OB/GYN Clinical Alert
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Maternal Outcomes Following COVID-19 Infection in Vaccinated and Unvaccinated Pregnant Patients
Pregnant patients who received the COVID-19 vaccine had lower rates of severe or critical COVID-19 infections compared to pregnant unvaccinated patients.
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Are Female Surgeons at Higher Risk for Infertility and Pregnancy Complications?
In this cross-sectional national survey of 850 surgeons, compared to the partners of male surgeons, female surgeons were more likely to have fewer children (1.8 vs. 2.3) and to delay having children because of surgical training (65% vs. 44%). Female surgeons also were more likely to use assisted reproductive technology (25% vs. 17%).
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Zuranolone Trial Shows Early Promise as an Oral Neuroactive Steroid for the Treatment of Postpartum Depression
Zuranolone was approved by the Food and Drug Administration for the treatment of postpartum depression (PPD) in March 2019. One potential factor identified in PPD etiology is the dramatic perinatal changes in circulating levels of allopregnanolone, a neuroactive steroid with gamma-aminobutyric acid type A (GABAA) receptor positive allosteric modulator properties. In brain regions associated with emotion and self-perception, neural network connectivity supported by GABAergic signaling is positively correlated with plasma allopregnanolone concentrations in individuals with PPD vs. healthy postpartum female individuals.
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Is Prenatal Screening for GBS Cost-Effective in the United States?
In this cost-effectiveness study, screening for group B streptococcus (GBS) at 36 0/7 to 37 6/7 weeks, with rescreening (if GBS results are negative after five weeks of initial screening), is the most cost-effective strategy.
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Barriers to Abortion Care and Self-Managed Abortion
In this prospective national study among people searching for abortion care online, 28% of respondents reported attempting self-managed abortion. Respondents living farther from an abortion facility and facing barriers to care were more likely to attempt self-managed abortion.
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Use of Ursodeoxycholic Acid in Pregnant Women with Obstetric Cholestasis
Ursodeoxycholic acid might be beneficial in reducing the risk of spontaneous preterm birth and meconium-stained amniotic fluid, but not stillbirths, in women with pregnancies complicated by obstetric cholestasis.
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Menopausal Hot Flashes: Can a Plant-Based Diet Provide Effective Treatment?
In this clinical trial, women randomized to a low-fat, vegan diet including one-half cup of cooked whole soybeans daily experienced a reduction in total hot flashes of 79% compared to 49% in the control group over 12 weeks of observation.
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Do Women 64 to 66 Years of Age Qualify to Discontinue Cervical Screening?
These studies evaluated adherence to national guidelines for exiting from cervical cancer screening at 65 years of age and managing abnormal results on screening with human papillomavirus (HPV) and Pap co-testing and found that the majority of women 64 to 66 years of age do not qualify to discontinue screening, and the majority of women with discordant Pap and HPV test results are managed incorrectly.
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SARS-CoV-2 Infection During Pregnancy and Increased Risk of Preeclampsia
A meta-analysis of 28 observational studies found that having SARS-CoV-2 infection during pregnancy was associated with a 58% increase in the adjusted odds of having preeclampsia compared to those without SARS-CoV-2 infection during pregnancy.
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COVID-19 Vaccination, Pregnancy, Lactation, and Fertility: What Should the OB/GYN Know?
With the increasing circulation of the Delta variant, it has become critically important for the OB/GYN to discuss COVID-19 vaccination with patients, and, specifically, to address concerns related to pregnancy, lactation, and fertility. This article reviews the most recent guidance from the American College of Obstetricians and Gynecologists, the Society of Maternal-Fetal Medicine, and the American Society for Reproductive Medicine on vaccination in reproductive-age individuals.