Obstetrics/Gynecology
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What Is the Optimal Mode of Delivery of the Second Twin?
In this randomized clinical trial, 343 pregnant women with twin gestations were randomized to planned cesarean delivery and planned vaginal delivery groups (208 patients vs. 135 patients, respectively) between October 2013 and March 2015. The cesarean delivery rate in the planned vaginal delivery arm was 49% compared to the cesarean rate of 99% in the planned cesarean delivery arm. If all criteria for vaginal delivery are met, it would be reasonable and appropriate to offer women with diamniotic twin gestations planned vaginal delivery between 34 0/7 to 37 6/7 weeks of gestation.
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Reducing Opioid Prescriptions Following Gynecologic Surgery
With sufficient institutional buy-in, appropriate patient education, and staff adherence to standardized postoperative prescribing practices, patients undergoing abdominal gynecologic surgery can leave the hospital safely and recover with low doses of opioid medications, or no opioid prescription at all.
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Are We Prescribing Enough Emergency Contraception?
In this national sample of obstetrician-gynecologists, the majority (84%) reported offering at least one form of emergency contraception, with 80% offering the levonorgestrel pill, 18% offering ulipristal acetate, and 29% offering the copper intrauterine device.
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The Utility of Nuchal Translucency Screening in the Era of Cell-Free Fetal DNA Testing
In this retrospective cohort study of 1,901 pregnant women between 11 weeks and 13 weeks six days of gestation who had a nuchal translucency (NT) screening for fetal aneuploidies and demonstrated NT measurements > 95th percentile, 47% of fetuses (894/1,901) had an NT between the 95th and 99th percentile and 53% (1,007/1,901) had an NT ≥ the 99th percentile. In addition, of the 43% of fetuses (814/1,901) with at least one abnormality (structural or genetic), 34% (279/814) would have been missed in the first trimester if only cell-free deoxyribonucleic acid was used for prenatal genetic screening.
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Study: IUD Counseling Can Appear Coercive
The results of a recent study revealed that providers might think they are promoting their young patients’ decision-making, but their focus on intrauterine devices and other long-acting reversible contraceptives can come across as coercive.
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Pregnancy Risk Increases When Young Women Travel
Although most international trips, including students’ study abroad programs, were put on hold in 2020, these might resume this year after the COVID-19 vaccine reaches student populations. Reproductive health providers can help young women prepare for the contraceptive needs and uncertainties of travel. A new study revealed that young female travelers overwhelmingly say they will be abstinent during their travels, but their actual experience is the opposite.
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New Contraceptive Patch Is a Weekly Option
Twirla, a new low-dose contraceptive patch, is effective at preventing pregnancy among American women, according to researchers. Phase III clinical trial results were favorable for efficacy, safety, and tolerability of a levonorgestrel/ethinyl estradiol transdermal delivery system. The new patch uses a progestin and contains less estrogen than prior patches.
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Should Family Planning Clinics Volunteer to Vaccinate Patients?
One of the biggest challenges this spring will be to find enough trained medical staff and ambulatory sites to vaccinate hundreds of millions of people within a six- to seven-month time frame. Family planning centers might be lower on the priority list for vaccination because they serve a younger population.
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Providers Can Reduce Vaccine Hesitancy Among Staff
As the COVID-19 vaccine was rolled out in the United States, many healthcare workers refused vaccination. Reproductive healthcare centers will need to obtain staff buy-in as they begin a vaccination program.
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How Family Planning Providers Can Handle Challenges of COVID-19 Vaccine Rollout
The coronavirus vaccine rollout faces challenges from logistical supply issues and vaccine hesitancy among healthcare staff and the general public. From a reproductive health provider perspective, the big question is how to handle the rollout and overcome challenges on both the supply and demand sides.