OB/GYN Clinical Alert – November 1, 2024

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.

Malpositioned IUDs: How Easy Are They to Remove?

In this retrospective cohort study of 436 malpositioned intrauterine devices (IUDs), of the 281 that underwent removal, 82% were removed on the first attempt and 73% were removed using only ring forceps. Most embedded and partially perforated IUDs also were removed using only ring forceps (59% and 67%, respectively).

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).

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.