The COVID-19 pandemic has uniquely affected outpatient prenatal care, which depends on frequent assessment of a pregnant mother and her fetus. At the start of the pandemic, the outpatient prenatal care program at Brigham and Women’s Hospital increased the use of virtual visits, allowing patients to regularly meet with their providers safely.
For women with complex medical needs, contraception throughout childbearing years may be essential for managing their underlying medical conditions and setting the stage for a healthy pregnancy when desired. To provide the needed expertise, the High Risk Contraception Clinic at Brigham and Women’s Hospital works with patients, often in collaboration with disease sub-specialists, to provide individualized contraceptive care within the framework of the underlying condition.
In the first randomized trial analysis of estrogen therapy after bilateral oophorectomy, women who underwent surgical menopause followed by estrogen therapy in their 50s showed a nearly one-third reduced risk of mortality over 18 years compared to women who received a placebo instead of estrogen. Older women (particularly age 70 and over) showed no such benefit and experienced a negative net effect from hormone therapy.
Ovarian cancer is one of the deadliest forms of women’s cancer, with a five-year survival rate of 47.4 percent. The standard of care for first-line treatment is platinum- and taxane-based chemotherapy, which results in high initial response rates.
For couples with recurrent miscarriage (RM), the condition remains unexplained in about 40 to 60 percent, even after costly testing. Chromosomal abnormalities—rearrangements of large chunks of DNA—in the genomes of one or both individuals trying to conceive are thought to be among the major genetic causes of RM. But routine chromosome analysis (karyotyping) can currently detect these abnormalities in only about 1 in 50 couples.
Uterine fibroids are highly prevalent in women over 35. As more women delay childbearing, techniques to remove uterine fibroids (leiomyomas) while also preserving fertility are of increasing importance.
Strong evidence that now connects preeclampsia with long-term maternal cardiovascular risks raises new questions for obstetricians (OBs): What is the best way to care for women after preeclampsia? And, what postpartum care and support might help women minimize immediate and long-term risks?
Jon I. Einarsson, MD, MPH, didn’t set out to be an inventor. Chief of the Division of Minimally Invasive Gynecologic Surgery at Brigham and Women’s Hospital, Einarsson is a champion of minimally invasive approaches for their benefits to patients. But as a teacher and mentor, he knows that some techniques that benefit patients are slightly more challenging technically for trainees and others to master.