OB/GYN Clinical Alert
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Is Nitrous Oxide an Effective Analgesic During Labor?
In this prospective cohort study at one large academic medical center in Colorado, 31% of women who opted for nitrous oxide for analgesia during labor did not require any other source of analgesia, such as an epidural or intravenous opioids. Risk factors for conversion to other modalities included labor induction, oxytocin augmentation, and labor after cesarean.
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A Note from OB/GYN Clinical Alert’s New Editor
Rebecca Allen, MD, MPH, begins role as editor.
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A New Treatment for Recurrent Bacterial Vaginosis?
In this randomized, controlled trial of 228 women, Lactobacillus crispatus CTV-05 (Lactin-V) applied vaginally for 11 weeks reduced the incidence of recurrent bacterial vaginosis from 45% in the placebo arm to 30% in the Lactin-V arm.
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Fezolinetant Shows Positive Response in Vasomotor Symptoms Associated with Menopause
A phase 2b trial using seven dosing regimens of a novel neurokinin-3 receptor antagonist, fezolinetant, shows statistically significant improvement in vasomotor symptoms vs. placebo in postmenopausal women.
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Does a Standardized Recovery Bundle After Cesarean Delivery Decrease Length of Stay?
Implementation of an enhanced recovery bundle after cesarean delivery reflected diverse positive outcomes. However, length of stay was reduced only by an average of two hours.
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Is RhoGAM Needed for Rh-Negative Women Experiencing First-Trimester Pregnancy Loss or Induced Abortion?
In this prospective cohort pilot study, the authors validated a flow cytometry protocol for detecting fetal red blood cells and determined that fetal red blood cell exposure in first-trimester uterine aspiration was well below the calculated threshold for maternal Rh sensitization.
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Restricting Access to Abortion Increases Complications
Restrictive abortion laws increase the chance that a woman will self-manage her abortion, a practice associated with an increased risk of complications.
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Should Metronidazole Be Added Routinely to Treatment Regimens for PID?
In this randomized, double-blind, controlled trial, routine treatment with metronidazole compared to placebo in addition to doxycycline and ceftriaxone reduced the presence of endometrial anaerobes, Mycoplasma genitalium, and pelvic tenderness at 30 days post-treatment. However, clinical improvement at three days post-treatment was no different between the two groups.
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COVID-19 and Pregnancy: What Obstetricians Need to Know
While data remain limited on this particular coronavirus, extrapolation from other viruses (severe acute respiratory syndrome and Middle East respiratory syndrome), and best clinical observations and expert recommendations have led to current guidelines in care.