Browse OB/GYN Clinical Alert Articles by Topic

Maternal Sepsis: Risk Factors that Could Lead to Postpartum Readmission

In this analysis of California deliveries between 2008 and 2011, risk factors for maternal readmission for sepsis were found to include preterm birth, hemorrhage, obesity, and a primary cesarean delivery.

Prenatal Care Visits During COVID-19

In this nested case-control study in the Boston area, there was no association between testing positive for COVID-19 during pregnancy or on admission to labor and delivery and the number of in-person prenatal care visits.

Application of Acetic Acid to Identify Lesions During Colposcopy

In this prospective study, one minute of acetic acid application was found to be sufficient to identify the most severe colposcopic lesion in 96.7% of subjects.

Outcomes in Pregnant Women Treated with Anti-Tumor Necrosis Factor-Alpha Biologic Therapy

In this population-based cohort study of 1,027 infants born to women treated with anti-TNF-α biologic therapy, there was an increased prevalence of preterm birth (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 1.29-2.02), cesarean delivery (aOR, 1.57; 95% CI, 1.35-1.82), and small for gestational age neonates (aOR, 1.36; 95% CI, 0.96-1.92) when treatment with anti-TNF was compared to non-biologic systemic treatment. Since disease processes varied greatly in these pregnant women, it was difficult to rule out confounding by disease severity (confounding by indication).

Tamoxifen for the Management of Bleeding Irregularities in Contraceptive Implant Users

In this double-blind, randomized controlled trial, etonogestrel implant users with prolonged or frequent menses who took 10 mg of tamoxifen twice daily for seven days as needed for irregular bleeding had an average of 9.8 (95% confidence interval, 4.6-15.0) more consecutive days of amenorrhea over a 90-day period compared to those who took a placebo.

Race Correction in Clinical Calculations — Is It Time to Reconsider?

Many clinical calculators use race as a predictive variable to assess risk for outcomes. Although most of the tools assume a genetic disposition for these outcomes, other factors, such as health disparities and other potential confounders, are more likely to be the underlying reasons for any race-related differences in outcomes.

Etonogestrel Contraceptive Implant and VTE in Postpartum Women

In this national retrospective cohort study of postpartum women, use of the etonogestrel contraceptive implant immediately postpartum was not associated with an increased rate of readmission for venous thromboembolism within 30 days of delivery.

Maternal and Pregnancy Characteristics Associated with Periviable Interventions

In this case control study using U.S. live birth records between 22 and 23 weeks of gestation, maternal intervention was positively associated with increasing maternal age, Medicaid use, preeclampsia, birth defects, twin gestation, multiparity, and infertility treatments while being negatively associated with non-Hispanic Black race. Positive associations for neonatal intervention included non-Hispanic Black race, preeclampsia, Medicaid use, infertility treatments, less than a high school education, increasing maternal age, and twin gestation, and negative associations included birth defects and small for gestational age pregnancies.

Apical Suspension at the Time of Vaginal Hysterectomy

The main objective of this study was to determine whether the use of apical suspension at the time of vaginal hysterectomy varies by surgeon specialty.

Is Vaginal Progestogen Equivalent to Intramuscular Progestogen for Preventing Preterm Birth in High-Risk Women?

In this open-label, equivalence randomized trial of vaginal progestogen compared to intramuscular progestogens for preventing preterm birth in high-risk women, the difference in the risk of preterm birth at < 37 weeks of gestation between both groups was 3.1% (95% confidence interval, -7.6% to 13.8%), which was within the equivalence margin of 15% used in the study.