J Reprod Med
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Depression and related psychopathologies have turned into a modern bubonic plague. World Health Organization figures signal a worldwide epidemic, affecting > or = 15% of the population and probably > 22% of women of childbearing age. ⋯ The obstetrician should regularly test for depression with simple means from the very first moment of planning for a child and should use the test results for a pregnancy mood profile. This profile could assist in determining the risk of postpartum depression and serve as an early alert for postpartum suicide.
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Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of complex persistent vulvar pain effectively managed with spinal cord stimulation. ⋯ Spinal cord stimulation may offer a new treatment for women with intractable neuropathic vulvar pain.
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To analyze the maternal and fetal outcomes of pregnancy and gynecologic problems in women with Marfan syndrome. ⋯ Women with Marfan syndrome are at high risk of aortic dissection in pregnancy even in the absence of preconceptional aortic root dilatation. Obstetric complications in patients with this condition have been underreported in the past. Women with aortic root dilatation of < 40 mm usually tolerate pregnancy well, with good maternal and fetal outcomes. Women with Marfan syndrome should be counseled regarding the risk of pregnancy to both mother and fetus. Patients who have cardiac decompensation or aortic dilatation > 40 mm are advised to avoid pregnancy.
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Rapidly progressive hirsutism or virilization in the postmenopausal woman raises the suspicion of an androgen-secreting tumor. Hormonal testing and imaging studies usually rule out an adrenal tumor. However, small, androgenizing ovarian tumors may not be detectable by imaging studies. ⋯ Because of the low morbidity associated with laparoscopic salpingo-oophorectomy, it may be reasonable to remove the ovaries of postmenopausal women who display virilization or rapidly progressive hirsutism and elevated androgens, even if imaging studies do not detect the ovarian tumor.