Obstetrics/Gynecology General
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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%.
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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.
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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).
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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.
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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.
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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.
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Regret in Younger Patients After Minimally Invasive Hysterectomy
A matched retrospective cohort study including 77 participants younger than 30 years of age and 164 participants aged 31-49 years demonstrated that a younger participant cohort had significantly higher rates of surgical and loss-of-fertility regret compared with an older participant cohort (32.5% vs. 9.1%, P < 0.001 and 39.0% vs. 13.4%, P < 0.001, respectively).
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Preterm Birth and the RSV Vaccine During Pregnancy
The follow-up MATISSE study explored the safety of the respiratory syncytial virus prefusion F (RSVpreF) vaccine in pregnant women and demonstrated no significant increase in preterm birth rates compared to the placebo, although it highlighted geographical and socioeconomic disparities in outcomes.
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Self-Testing for STIs Can Help Improve Access and Reduce Outbreaks
The increasing cases of syphilis, congenital syphilis, and some other sexually transmitted infections (STIs) in the post-pandemic era suggest clinicians and public health departments need additional strategies and tools to combat the problem.
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Vaccine Hesitancy Could Dampen Enthusiasm for Vaccines to Combat STIs
While the sexually transmitted infection (STI) prevention world’s research pipeline contains new vaccines to fight major STIs — a potentially exciting development — there also is concern about growing vaccine hesitancy and misinformation in the United States.