Obstetrics/Gynecology
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Placenta Accreta Spectrum Among Patients Seeking Abortion
Placenta accreta spectrum (PAS) in patients seeking abortions poses significant risks, especially for those with prior cesarean deliveries. PAS, often related to prior cesarean deliveries, increases abortion-related complications. Ultrasound is key for detection, but access to skilled care may be limited because of state-based abortion restrictions, leading to worse outcomes for affected patients.
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Antibiotic Choice for Preventing SSIs in Gynecologic Surgery
In a retrospective review of 3,087 patients undergoing hysterectomy or laparotomy for gynecologic surgery at a single institution who received cefazolin alone or a combination cefazolin and metronidazole for surgical prophylaxis, the combination resulted in a significantly lower surgical site infection rate (4.5% vs. 2.3%; P = 0.0115).
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Using Deep Learning to Identify Fetal Head Position in Labor
An artificial intelligence (deep learning) model accurately detected fetal head position during the second stage of labor using transperineal ultrasound, but validation of the model on larger datasets and real-time patients before clinical use is important.
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The Fourth Trimester: Emergencies in the Postpartum Period
The most common causes of maternal death in the postpartum period include infection, hemorrhage, cardiomyopathy, and mental health-related conditions.
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Multicomponent Breastfeeding Interventions in Women with a Body Mass Index > 25
The study found no statistically significant differences in breastfeeding outcomes between the intervention and control groups at various postpartum time points, although the intervention group received more hospital-based support, while the control group sought more private lactation support.
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What Do Patients Know About Anti-Müllerian Hormone Testing?
In this randomized, controlled, online questionnaire trial, participants who received evidence-based information about anti-Müllerian hormone (AMH) testing had lower interest in getting an AMH test (mean difference, 1.05; 95% confidence interval, 0.83-1.30) than individuals who viewed the control information from a direct-to-consumer website.
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Rethinking Endometrial Thickness Thresholds that Prompt Endometrial Biopsy to Rule Out Endometrial Cancer
In a retrospective review of 1,494 pre- and postmenopausal Black individuals who underwent transvaginal ultrasonography, 24 of 210 individuals (11.4%) with endometrial cancer had an endometrial thickness lower than the threshold for undergoing biopsy to detect cancer.
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Reproductive Healthcare in Adolescents with Autism and Other Developmental Disabilities
This cohort study of 3,723 female adolescents from the Kaiser Permanente healthcare system in California found that adolescents with autism or developmental disability were less likely to see an OB/GYN or be prescribed contraception compared with their typically developing peers. This study identified disparities present in reproductive healthcare for this population, despite higher rates of menstrual-related diagnoses.
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Neurodevelopmental and Psychiatric Risks in Children of Pregnant Mothers Who Use Cannabis
Although current research has not conclusively established a direct link between prenatal cannabis use and an increased risk of autism spectrum disorder (ASD), psychotic symptoms, anxiety, or depression in offspring, there is evidence suggesting that prenatal cannabis exposure may modestly elevate the risk of attention-deficit/hyperactivity disorder (ADHD). Additionally, children exposed to cannabis in utero may be more likely to use cannabis later in life.
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Evaluating the Effectiveness of Treatment Strategies for Managing Cesarean Scar Ectopic Pregnancies
A review of 460 international cases of cesarean scar pregnancies demonstrated that surgical treatments were extremely effective options, with successful completion in 91.5% (95% confidence interval [CI], 87.8 to 95.2) of suction evacuations and 91.8% (95% CI, 83.8 to 99.9) of surgical excisions compared with a lower success rate for medical options, including local gestational sac injection or systemic methotrexate.