Browse OB/GYN Clinical Alert Articles by Topic

Obesity in Pregnancy

Obesity in pregnancy can be attributed to multiple factors that include genetic predispositions, lifestyle factors (such as diet and physical activity), and socioeconomic conditions. Over the last two decades, there has been a significant rise in obesity rates among pregnant women, particularly with a notable 33% increase from 2001 to 2018 in women aged 20 to 39 years.

Actinomycin-D Treatment for Preventing Post-Molar Gestational Trophoblastic Neoplasia

This 28-year retrospective cohort study demonstrated that administration of a single 1.25 mg/m² intravenous dose of actinomycin-D at the time of uterine evacuation for patients with high-risk complete hydatidiform molar pregnancies was associated with a significantly lower rate of post-molar gestational trophoblastic neoplasia (19% vs. 40%, P < 0.001) and a 52% reduction in relative risk (RR; RR = 0.48; 95% confidence interval, 0.35-0.66) in the development of post-molar gestational trophoblastic neoplasia.

What Hormonal Side Effects Should New Users of the Levonorgestrel 52-mg IUD Expect?

This secondary analysis compares the incidence of hormone-related side effects of the levonorgestrel 52-mg intrauterine device (IUD) between users who previously were using combined hormone contraceptives vs. nonhormonal contraceptives to understand which side effects can be directly attributed to the IUD and which are more likely secondary to discontinuation of combined hormonal contraceptives.

Are Male Partners the Key to Preventing Recurrent Bacterial Vaginosis?

In this open label, randomized controlled trial, couples in monogamous relationships whose female partner was diagnosed with bacterial vaginosis were randomized to treatment of the female partner only or to treatment of the female partner plus the male partner. After 150 couples had completed the 12-week follow-up period, recurrence of bacterial vaginosis occurred in 24 of 69 women (35%) in the partner-treatment group and in 43 of 68 women (63%) in the control group, indicating an absolute risk difference of -2.6 recurrences per person-year (95% confidence interval, -4.0 to -1.2; P < 0.001).

Should Trial of Labor Be Offered to Women with Two Previous Cesarean Deliveries and Twin Gestations?

In twin pregnancies among women with two prior cesarean deliveries, there were no significant differences observed in adverse maternal or neonatal outcomes, yet the probability of a successful vaginal birth stood at 37.8%.

Modified Laparoscopic Radical Hysterectomy in Early-Stage Cervical Cancer

In this retrospective cohort study including 276 patients with early-stage cervical cancer, modified tumor-free techniques during laparoscopic radical hysterectomy, including avoidance of a uterine manipulator and vaginal closure prior to colpotomy, demonstrated a lower recurrence rate (1.3% vs. 12.8%) and significantly better two-year disease-free survival (99.3% vs. 91.9%, P = 0.002) compared with traditional laparoscopic radical hysterectomy.

Trends in Contraceptive Use Among Abortion Patients

In this cross-sectional study of 88,550 patients presenting for abortion services in England and Wales in 2018 and 2023, the use of effective methods of contraception decreased over time (hormonal methods: 18.8% vs. 11.3%, P < 0.001; long-acting reversible contraceptives: 3% vs. 0.6%, P < 0.001), while fertility awareness-based methods increased from 0.4% to 2.5% (P < 0.001).

New Guidelines for HPV Testing of Self-Collected Vaginal Specimens

This article outlines national consensus guidelines for the use of human papillomavirus (HPV) testing of self-collected vaginal specimens for cervical cancer screening.

Cesarean Scar Ectopic Pregnancy

Cesarean scar ectopic pregnancy is a complication in which an embryonic pregnancy implants in the fibrous scar of a previous cesarean incision. This abnormally located pregnancy places the patient at increased risk for uterine dehiscence, hemorrhage, and abnormal placentation as the pregnancy progresses.

How Common Are Hormonal Side Effects with the 52-mg Levonorgestrel IUD?

In this secondary analysis of the ACCESS IUS trial, participants who used combined hormonal contraceptives compared to nonhormonal contraceptives prior to enrolling were more likely to complain of acne in the first six months (13% vs. 8.5%, P = 0.006) and 12 months (15.7% vs. 10.6%, P = 0.005) of levonorgestrel intrauterine device use. Overall, the rate of discontinuation in the first six months because of adverse events was 5.5%, with no difference between the two groups.