OB/GYN Clinical Alert
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Use of CNMs and Hospitalists
A study assessing the effects of instituting a model of certified nurse midwife with MD laborist backup on a private patient population showed a decrease in cesarean section rate and an increase in vaginal birth after cesarean delivery rate without any change in combined neonatal outcome.
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Fluconazole Use During Pregnancy
In this large cohort study from Denmark, use of oral fluconazole during pregnancy was associated with a slightly increased risk of spontaneous abortion and no increased risk of stillbirth.
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2016 USPSTF Update: Recommendations for and Effectiveness of Screening Mammography
The U.S. Preventive Services Task Force recently released updates to the 2009 recommendations on breast cancer screening. Additional studies published since the last review strengthen the conclusion that mammography screening results in a reduction in the risk of death from breast cancer.
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Is There a Link Between Miscarriage and Future Cardiovascular Disease?
In this Scottish retrospective cohort study of 60,000 women, two or more miscarriages were found to increase the risk of future ischemic heart disease by two- to three-fold.
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Does a History of D&C Increase the Risk of Premature Delivery?
In a meta-analysis, a history of dilation and curettage for management of miscarriage or termination of pregnancy was associated with an increased risk of preterm birth in a subsequent pregnancy but the association is weak and most likely explained by confounding.
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Low-dose Aspirin and Preeclampsia
A study comparing outcomes before and after offering low-dose aspirin to patients who were deemed to be high risk by a first trimester protocol showed a decrease in preterm birth prior to 34 weeks and a decrease in early-onset preeclampsia.
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Menopausal Hormone Therapy: Useful and Indicated for Vasomotor Symptoms
The benefits may exceed the risks for most women within 10 years of menopause.
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Recurrence Rate for Placental Abruption
A study from the Netherlands involving more than 1 million patients has shown that recurrence of placental abruption happens more frequently in those patients whose first abruption occurred at term and/or in their first pregnancy, as well as in those with a history of hypertension.
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Hormone Replacement Therapy Controversies: Have We Harmed Women?
The interpretation of hormone replacement therapy in postmenopausal women has varied dramatically before and after the publication of the Women’s Health Initiative study in 2002. New studies question the validity of the conclusions reached by the investigators.
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Molecular Diagnostics: A Step Forward in Breast Cancer Treatment?
Use of a gene-expression assay to predict prognosis may reduce the need for adjuvant chemotherapy in some women with early stage invasive breast cancer.