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Obstetrics/Gynecology Topics

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  • 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.

  • 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.