OB/GYN Clinical Alert
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The Changing Face of Labor Management
Throught the years, clinicians' understanding of the conduct of labor has undergone periodic re-evaluation. In the 1950s, cesarean delivery was a major operation. Today, the procedures are shorter, accompanied by less surgical fanfare, and associated with fewer days in the hospital. Nevertheless, as the only other option to vaginal delivery, the operation, performed in 35% of cases for failure to progress, still should be considered “major” considering its potential for maternal complications.
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Update on Treatments for Vulvovaginal Atrophy
Vulvovaginal atrophy, now known as the genitourinary syndrome of menopause (GSM), occurs with the decline of estrogen in the menopausal period. As with many clinical conditions, the spectrum of GSM requires the clinician to consider the effect on the patient’s quality of life. Although many symptoms are pacified effectively with situational lubricants and regular moisturizers, local estrogen is a safe, effective, and affordable way to treat the vulvovaginal changes of menopause.
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Infertility Therapy Leads to Increased Risk of Severe Maternal Morbidity
Women undergoing infertility treatment, particularly in vitro fertilization, are at higher risk of severe maternal morbidity, but the overall risk remains low.
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Predicting Recurrence After Pelvic Organ Prolapse Surgery
SYNOPSIS: Prediction models can provide helpful information regarding the risk of recurrence after prolapse surgery.
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Ultrasound vs. MRI in Diagnosis of Placenta Accreta
The authors of this two-center study found that magnetic resonance is not superior to ultrasound in diagnostic accuracy for placenta accreta spectrum disorders, and its usefulness is tempered particularly by a tendency to falsely upgrade the stage of severity.
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Welcome New Board Member
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Should Two-Dose Methotrexate Be the Standard of Care for Ectopic Pregnancy?
In this meta-analysis, the two-dose methotrexate treatment protocol was associated with higher odds of treatment success and a shorter treatment period compared to the single-dose protocol.
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Ripples From Original WHI Study Results Continue: Is This Appropriate?
Recommendations for menopausal hormone therapy were widely publicized and adopted following the original publication of the results of the Women’s Health Initiative and affected both initiation and continuation of estrogen therapy through at least 2013.
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Perimenopausal Depression
OB/GYNs strive to screen women for perinatal depression both in pregnancy and postpartum. Although depression frequently affects reproductive-age women, it is common in women throughout the lifespan. This article discusses depression in perimenopausal women.
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Brexanolone for Postpartum Depression: Promising, but Will It Deliver?
In two double-blind, randomized, placebo-controlled, Phase III trials of brexanolone, a new medicine for postpartum depression, researchers found a significant reduction in symptoms at 60 hours of infusion compared to placebo.