Browse OB/GYN Clinical Alert Articles by Topic

Loop Electrosurgical Excision Procedure of the Cervix: Which Is the Best Method of Anesthesia?

In this randomized controlled trial comparing local anesthesia and general anesthesia for loop electrosurgical excision procedure of the cervix, there was no difference in patient satisfaction. However, women in the local anesthesia group had significantly smaller cone volumes and less blood loss than those in the general anesthesia group.

A Prospective Look at the Course of Untreated ADHD in Pregnancy Gains Attention

Twenty-five women with perinatal attention-deficit hyperactivity disorder were followed prospectively during pregnancy for changes in anxiety, depression, perceived stress, and functional impairment. Statistically significant differences in mood and functional impairment in the family domain were found in those who discontinued their psychostimulant.

Oral Progestogens for Prevention of Miscarriage

In this double-blind, randomized clinical trial, 406 pregnant women were randomized to dydrogesterone or placebo. There were no statistically significant differences in the primary outcome (miscarriage before 20 weeks of gestation; relative risk, 0.897; 95% confidence interval, 0.548-1.467; P = 0.772), which occurred in 12.8% and 14.3% in the dydrogesterone and placebo arms, respectively. The use of dydrogesterone in women with threatened miscarriage for the prevention of early pregnancy loss in the first trimester failed to decrease the miscarriage rate or increase the live birth rate.

Is HPV Testing Superior to Pap Testing Alone in Women at Risk of Cervical Cancer?

In this registry-based screening study of women in Catalonia, Spain, a negative human papillomavirus (HPV) and cytology co-test at baseline was associated with a cumulative incidence of cervical precancer of 0.4% at five years and 1.3% at nine years, compared to 27% among women with abnormal HPV testing at baseline.

Pregnancy After Treatment for Pelvic Floor Disorders

This consensus document was developed as a reference for physicians caring for and advising women in pregnancy following prior surgical treatment for pelvic floor disorders.

The Pregnancy Perspective: What Has COVID-19 Affected?

In this cross-sectional descriptive study, women using the Ovia pregnancy app expressed receiving adequately safe maternal care during the COVID-19 pandemic, but voiced concerns related to obtaining infant supplies and prenatal education.

What Is the Optimal Mode of Delivery of the Second Twin?

In this randomized clinical trial, 343 pregnant women with twin gestations were randomized to planned cesarean delivery and planned vaginal delivery groups (208 patients vs. 135 patients, respectively) between October 2013 and March 2015. The cesarean delivery rate in the planned vaginal delivery arm was 49% compared to the cesarean rate of 99% in the planned cesarean delivery arm. If all criteria for vaginal delivery are met, it would be reasonable and appropriate to offer women with diamniotic twin gestations planned vaginal delivery between 34 0/7 to 37 6/7 weeks of gestation.

Reducing Opioid Prescriptions Following Gynecologic Surgery

With sufficient institutional buy-in, appropriate patient education, and staff adherence to standardized postoperative prescribing practices, patients undergoing abdominal gynecologic surgery can leave the hospital safely and recover with low doses of opioid medications, or no opioid prescription at all.

Are We Prescribing Enough Emergency Contraception?

In this national sample of obstetrician-gynecologists, the majority (84%) reported offering at least one form of emergency contraception, with 80% offering the levonorgestrel pill, 18% offering ulipristal acetate, and 29% offering the copper intrauterine device.

The Utility of Nuchal Translucency Screening in the Era of Cell-Free Fetal DNA Testing

In this retrospective cohort study of 1,901 pregnant women between 11 weeks and 13 weeks six days of gestation who had a nuchal translucency (NT) screening for fetal aneuploidies and demonstrated NT measurements > 95th percentile, 47% of fetuses (894/1,901) had an NT between the 95th and 99th percentile and 53% (1,007/1,901) had an NT ≥ the 99th percentile. In addition, of the 43% of fetuses (814/1,901) with at least one abnormality (structural or genetic), 34% (279/814) would have been missed in the first trimester if only cell-free deoxyribonucleic acid was used for prenatal genetic screening.