oral contraceptives and a progestin IUD. Recent ultrasound revealed a large endometrioma in the right ovary. Colonoscopy results indicated deep endometriosis of the sigmoid colon.
Stephanie Estes, M.D., of Penn State Hershey Obstetrics and Gynecology says, “In complex cases like this, a minimally invasive surgical procedure using robotic technology in a single operation offers the best odds for success, both procedurally and with a good recovery. A gynecologic surgeon would begin with a hysterectomy, and then a colorectal surgeon would resect the affected portion of sigmoid colon en bloc, to complete the procedure.” Estes continues, “With the robotic surgical tools we use, there is definitely better dexterity and enhanced 3D visualization of tissue and organs, compared to an open abdominal approach. This minimally invasive approach is really key for complex cases with widespread pathology, to avoid injury to delicate surrounding tissues.” Continue reading
John T. Repke, M.D., F.A.C.O.G.
Greetings from Penn State Hershey! I am pleased to share with you the first issue of the OB/GYN Medical Report from the Department of Obstetrics and Gynecology of the Penn State College of Medicine and Penn State Milton S. Hershey Medical Center.
We recognize the importance of collaboration among our peer physicians, and regularly work with other academic medical schools to propel our field forward through new research discoveries, better patient care, and educating new physicians. Our hope is that this publication helps inform physicians like yourself of some of this important work, and that you find it to be a valuable resource.
In the coming year, this publication will feature Penn State Hershey clinicians and researchers who are helping to raise current standards of patient care and shape the future of OB/GYN practice. Our department features five divisions – General OB/GYN, Maternal-Fetal Medicine (MFM), Reproductive Endocrinology and Infertility (REI), Gynecologic Oncology, and Urogynecology/ Minimally Invasive Gynecologic Surgery. Continue reading