OB/GYN Clinical Alert
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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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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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Etonogestrel Contraceptive Implant and VTE in Postpartum Women
In this national retrospective cohort study of postpartum women, use of the etonogestrel contraceptive implant immediately postpartum was not associated with an increased rate of readmission for venous thromboembolism within 30 days of delivery.
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Maternal and Pregnancy Characteristics Associated with Periviable Interventions
In this case control study using U.S. live birth records between 22 and 23 weeks of gestation, maternal intervention was positively associated with increasing maternal age, Medicaid use, preeclampsia, birth defects, twin gestation, multiparity, and infertility treatments while being negatively associated with non-Hispanic Black race. Positive associations for neonatal intervention included non-Hispanic Black race, preeclampsia, Medicaid use, infertility treatments, less than a high school education, increasing maternal age, and twin gestation, and negative associations included birth defects and small for gestational age pregnancies.
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Apical Suspension at the Time of Vaginal Hysterectomy
The main objective of this study was to determine whether the use of apical suspension at the time of vaginal hysterectomy varies by surgeon specialty.
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Is Vaginal Progestogen Equivalent to Intramuscular Progestogen for Preventing Preterm Birth in High-Risk Women?
In this open-label, equivalence randomized trial of vaginal progestogen compared to intramuscular progestogens for preventing preterm birth in high-risk women, the difference in the risk of preterm birth at < 37 weeks of gestation between both groups was 3.1% (95% confidence interval, -7.6% to 13.8%), which was within the equivalence margin of 15% used in the study.
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Malaria Prophylaxis During Pregnancy
In a retrospective study of American military women involving 50 treated with atovaquone-proguanil and 156 exposed to mefloquine, no increase in risk of fetal loss or adverse infant outcomes was identified. Atovaquone-proguanil seems safe for use in pregnancy, but data are limited.
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Many Serious Cardiac Complications of Pregnancy Are Preventable
Investigators determined about half of serious cardiac complications of pregnancy are preventable.
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Macrolides During Pregnancy — Behind the Headlines
Despite published concerns, there is no good evidence that macrolide use during pregnancy causes birth defects.