Browse Obstetrics/Gynecology Articles by Topic

Postoperative Antibiotics After Cesarean Delivery to Reduce SSI

This randomized, double-blind clinical trial including 321 women with a pre-pregnancy body mass index > 30 kg/m² demonstrated no difference in surgical site infection composite between participants receiving oral cephalexin and metronidazole for 48 hours after cesarean delivery compared to placebo (5.6% vs. 6.8%; odds ratio, 0.80; 95% confidence interval, 0.33-2.22; P = 0.64).

Adverse Outcomes in Women with a History of Recurrent Pregnancy Loss

Women with a history of recurrent pregnancy loss are at significantly increased risk of adverse outcomes, including preeclampsia, placental abruption, cesarean delivery, preterm birth, stillbirth, and perinatal mortality.

What Is the Genitourinary Syndrome of Lactation?

In this systematic review of 65 studies, the prevalence of vaginal atrophy among postpartum breastfeeding patients was 63.9% (95% confidence interval [CI], 55.3% to 71.6%) and vaginal dryness symptoms occurred in 53.6% (95% CI, 33.6% to 72.5%). Dyspareunia also was elevated, with a prevalence of 60.0% at three months, (95% CI, 45.1% to 73.3%), 39.7% at six months, (95% CI, 28.9% to 51.5%), and 28.5% at 12 months (95% CI, 26.3% to 30.9%).

Gepotidacin Tablets (Blujepa)

The U.S. Food and Drug Administration has approved gepotidacin, a first-in-class antibacterial medication for the treatment of uncomplicated urinary tract infections. It is the first new class of oral antibiotics approved in nearly 30 years.

Can Hyperemesis Gravidarum Be Prevented with Metformin?

Although differences were not statistically significant, women with pre-conceptional metformin exposure appeared to have lower rates of hyperemesis gravidarum and comparable nausea and vomiting symptom severity, suggesting a potential protective effect that warrants further investigation in larger, adequately powered studies.

What Are Period Pills?

In this national survey of almost 7,000 people aged 15 to 49 years who were assigned female sex at birth, conducted between December 2021 and January 2022, one-quarter of participants (24%; 95% confidence interval [CI], 22%, 25%) stated that they would personally use period pills and about half of the respondents (52%; 95% CI, 50%, 53%) were in favor of the availability of period pills.

Intrauterine Hemorrhage-Control Devices for Postpartum Hemorrhage

This multicenter, prospective, observational study comparing intrauterine balloon tamponade vs. vacuum-induced devices for postpartum hemorrhage demonstrated no difference in blood loss after device placement (median quantitative blood loss, 194 mL balloon vs. 240 mL vacuum; P = 0.40), need for blood transfusion (59.7% balloon vs. 50.0% vacuum; P = 0.08), need for more than three units of packed red blood cells (27.0% balloon vs. 24.9% vacuum; P = 0.53), or device failure (7.7% balloon vs. 8.5% vacuum; P = 0.70).

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.