OB/GYN Clinical Alert
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Pregnancy Outcomes in Women with CVD
Pregnant patients with severe cardiac disease experience a higher risk of adverse cardiac outcomes compared to those with mild to moderate disease.
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Sickle Cell Disease During Pregnancy
Sickle cell disease (SCD) is the most commonly inherited autosomal recessive genetic hemoglobinopathy in the United States. People with SCD account for only 0.1% of all deliveries, but approximately 1% of maternal deaths, a 10-fold increased risk.
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Are Urine Dipsticks Accurate for Preeclampsia Diagnosis?
This systematic review found that urine dipsticks of 1+ protein had a sensitivity of only 68% for the diagnosis of preeclampsia (95% confidence interval, 0.57-0.77), which was considered poor. Performance improved at thresholds of 2+ and 3+ protein.
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Patient Education Resources for Understanding Pelvic Floor Disorders
Online patient resources for pelvic floor disorders on the American Urogynecology Society patient portal are underused by women with pelvic floor disorders.
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COVID-19 Vaccine and the Menstrual Cycle
In a retrospective cohort analysis of prospectively tracked menstrual cycle data from the smart phone application “Natural Cycles,” the COVID-19 vaccine is associated with a less than one day change in menstrual cycle length, and no change in menses length.
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Glycemic Control During Labor in Women with Diabetes
This study demonstrated an increased risk of neonatal hypoglycemia in neonates born to patients with diabetes as the result of maternal hyperglycemia in labor. However, strict intrapartum maternal glycemic control appeared to be associated with a reduced risk of neonatal hypoglycemia only in patients with gestational diabetes on medication, but not for other diabetes subtypes.
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Oral vs. IV Iron for the Treatment of Iron-Deficiency Anemia in Pregnant Women
Compared to oral iron, intravenous iron reduced maternal anemia at delivery (40% vs. 85%, P = 0.039), and rates of maternal hemoglobin < 10 g/dL were lower with intravenous iron compared to oral iron (10% vs. 54%, P = 0.029). Rates of mild to moderate adverse events were similar between the two groups, and no severe adverse reactions were noted with intravenous iron.
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The Pseudogestational Sac of Ectopic Pregnancy: Does it Really Matter?
In this retrospective cohort study of 1,236 women, the rate (2.2%) of ectopic pregnancy was rare among women with a fluid collection (or pseudosac) in the uterus. The size of the fluid collection was not predictive of ectopic pregnancy. The presence of an intrauterine fluid collection decreased the risk of ectopic pregnancy (adjusted relative risk, 0.09; 95% confidence interval, 0.05-0.19) after adjusting for age and the presence of bleeding.
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Is the Timing of Interval Postpartum Insertion of Intrauterine Device Associated with the Frequency of Complications?
Having an intrauterine device (IUD) inserted at four to eight weeks postpartum was associated with higher frequency of uterine perforation, but not higher frequency of expulsion, compared to IUD insertion at nine to 36 weeks postpartum. Overall, perforation and expulsion rates were low.
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The Effects of Maternal Cannabis Use During Pregnancy on the Neurobehavioral Development of Children at Ages 3-6 Years
This study examined associations between maternal cannabis use in pregnancy and neurobehavioral problems diagnosed in children between ages 3 and 6 years. Maternal cannabis use was associated with higher cortisol levels, as well as abnormal behaviors, including anxiety, aggression, and hyperactivity. Placental analyses for a subset of children indicate a potential mechanism for neurobehavioral disorders as the result of selective gene regulation.