Browse OB/GYN Clinical Alert Articles by Topic

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.

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).

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.

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.

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).

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.

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%).