OB/GYN Clinical Alert – October 1, 2020
October 1, 2020
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Race Correction in Clinical Calculations — Is It Time to Reconsider?
Many clinical calculators use race as a predictive variable to assess risk for outcomes. Although most of the tools assume a genetic disposition for these outcomes, other factors, such as health disparities and other potential confounders, are more likely to be the underlying reasons for any race-related differences in outcomes.
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Tamoxifen for the Management of Bleeding Irregularities in Contraceptive Implant Users
In this double-blind, randomized controlled trial, etonogestrel implant users with prolonged or frequent menses who took 10 mg of tamoxifen twice daily for seven days as needed for irregular bleeding had an average of 9.8 (95% confidence interval, 4.6-15.0) more consecutive days of amenorrhea over a 90-day period compared to those who took a placebo.
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Outcomes in Pregnant Women Treated with Anti-Tumor Necrosis Factor-Alpha Biologic Therapy
In this population-based cohort study of 1,027 infants born to women treated with anti-TNF-α biologic therapy, there was an increased prevalence of preterm birth (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 1.29-2.02), cesarean delivery (aOR, 1.57; 95% CI, 1.35-1.82), and small for gestational age neonates (aOR, 1.36; 95% CI, 0.96-1.92) when treatment with anti-TNF was compared to non-biologic systemic treatment. Since disease processes varied greatly in these pregnant women, it was difficult to rule out confounding by disease severity (confounding by indication).
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Application of Acetic Acid to Identify Lesions During Colposcopy
In this prospective study, one minute of acetic acid application was found to be sufficient to identify the most severe colposcopic lesion in 96.7% of subjects.