Browse OB/GYN Clinical Alert Articles by Topic

Pap Smear Management: An Update on Recent Recommendations

Despite its current prevalence in the care of patients, the Pap smear has been used for less than 100 years. A major advancement in the field of screening came in the late 1970s and early 1980s with the identification that the human papilloma virus (HPV). Since the year 2000, there have been multiple progressive cycles of updates to both screening and management guidelines as the result of our rapidly evolving understanding of HPV.

A New Nonhormonal Vaginal Gel Contraceptive

In this single-arm, open-label, Phase III study of a novel vaginal pH regulator gel among 1,384 sexually active women aged 18 to 35 years, the seven-cycle cumulative pregnancy rate was 13.7% (95% confidence interval, 10.0% to 17.5%).

Is Universal Rescreening of Pregnant Women for Hepatitis C Cost-Effective?

In this cost-effectiveness analysis study, the authors assessed the cost effectiveness of offering hepatitis C virus (HCV) antenatal rescreening to U.S. women who previously were screened HCV negative in a prior pregnancy.

Body Mass Index and Safety of Postpartum Tubal Ligation

In a single-institution, retrospective review of 3,670 postpartum tubal ligations performed after vaginal delivery, there was no association between increasing body mass index and surgical morbidity.

Perinatal Mental Health During the COVID-19 Pandemic: The Role of the OB/GYN

The obstetrical effect of COVID-19 has received attention worldwide. However, data examining the psychological effect on women in the perinatal period still are emerging. Although there is little doubt that COVID-19 has increased depression and anxiety in many demographic groups, a small amount of existing literature begins to give us some insight into the incidence, risk factors, and protective factors for mental illness in perinatal women during the COVID-19 pandemic.

HPV Vaccination Reduces the Risk of Invasive Cervical Cancer

In this retrospective cohort study of women in Sweden, receipt of human papillomavirus vaccination prior to age 17 years was associated with an 88% decrease in cervical cancer, and vaccination at ages 17 to 30 years was associated with a 53% decrease in cervical cancer.

Female Caregivers May Delay Seeking Care for Pelvic Floor Disorders

One-third of patients presenting for urogynecologic subspecialty care are caregivers. Of these, women caring for an adult are more likely to delay seeking care for pelvic floor disorders.

Does Epidural Analgesia for Labor and Delivery Pain Relief Cause Autism?

In this retrospective cohort study of 147,895 singleton births, epidural anesthesia was used in 74.2% of cases and the hazard ratio for the subsequent diagnosis of autism spectrum disorders was 1.37 (95% confidence interval, 1.23-1.53).

Understanding the Utility of Hemoglobin A1c in Diagnosing Gestational Diabetes in Early Pregnancy

In this retrospective cohort study of 243 pregnant women who had combined hemoglobin A1c (HbA1c) and a two-step oral glucose tolerance testing at less than 21 weeks of gestation, median values of HbA1c were higher in women with gestational diabetes compared to nondiabetics (5.8% compared to 5.3%; P < 0.001). The predictive probability of using HbA1c in diagnosing diabetes in early pregnancy was high compared to two-step testing (area under the curve, 0.8), with an optimal diagnostic threshold of 5.6%. Although a HbA1c level of > 6.5% is diagnostic of early gestational diabetes, a lower diagnostic threshold might be justified during pregnancy.

Outpatient Foley Catheter for Induction of Labor in Nulliparous Women

In this randomized controlled trial among nulliparous patients with low Bishop scores, outpatient placement of a Foley catheter the day prior to scheduled admission, when compared to inpatient placement, showed a decreased mean time from admission to delivery.