OB/GYN Clinical Alert
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Are Deep Contraceptive Implant Removals Predictable?
In this retrospective cohort study of 747 patients undergoing contraceptive implant removal, lower body mass index at insertion, weight gain during use, and longer duration of use were risk factors for deep contraceptive implant removal procedures.
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HPV Vaccination Disparities Among Adult Women in the United States
A longitudinal, cross-sectional cohort study of 113,344 participants demonstrated that lack of health insurance, lack of stable employment, and lower income were significantly associated with decreased human papillomavirus vaccination uptake in women aged 18-47 years residing in the United States.
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Placenta Accreta Spectrum Among Patients Seeking Abortion
Placenta accreta spectrum (PAS) in patients seeking abortions poses significant risks, especially for those with prior cesarean deliveries. PAS, often related to prior cesarean deliveries, increases abortion-related complications. Ultrasound is key for detection, but access to skilled care may be limited because of state-based abortion restrictions, leading to worse outcomes for affected patients.
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Malpositioned IUDs: How Easy Are They to Remove?
In this retrospective cohort study of 436 malpositioned intrauterine devices (IUDs), of the 281 that underwent removal, 82% were removed on the first attempt and 73% were removed using only ring forceps. Most embedded and partially perforated IUDs also were removed using only ring forceps (59% and 67%, respectively).
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Using Deep Learning to Identify Fetal Head Position in Labor
An artificial intelligence (deep learning) model accurately detected fetal head position during the second stage of labor using transperineal ultrasound, but validation of the model on larger datasets and real-time patients before clinical use is important.
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Multicomponent Breastfeeding Interventions in Women with a Body Mass Index > 25
The study found no statistically significant differences in breastfeeding outcomes between the intervention and control groups at various postpartum time points, although the intervention group received more hospital-based support, while the control group sought more private lactation support.
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What Do Patients Know About Anti-Müllerian Hormone Testing?
In this randomized, controlled, online questionnaire trial, participants who received evidence-based information about anti-Müllerian hormone (AMH) testing had lower interest in getting an AMH test (mean difference, 1.05; 95% confidence interval, 0.83-1.30) than individuals who viewed the control information from a direct-to-consumer website.
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Rethinking Endometrial Thickness Thresholds that Prompt Endometrial Biopsy to Rule Out Endometrial Cancer
In a retrospective review of 1,494 pre- and postmenopausal Black individuals who underwent transvaginal ultrasonography, 24 of 210 individuals (11.4%) with endometrial cancer had an endometrial thickness lower than the threshold for undergoing biopsy to detect cancer.
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Reproductive Healthcare in Adolescents with Autism and Other Developmental Disabilities
This cohort study of 3,723 female adolescents from the Kaiser Permanente healthcare system in California found that adolescents with autism or developmental disability were less likely to see an OB/GYN or be prescribed contraception compared with their typically developing peers. This study identified disparities present in reproductive healthcare for this population, despite higher rates of menstrual-related diagnoses.
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Neurodevelopmental and Psychiatric Risks in Children of Pregnant Mothers Who Use Cannabis
Although current research has not conclusively established a direct link between prenatal cannabis use and an increased risk of autism spectrum disorder (ASD), psychotic symptoms, anxiety, or depression in offspring, there is evidence suggesting that prenatal cannabis exposure may modestly elevate the risk of attention-deficit/hyperactivity disorder (ADHD). Additionally, children exposed to cannabis in utero may be more likely to use cannabis later in life.