Obstetrics/Gynecology
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Teen Pregnancies in the ED Part 2: Handling Complications
Teenage pregnancies have a higher incidence of adverse medical outcomes and obstetrical complications that are critical for providers to recognize and manage in a timely manner. The author provides a succinct, comprehensive review of the critical aspects of trauma in pregnancy; preeclampsia; hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome; venous thromboembolism; as well as precipitous delivery and postpartum hemorrhage.
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Gestational Diabetes Mellitus: An Update on Care
Early detection of gestational diabetes mellitus (GDM) allows for the implementation of appropriate interventions to reduce the adverse effects of uncontrolled hyperglycemia, making GDM screening an integral part of prenatal care. However, the question of whether to adopt universal or selective (risk-based) screening for GDM has been a subject of ongoing debate and lacks a clear international consensus.
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Is Cannabis Abuse During Pregnancy Associated with Poor Neonatal Outcomes?
Cannabis use disorder is associated with small but significant increased risks measured in multiple neonatal outcomes.
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Permanent Contraception Regret in the Modern Age
In this Canadian cross-sectional survey of a convenience sample of 844 patients who had undergone female sterilization, the prevalence of regret was 16%.
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Pelvic Exams During Annual Gynecologic Visits
A retrospective chart review of 1,121 patients undergoing annual gynecology exams showed that 1.2% (95% confidence interval [CI], 0.5 to 1.9) of asymptomatic patients had physical exam findings on pelvic exam compared to 32.4% (95% CI, 27.0 to 37.8) of symptomatic patients.
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Imported Gestational Malaria
Pregnant women can develop malaria in non-endemic areas, even when they are far removed from malaria exposure both geographically and temporally.
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Zuranolone Therapy for Depression in the Postpartum Period
Zuranolone was well tolerated and resulted in substantial improvement of depressive symptoms in the postpartum period, suggesting that it may be a promising new oral therapy for postpartum depression.
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How Does the Genitourinary Syndrome of Menopause Affect Patients?
This analysis of baseline questionnaire responses from 302 individuals enrolled in the MsFLASH Vaginal Health Trial demonstrated that the most commonly reported symptoms were vaginal dryness (94%), pain with vaginal penetration (84%), vulvovaginal pain and soreness (76%), and vulvovaginal irritation (73%). The symptom most often rated severe was pain with vaginal penetration (40%).
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Mifepristone as a Treatment Option for Adenomyosis
This multicenter, placebo-controlled, double-blind randomized clinical trial was conducted in 10 hospitals in China and enrolled 134 patients with diagnosed adenomyosis to evaluate mifepristone as an effective treatment for adenomyosis pain symptoms. Among the intervention group, 98.1% had total remission of adenomyosis pain symptoms as well as improved secondary outcomes with no serious adverse events. Mifepristone is promising for treating pain from adenomyosis.
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Perioperative Practice Patterns in the Surgical Treatment of Female Stress Urinary Incontinence
Board-certified urogynecologists had higher surgical volumes of stress incontinence surgeries, were more likely to perform perioperative tasks, and had lower readmission rates compared with non-urogynecologists performing anti-incontinence procedures.