March 22 2010


by Nathan Fujita

Adenomyosis is also known as endometriosis interna. Like endometriosis, it is an abnormal location of the endometrial lining cells. With adenomyosis, the glands of the womb lining migrate into the myometrium, the muscle layer. There they grow and respond to the hormones of the menstrual cycle. Typical symptoms are severe cramps and heavy menstrual bleeding.

January 19 2010

Air Travel During Pregnancy

by Nathan Fujita

Most commercial airlines allow pregnant women to travel up to 36 weeks gestation. Prolonged immobilization and low humidity may increase the risk for blood clot formation in the lower extremities. Preventive measures include support stockings, periodic movement of the lower extremities, avoidance of restrictive clothing and hydration. Seatbelts should be used continuously. Radiation exposure is increased, but for the occasional traveler the recommended threshold of 1 mSv is unlikely to be reached. However, aircrew and frequent flyers may exceed these limits. From ACOG Committee Opinion 443, Oct 2009.

January 10 2010

Should ovaries be removed routinely at hysterectomy?

by Nathan Fujita

The conventional thinking is that ovaries should be removed with hysterectomy in older women to prevent ovarian cancer. An article in the May 2009 Obstetrics and Gynecology by Parker et al suggests that we should rethink this dictum. They followed over 29,000 women for over 24 years and revealed that while the risk for ovarian and breast cancer is decreased in women who had their ovaries removed, there was an increase in all-cause mortality, coronary heart disease and lung cancer. Ovarian removal was not associated with increased survival at any age group.

May 22 2009

The First Gynecologic Surgery

by Nathan Fujita

The first abdominal and gynecologic surgery was performed on December 25, 1809 by Dr. Ephrim McDowell on Mrs. Jane Crawford. This operation was done without anesthesia on a table in an upstairs bedroom. The left ovarian tumor weighed 22.5 pounds and was removed in 25 minutes. There was no pathology report, but the tumor is believed to be a benign mucinous cystadenoma.

In 1809 Abraham Lincoln was born, James Madison was president, Napoleon occupied Vienna, and Beethoven composed his fifth symphony.

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.