Browse OB/GYN Clinical Alert Articles by Topic

Long-Term Outcomes of Peripartum Cardiomyopathy

A large, prospective, observational study from Israel of peripartum cardiomyopathy has shown that, in general, outcomes are favorable, with high rates of left ventricular function recovery that remain stable and with no mortality but also that show high rates of cardiovascular comorbidities during long-term follow-up.

Fertility-Sparing vs. Surgical Treatment for Stage I Endometrial Cancer

This retrospective cohort study using the National Cancer Database demonstrated similar overall survival between fertility-sparing treatment and hysterectomy for patients younger than 40 years of age with clinical stage 1, low-grade endometrial cancer (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.50-2.00) but an increased mortality risk for patients aged 40-49 years receiving fertility-sparing treatment (HR, 4.94; 95% CI, 1.89-12.91).

Spironolactone for the Treatment of Acne Vulgaris

In this meta-analysis of 563 patients from five randomized controlled trials, objective assessment of acne improvement was higher in the spironolactone group compared to the placebo group (odds ratio, 6.59; 95% confidence interval, 3.50-12.43).

Acetaminophen Use During Pregnancy and Neurodevelopmental Disorders

The synthesized evidence on prenatal acetaminophen exposure and neurodevelopmental outcomes highlights modest and inconsistent associations and emphasizes that causality remains unproven because of confounding and measurement biases. The authors conclude that, consistent with American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine guidance, acetaminophen remains appropriate in pregnancy when clinically indicated.

The Proton Pump Inhibitor Use and Hypertension Link in Menopausal Women

In a large study, long-term use of proton pump inhibitors in menopausal women was associated with an increased risk of developing hypertension.

Comparison of the Mini and Standard Copper IUD

This Phase III randomized clinical trial demonstrated a three-year cumulative pregnancy rate of 4.8% (95% confidence interval, 2.75 to 6.86) for the NTCu380 mini intrauterine device (IUD), with similar discontinuation rates between the mini copper IUD and the TCu380A standard copper IUD (51.3% vs. 57.3%, P = 0.07), but fewer discontinuations for bleeding and pain for the mini copper IUD (14.5% vs. 27.3%, P < 0.001).

Antenatal Corticosteroids for the Periviable Fetus at 22 Weeks of Gestation

The 2021 American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine practice advisory significantly increased the use of antenatal corticosteroids at 22 weeks of gestation in U.S. hospitals planning neonatal resuscitation, highlighting both the powerful influence of clinical guidelines on practice patterns and the persistence of disparities driven by sociodemographic factors.

What Is the Risk of CT Exposure Before Conception?

In this retrospective cohort study among 5,142,339 pregnancies in Ontario, Canada, exposure to preconception computed tomography (CT) was weakly associated with spontaneous pregnancy loss (adjusted hazard ratio [aHR], 1.08; 95% confidence interval [CI], 1.07 to 1.08 for one CT scan; aHR, 1.14; 95% CI, 1.12 to 1.16 for two CT scans; and aHR, 1.19; 95% CI, 1.16 to 1.21 for three or more CT scans). For the 3,451,968 live births, there was a similar weak association with congenital anomalies (aHR, 1.06; 95% CI, 1.05 to 1.08 for one CT scan; aHR, 1.11; 95% CI, 1.09 to 1.14 for two CT scans; and aHR, 1.15; 95% CI, 1.11 to 1.18 for three or more CT scans).

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.

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.