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Obstetrics/Gynecology

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  • Increasing Incidence of Stage IV Cervical Cancer

    This study examined the incidence of stage IV cervical cancer in the United States between 2001 and 2018. Rates were highest among Black women, but the annual rate of increase was highest among white women in the South aged 40-44 years. Compared with Black women, white women also had lower rates of guideline-adherent cervical cancer screening, and white teens had lower rates of human papillomavirus vaccination.

  • Extended Use of Intrauterine Devices: New Data

    In this prospective cohort study, 362 participants started year 6 of the device and 223 women completed eight years of 52-mg levonorgestrel intrauterine device use. For years 6-8, the three-year Pearl Index (95% confidence interval) was 0.28 (0.03-1.00), with a three-year cumulative failure rate of 0.68% (0.17-2.71).

  • Prevalence of Urinary Incontinence Among Adult U.S. Women Has Increased

    The updated prevalence of urinary incontinence using the National Health and Nutrition Examination Survey data is 60% in community-dwelling women, which is an increase from prior estimates.

  • CDC: Most Pregnancy-Related Deaths Are Preventable

    Recent data indicate mental health conditions, excessive bleeding are the leading causes of pregnancy-related deaths in the United States.

  • Can Maternal COVID-19 Vaccination Protect Newborns?

    In this case control study, 537 case infants younger than 6 months of age who were admitted to the hospital with COVID-19 were compared to 512 control infants who were hospitalized for other reasons; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against COVID-19 during the pregnancy. The effectiveness of maternal vaccination against infant hospitalization for COVID-19 was 52% overall, 80% during the Delta variant period, and 38% during the Omicron variant period. Effectiveness increased when the vaccine was received after 20 weeks of pregnancy.

  • Prevalence of Urinary Incontinence Among Adult U.S. Women Has Increased

    The updated prevalence of urinary incontinence using the National Health and Nutrition Examination Survey data is 60% in community dwelling women, which is an increase from prior estimates.

  • Utility of the Simplified Bishop Score in Trial of Labor After Cesarean Success

    This study demonstrated that a higher likelihood of vaginal birth after cesarean was associated with a favorable simplified Bishop score on admission. This emphasizes the need for delaying patient counseling on the choice of trial of labor after cesarean delivery until the end of pregnancy to incorporate the cervical exam into decision-making.

  • Self-Managed Abortion: A Guide to Harm Reduction and Patient-Centered Care

    Even before the Dobbs v Jackson Women’s Health Organization decision, access to safe, legal abortion within the formal healthcare system was increasingly restricted. In this context, patients may turn to self-managed abortion (SMA). Clinicians should understand the course of SMA, including its overall safety, rare complications, and potential legal risks to patients.

  • Ethicists Asked to Weigh in on Medical Necessity of Abortion

    If ethicists are asked to weigh in, they should suggest a second medical opinion (if time permits) and encourage the institution to clarify any legal questions, ideally before there is an emergency. Institutions also should assure clinicians they will have support from the ethics committee in the event of overzealous prosecution.

  • Abortion Providers and Patients Under Threat of Privacy Breaches

    Reproductive health providers and people seeking abortion care need only look at the not-so-distant past in the United States to predict a future in which their privacy is in legal and physical jeopardy. Physicians who perform legal abortions also face privacy breaches that place the providers and families at risk from doxing, threats, and other harms.