Editorial Open Access

Ultrasound in Obstetrics and Gynecology

Elliot M. Levine

Advanced ultrasound offers an important diagnostic clinical tool for the specialty of Obstetrics (OB) and Gynecology (GYN). The advanced ultrasound technologies, such as power Doppler angiography, with its assessment of vascular flow, adds to the described clinical benefits. The imaging technology that this represents, offers diagnostic abilities for a variety of obstetric and gynecologic conditions

Case Series Open Access

Intrauterine Device Embedment Resulting in Its Fracture: A Case Series

Leah Delfinado , Imaan Ansari , Elliot M. Levine , Carlos M. Fernandez , Marie Cabiya

Purpose: As long-acting reversible contraceptive choices are becoming more popular among young women, proper informed consent over potential complications should be addressed when such decisions are made. A local case series was analyzed to consider the risk of intrauterine device (IUD) fracture. Materials and Methods: A retrospective review of provider experience with the intrauterine device over a seven-year period was undertaken, to specifically analyze the incidence of IUD embedment and fracture in the studied population.

Research Article Open Access

Ectopic Pregnancy: Vascularity Index as a Novel Diagnostic Criterion

Carlos M. Fernandez , Elliot M. Levine , Irma Sodini , Mai Britt Campbell , Stephen Locher

Since the medical management of ectopic pregnancy (EP) was introduced by Dr. Steven Ory, and published in 1986 in the American Journal of Obstetrics and Gynecology, diagnostic criteria have been established to predict its successful medical treatment with methotrexate (MTX), including its maximum diameter (MaxDia), its associated human chorionic gonadotropin (hCG) level, and whether there was identified cardiac motion (CM).

Editorial Open Access

Racial/Ethnic Bias and Its Role in Severe Maternal Morbidity

Leah Delfinado , Elliot M. Levine , Carlos M. Fernandez

Racial and ethnic health disparities have been identified by many information sources in recent years, and a specific example of this is severe maternal morbidity and mortality, which includes mortality from postpartum hemorrhage. It is this racial/ethnic health disparity that has been highlighted in news reports that should be of concern to all physicians and healthcare providers, recognizing that women of color have more than three times the risk of dying in childbirth than white women.

Editorial Open Access

Addressing Racial/Ethnic Healthcare Disparities and the Rising Incidence of Syphilis

Elliot M. Levine , Carlos M. Fernandez

Some sexually transmitted infections have posed a particular epidemiologic problem for some communities, in that racial/ethnic disparities have been demonstrated. Syphilis represents a specific example of such an infection, compounding the medical problem further by adding to the serious consequences of its vertical perinatal transmissibility to the neonate, in addition to its sexual, or horizontal, transmission.

Editorial Open Access

Predatory versus Non-Predatory Journals: An Important Distinction to be Made

Elliot M. Levine

The term, “predatory”, is defined in Webster’s dictionary as “inclined or intended to injure or exploit others for personal gain”. This term was first applied to some journals by Professor Beall in 2012, describing those journals as being without scholarly merit and being exploitative for a journal’s gain.

Editorial Open Access

Use of Algorithms to Predict Disease in Obstetrics: A Clinical Perspective

Elliot M. Levine

Artificial Intelligence (AI) has been the subject of many contributions to the lay and professional literature in the past few years. While it may seem that the medical benefits of its use are immense, there may be reasons to consider a degree of caution in this regard. In particular, the clinical value of using algorithms to predict disease should be measured against the cases in which such algorithms are not used. Then, the resultant costs can be measured to show possible clinical benefit of AI. 

Editorial Open Access

Exploration of Real-World Obstetric Data Regarding Cesarean Delivery Rate Since the ARRIVE Trial

Carlos M. Fernandez , Elliot M. Levine , Teresa Tam

The cesarean delivery rate reported for the USA is an important element which impacts parturients in many ways, and which is a measurable factor. It is essential to determine if this rate compares with what had been predicted according to a previously published randomized controlled trial recommending an early term induction of labor. Such a comparison is possible, and should be reviewed, and which follows.

Editorial Open Access

Primary Dysmenorrhea: A Questionable Diagnosis in the Modern Era

Elliot M. Levine , Carlos M. Fernandez , Teresa Tam

The term “Primary Dysmenorrhea” may no longer adequately describe a patient’s diagnosis, given the capabilities of modern imaging technology to detect possible deep infiltrating endometriosis. Laparoscopy alone may not be sufficient for diagnosing endometriosis. Considering the availability of specific therapeutic interventions tailored for endometriosis, there is a compelling case for pursuing a more targeted diagnostic approach.

Editorial Open Access

Comprehensive Management of Endometriosis: Implementation from Research to Clinical Practice

Carlos M. Fernandez , Elliot M. Levine , Teresa Tam

Appendiceal endometriosis (AE) represents a clinically significant yet frequently overlooked manifestation of endometriosis that may contribute to persistent symptoms and suboptimal treatment outcomes. Multiple comprehensive reviews demonstrate that appendiceal involvement occurs in a notable percentage of women with endometriosis and can present with distinctive symptom patterns.

Letter to the Editor Open Access

Methotrexate Treatment of Ectopic Pregnancy

Elliot M. Levine

In their detailed review of randomized controlled trials (RCTs) of intact  tubal ectopic pregnancies (EPs) treated with methotrexate  (MTX), the benefit of single dose MTX treatment was made  clear,recognizing the easily administered low-cost treatment as having an 81% success rate.