Browse OB/GYN Clinical Alert Articles by Topic

Update on Early Pregnancy Loss Management

Early pregnancy loss affects 15% to 20% of pregnancies and typically is diagnosed via ultrasound. Management options — expectant, medical, or procedural — should be tailored to patient preference. For medical management, mifepristone combined with misoprostol offers the highest success. Routine Rh testing before 12 weeks is no longer broadly recommended. Shared decision-making and access to effective medications remain critical.

Which Method Is Best for Assessing Fetal Well-Being During Labor?

Although this study began as a randomized controlled trial and did not show a statistically significant difference between groups for the primary outcome, pooled analysis via a meta-analysis incorporating prior pilot data suggested a potential reduction in cesarean delivery with digital fetal scalp stimulation (dFSS) compared to fetal scalp blood sampling. Secondary maternal and neonatal outcomes were similar between the two groups, both procedures were well-tolerated, and clinicians showed a clear preference for dFSS.

Lymphedema Risk After Pelvic Sentinel Lymph Node Biopsy in Endometrial Cancer

This prospective longitudinal cohort study in Denmark of women with low-grade endometrial cancer undergoing sentinel lymph node mapping during surgical staging demonstrated a statistically significant mean change in patient-reported outcome lymphedema scores from prior to surgery (5.0; 95% confidence interval, 3.3 to 6.8). However, the change did not meet preset thresholds for clinical importance (8.0 points). The study did identify body mass index (P = 0.01) and preoperative leg swelling (P < 0.01) as risk factors for lymphedema and demonstrated that this complication negatively affects several quality-of-life domains.

Assessing the Availability of Procedural, Later Abortion Services Pre- and Post-Dobbs

From 2021 to 2023, the number of publicly advertising procedural abortion facilities in the United States decreased 11%. Of those that persisted, 28% of facilities decreased their gestational age limits and 21% increased their gestational age limits.

Antibiotics for Asymptomatic Bacteriuria: Using Urinalysis to Improve Stewardship

A cohort study found that in patients receiving antibiotics for a urinary tract infection, a urinalysis with pyuria and/or nitrituria identified 40% more cases of unnecessary antibiotic use compared to asymptomatic bacteriuria.

Addressing the Recurrence of Bacterial Vaginosis: The Emerging Role of Male-Partner Therapy

This open-label, randomized controlled trial involving 164 monogamous heterosexual couples demonstrated that for women diagnosed with bacterial vaginosis (BV), concurrent male partner treatment with a combination of oral metronidazole and topical clindamycin resulted in an 43% absolute risk reduction in BV recurrence at 12 weeks, representing a hazard ratio of 0.37 (95% confidence interval, 0.22 to 0.61).

Vasectomy Follow-Up Rates: How Good Are They?

In this retrospective cohort study of 2,567 patients at a single institution, 42.1% of men did not follow up at all after vasectomy for semen analysis. Of those with spermatozoa on the initial testing post-vasectomy, 43.3% of men failed to return for repeat testing.

Adolescent Pregnancy

Adolescent pregnancy is shaped by socioeconomic disadvantage, rural residence, early marriage, history of abuse, and limited contraceptive access. These factors increase the risk for anemia, stillbirth, preeclampsia, preterm birth, and low birthweight in adolescent mothers. Meaningful reduction requires coordinated, multisectoral action, with targeted educational and reproductive health interventions focused on adolescents.

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.