OB/GYN Clinical Alert
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Assessing the Availability of Procedural, Later Abortion Services Pre- and Post-Dobbs
From 2021 to 2023, the number of publicly advertising procedural abortion facilities in the United States decreased 11%. Of those that persisted, 28% of facilities decreased their gestational age limits and 21% increased their gestational age limits.
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Lymphedema Risk After Pelvic Sentinel Lymph Node Biopsy in Endometrial Cancer
This prospective longitudinal cohort study in Denmark of women with low-grade endometrial cancer undergoing sentinel lymph node mapping during surgical staging demonstrated a statistically significant mean change in patient-reported outcome lymphedema scores from prior to surgery (5.0; 95% confidence interval, 3.3 to 6.8). However, the change did not meet preset thresholds for clinical importance (8.0 points). The study did identify body mass index (P = 0.01) and preoperative leg swelling (P < 0.01) as risk factors for lymphedema and demonstrated that this complication negatively affects several quality-of-life domains.
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Which Method Is Best for Assessing Fetal Well-Being During Labor?
Although this study began as a randomized controlled trial and did not show a statistically significant difference between groups for the primary outcome, pooled analysis via a meta-analysis incorporating prior pilot data suggested a potential reduction in cesarean delivery with digital fetal scalp stimulation (dFSS) compared to fetal scalp blood sampling. Secondary maternal and neonatal outcomes were similar between the two groups, both procedures were well-tolerated, and clinicians showed a clear preference for dFSS.
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Update on Early Pregnancy Loss Management
Early pregnancy loss affects 15% to 20% of pregnancies and typically is diagnosed via ultrasound. Management options — expectant, medical, or procedural — should be tailored to patient preference. For medical management, mifepristone combined with misoprostol offers the highest success. Routine Rh testing before 12 weeks is no longer broadly recommended. Shared decision-making and access to effective medications remain critical.