Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital

or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure. Index 335 “
“William F. Rayburn William H. Kutteh Paul R. Brezina and William H. Kutteh There are few conditions in Bcl-2 inhibitor medicine associated with more heartache to patients than recurrent pregnancy loss (RPL). The management of early RPL is a formidable see more clinical challenge for physicians. Great strides have been made in characterizing the incidence and diversity of this heterogeneous disorder and a definite cause of pregnancy loss can be established in more than half of couples after a thorough evaluation. In this review, current data are evaluated and a clear roadmap is provided for the evaluation and treatment of RPL. Ole B. Christiansen The aim of this article is to highlight pitfalls in research methodology that may explain why studies in recurrent pregnancy loss (RPL)

often provide very divergent results. It is hoped that insight into this issue will help clinicians decide which published studies are the most valid. It may help researchers to eliminate methodological flaws in future studies, which will hopefully lead to some kind of agreement about the usefulness of diagnostic

tests and treatments in RPL. Paul R. Brezina and William G. Kearns Oxalosuccinic acid As medicine has evolved over the last century, medical genetics has grown from nonexistence to one of the most visible aspects of how we understand and treat disease. This increased role of genetics within medicine will only increase in the coming years, and its role in reproductive medicine will be significant. Genetics has emerged as a primary focus of research with translational applications within reproductive medicine. The aim of this article is to outline the applications of genetics currently available and how these technologies can provide a positive impact on patient care. Carolyn R. Jaslow Uterine anomalies are one of the most common parental causes of recurrent pregnancy loss, occurring in about 19% of patients. Congenital uterine anomalies are most likely caused by HOX gene mutations, although the mechanism is probably polygenic. There are no known environmental causes other than estrogenic endocrine disruptors such as diethylstilbestrol. Acquired uterine anomalies may result from uterine trauma (adhesions) or benign growths of the myometrium (fibroids) or endometrium (polyps).