OB/GYN Clinical Alert
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Pregnancy After Treatment for Pelvic Floor Disorders
This consensus document was developed as a reference for physicians caring for and advising women in pregnancy following prior surgical treatment for pelvic floor disorders.
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The Pregnancy Perspective: What Has COVID-19 Affected?
In this cross-sectional descriptive study, women using the Ovia pregnancy app expressed receiving adequately safe maternal care during the COVID-19 pandemic, but voiced concerns related to obtaining infant supplies and prenatal education.
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What Is the Optimal Mode of Delivery of the Second Twin?
In this randomized clinical trial, 343 pregnant women with twin gestations were randomized to planned cesarean delivery and planned vaginal delivery groups (208 patients vs. 135 patients, respectively) between October 2013 and March 2015. The cesarean delivery rate in the planned vaginal delivery arm was 49% compared to the cesarean rate of 99% in the planned cesarean delivery arm. If all criteria for vaginal delivery are met, it would be reasonable and appropriate to offer women with diamniotic twin gestations planned vaginal delivery between 34 0/7 to 37 6/7 weeks of gestation.
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Reducing Opioid Prescriptions Following Gynecologic Surgery
With sufficient institutional buy-in, appropriate patient education, and staff adherence to standardized postoperative prescribing practices, patients undergoing abdominal gynecologic surgery can leave the hospital safely and recover with low doses of opioid medications, or no opioid prescription at all.
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Are We Prescribing Enough Emergency Contraception?
In this national sample of obstetrician-gynecologists, the majority (84%) reported offering at least one form of emergency contraception, with 80% offering the levonorgestrel pill, 18% offering ulipristal acetate, and 29% offering the copper intrauterine device.
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The Utility of Nuchal Translucency Screening in the Era of Cell-Free Fetal DNA Testing
In this retrospective cohort study of 1,901 pregnant women between 11 weeks and 13 weeks six days of gestation who had a nuchal translucency (NT) screening for fetal aneuploidies and demonstrated NT measurements > 95th percentile, 47% of fetuses (894/1,901) had an NT between the 95th and 99th percentile and 53% (1,007/1,901) had an NT ≥ the 99th percentile. In addition, of the 43% of fetuses (814/1,901) with at least one abnormality (structural or genetic), 34% (279/814) would have been missed in the first trimester if only cell-free deoxyribonucleic acid was used for prenatal genetic screening.
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Pap Smear Management: An Update on Recent Recommendations
Despite its current prevalence in the care of patients, the Pap smear has been used for less than 100 years. A major advancement in the field of screening came in the late 1970s and early 1980s with the identification that the human papilloma virus (HPV). Since the year 2000, there have been multiple progressive cycles of updates to both screening and management guidelines as the result of our rapidly evolving understanding of HPV.
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A New Nonhormonal Vaginal Gel Contraceptive
In this single-arm, open-label, Phase III study of a novel vaginal pH regulator gel among 1,384 sexually active women aged 18 to 35 years, the seven-cycle cumulative pregnancy rate was 13.7% (95% confidence interval, 10.0% to 17.5%).
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Is Universal Rescreening of Pregnant Women for Hepatitis C Cost-Effective?
In this cost-effectiveness analysis study, the authors assessed the cost effectiveness of offering hepatitis C virus (HCV) antenatal rescreening to U.S. women who previously were screened HCV negative in a prior pregnancy.
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Body Mass Index and Safety of Postpartum Tubal Ligation
In a single-institution, retrospective review of 3,670 postpartum tubal ligations performed after vaginal delivery, there was no association between increasing body mass index and surgical morbidity.