OB/GYN Clinical Alert – September 1, 2025

What Is the Genitourinary Syndrome of Lactation?

In this systematic review of 65 studies, the prevalence of vaginal atrophy among postpartum breastfeeding patients was 63.9% (95% confidence interval [CI], 55.3% to 71.6%) and vaginal dryness symptoms occurred in 53.6% (95% CI, 33.6% to 72.5%). Dyspareunia also was elevated, with a prevalence of 60.0% at three months, (95% CI, 45.1% to 73.3%), 39.7% at six months, (95% CI, 28.9% to 51.5%), and 28.5% at 12 months (95% CI, 26.3% to 30.9%).

Adverse Outcomes in Women with a History of Recurrent Pregnancy Loss

Women with a history of recurrent pregnancy loss are at significantly increased risk of adverse outcomes, including preeclampsia, placental abruption, cesarean delivery, preterm birth, stillbirth, and perinatal mortality.

Postoperative Antibiotics After Cesarean Delivery to Reduce SSI

This randomized, double-blind clinical trial including 321 women with a pre-pregnancy body mass index > 30 kg/m² demonstrated no difference in surgical site infection composite between participants receiving oral cephalexin and metronidazole for 48 hours after cesarean delivery compared to placebo (5.6% vs. 6.8%; odds ratio, 0.80; 95% confidence interval, 0.33-2.22; P = 0.64).

Updates on Cervical Cancer Prevention: Summary and Projected Effect

HPV vaccination and updated screening strategies offer OB/GYN providers powerful tools to prevent cervical cancer. Recent advances, risk-based management, and enhanced follow-up can provide targeted care for high-risk patients to reduce the incidence of cervical cancer while avoiding unnecessary procedures.