OB/GYN Clinical Alert
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Managing Suspected Preeclampsia Using the sFlt-1/PlGF Ratio
The sFlt-1/PlGF ratio is a clinically valuable tool for ruling out preeclampsia and improving obstetric decision-making, although its effect depends on appropriate use, clinician confidence in negative results, and adherence to validated protocols.
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Endometrial Biopsy: What Leads to an Insufficient Sample?
In this large retrospective cohort study at a single health system, the rate of insufficient endometrial biopsies among 27,456 patients was 12.1%. The largest risk factor for an insufficient sample was postmenopausal status (adjusted odds ratio, 5.27; 95% confidence interval, 4.88-5.70). Among premenopausal women, a history of cesarean delivery (9.6% vs. 7.2%; P < 0.001) and leiomyomas (10.3% vs. 7.2%; P < 0.001) was associated with insufficient samples.
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Is Routine Voiding Necessary Following Minimally Invasive Hysterectomy?
This unblinded, randomized clinical trial of patients undergoing minimally invasive benign nonurogynecologic hysterectomy with anticipated same-day discharge demonstrated that eliminating the requirement to void prior to discharge reduced time spent in the post-anesthesia care unit by 27.14 minutes (173.26 mins no void vs. 201.95 mins void; P = 0.002) without increasing the proportion of patients with postoperative urinary retention (3% void vs. 1% no void; P = 3.69).
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A Closer Look at a New Low-Dose Copper IUD
This study reports on the three-year data from an ongoing Phase III study evaluating the efficacy, safety, and tolerability of a new low-dose copper intrauterine device (IUD), demonstrating low rates of expulsion and discontinuation and expanding the nonhormonal IUD options available in the United States.
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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.
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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).
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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.
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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%).
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Gepotidacin Tablets (Blujepa)
The U.S. Food and Drug Administration has approved gepotidacin, a first-in-class antibacterial medication for the treatment of uncomplicated urinary tract infections. It is the first new class of oral antibiotics approved in nearly 30 years.
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Can Hyperemesis Gravidarum Be Prevented with Metformin?
Although differences were not statistically significant, women with pre-conceptional metformin exposure appeared to have lower rates of hyperemesis gravidarum and comparable nausea and vomiting symptom severity, suggesting a potential protective effect that warrants further investigation in larger, adequately powered studies.