Obstetrics/Gynecology
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The Best Treatment for Heavy Menstrual Bleeding
This randomized controlled trial among 62 individuals compared the 52-mg levonorgestrel intrauterine device to combined oral contraceptives for heavy menstrual bleeding and found that, in the intention-to-treat analyses, there was no significant difference in Menstrual Bleeding Questionnaire scores at six months or 12 months (mean difference, 2.5; 95% confidence interval [CI], -10.0, 5.0; and mean difference, -1.1; 95% CI, -8.7, 6.5, respectively).
Why It Is Worth Making Sure All Your Pregnant Patients Receive the Influenza Vaccine
Infants younger than 6 months of age are at risk for severe influenza infections. Vaccination during pregnancy reduces infection and hospitalization risk by nearly 70%.
Respiratory Syncytial Virus Infection During Pregnancy
Although women who developed respiratory syncytial virus (RSV) infection during pregnancy had a higher risk of preterm birth compared to those without RSV infection, the risk of miscarriage, stillbirth, low birth weight, and small for gestational age fetus were similar between the RSV and placebo groups.
Malaria in Pregnancy — Simplified Treatment Decisions
History, data, and international consensus lead to the same conclusion: Artemether-lumefantrine is the first choice for treatment of uncomplicated falciparum malaria in everyone, even pregnant women.
Variables Associated with Resolution and Persistence of Ovarian Cysts
This prospective cohort study evaluated 2,683 individuals with incidental cysts discovered during ovarian cancer screenings to determine what factors are associated with cyst resolution over time. Characteristics such as smaller cysts, septated cysts, younger age, premenopausal status, and family history of ovarian cancer were associated with an increased percentage of cyst resolution overall, and factors including older age and lack of hormone therapy were associated with a faster rate of cyst resolution over time. The findings of this study indicate that different surveillance times may be appropriate, depending on cyst morphology and patient characteristics.
Metformin for the Management of Early Gestational Diabetes
The administration of metformin in the early stages of gestational diabetes did not demonstrate superiority over placebo in relation to the need to start insulin therapy prior to delivery, or on fasting blood glucose concentrations ≥ 5.1 mmol/L at either the 32nd or 38th weeks of gestation (composite primary outcome).
Oral Contraception and Obesity
This study was a re-analysis of drospirenone 4 mg Phase III efficacy trials comparing 590 non-obese and 325 obese patients who showed equivalent pregnancy rates with Pearl Indices of 3.0 (95% confidence interval [CI], 1.3 to 5.8) and 2.9 (95% CI, 0.8 to 7.3), respectively.
Magnesium Sulfate for Neuroprotection
Magnesium sulfate did not improve neurological function and child survival at 2 years of age in women at risk of imminent preterm birth treated between 30 and 34 weeks of gestation.
How Did the COVID-19 Pandemic Affect Permanent Contraception Procedures?
A national review of inpatient permanent contraception procedures between Jan. 1, 2019, and Dec. 31, 2020, demonstrated that the rate of procedures decreased in 2020 compared with 2019, with the steepest monthly decline (14.5%) being between February and April 2020, the first wave of the COVID-19 pandemic.
Rh Sensitization Following Induced Abortion
In this multicenter, observational, prospective cohort study, flow cytometry was used to detect circulating fetal red blood cells (fRBCs) in maternal blood among 506 participants before and after induced abortion up to 12 weeks’ gestation. Only three participants had elevated fRBCs at baseline, and only one of these had elevated fRBC counts following the abortion, which indicates that first trimester abortion is not a risk factor for Rh sensitization.