OB/GYN Clinical Alert – February 1, 2025

February 1, 2025

• Interventions for Pain During Office Endometrial Biopsy

  In this randomized controlled trial, the use of transcutaneous electric nerve stimulation during endometrial biopsy did not clinically significantly reduce pain compared to placebo (median [interquartile range], 50 mm [20 mm to 80 mm] vs. 60 mm [40 mm to 100 mm]; P = 0.039), but was associated with increased satisfaction with the procedure.

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• Do Warm Compresses Combined with Perineal Massage Reduce Perineal Trauma During Labor?

  In this randomized trial, the addition of warm compresses to perineal massage during the second stage of labor showed no significant difference in reducing perineal tears, obstetric anal sphincter injuries, or episiotomies compared to perineal massage alone.

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• Intrauterine Instillation of Mepivacaine at the Time of IUD Placement

  In a randomized clinical trial of 151 women, intrauterine instillation of mepivacaine significantly reduced pain with intrauterine device insertion on visual analog scales both before (53.9 mm vs. 67.2 mm, respectively; P < 0.001) and after adjustment for individual provider variability (55.2 mm vs. 77.4 mm, respectively; P < 0.001), compared to placebo.

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• Parvovirus and Increasing Danger in Pregnancy and Sickle Cell Disease

  The incidence of human parvovirus B19 infection is increasing in the United States, putting vulnerable groups at risk of serious complications.

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