OB/GYN Clinical Alert
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Surgical Management of Missed and Incomplete Abortion: Is Hysteroscopy Useful?
In this randomized controlled trial of 563 women comparing vacuum aspiration and operative hysteroscopy for incomplete spontaneous abortion, there was no difference in pregnancy rates within the following two years (62.8% hysteroscopy vs. 67.6% vacuum aspiration; risk difference, -4.8%; 95% confidence interval, -13% to 3%).
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Menstrual Suppression Method Outcomes Among Transgender and Gender-Diverse Adolescents
In a retrospective chart review of transgender and gender-diverse adolescents at a single institution seeking menstrual suppression methods, most individuals had high rates of method continuation, amenorrhea, improved bleeding, and a reduction in dysphoria and mood symptoms.
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Azithromycin Prophylaxis for the Prevention of Maternal Sepsis or Death in Women Undergoing Vaginal Delivery
A single oral dose of azithromycin dramatically reduced the risk of maternal sepsis or death among women planning vaginal deliveries compared to placebo but had little effect on neonatal sepsis or mortality.
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OB/GYN Clinical Alert Celebrates 40 Years
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Does Topiramate Decrease the Efficacy of Oral Contraceptives?
In this retrospective cohort study, women taking low-dose topiramate (< 200 mg per day) and oral contraception did not have more contraceptive failures compared to women taking other headache remedies (propanolol, metoprolol, amitriptyline, venlafaxine, or verapamil), with an adjusted rate difference of 0.00 (95% confidence interval, -0.3, 0.3).
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CIN2 Is More Likely to Progress if HPV 16 Is Present
This study examined rates of cervical intraepithelial neoplasia grade 2 (CIN2) regression and progression among women ages 25-30 years and found that regression rates varied by human papillomavirus (HPV) genotype: 51% regression and 47% progression in HPV 16 infections compared to 83% regression and 16% progression for infections with other HPV types.
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Diagnosis of Obstructive Sleep Apnea During Pregnancy
Obstructive sleep apnea is associated with several adverse maternal and fetal outcomes.
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Retrospective Cohort Analysis of Perinatal Outcomes Following Bariatric Surgery
In a retrospective study of a racially and ethnically diverse cohort in 2012-2018, patients with a live birth after bariatric surgery had a lower risk of preeclampsia, gestational diabetes or impaired fasting glucose, and having a large-for-gestational-age infant — but a higher risk of having a small-for-gestational-age infant — relative to matched controls who did not have bariatric surgery before their live birth.
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Opioid Use Disorders During Pregnancy
Currently, the United States faces an enormous opioid crisis, with opioid use disorder (OUD) being the leading cause of morbidity and mortality in some states. The number of pregnant people with OUD increased from 1.5 cases per 1,000 hospital deliveries to 6.5 cases per 1,000 hospital deliveries in the United States between 1999 and 2014, a more than four-fold rise. Proper identification and management of pregnant and postpartum people with OUD is crucial.
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The Efficacy of Prenatal Patients Using a Mindfulness App
This randomized trial conducted early in the pandemic with women from an obstetric and gynecologic practice found use of a mobile app promoting mindfulness practice (such as meditation) was associated with a decrease in perceived stress, self-reported anxiety and depression, and sleep disturbance in the intervention group.