OB/GYN Clinical Alert
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COVID-19 Vaccine and the Menstrual Cycle
In a retrospective cohort analysis of prospectively tracked menstrual cycle data from the smart phone application “Natural Cycles,” the COVID-19 vaccine is associated with a less than one day change in menstrual cycle length, and no change in menses length.
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Glycemic Control During Labor in Women with Diabetes
This study demonstrated an increased risk of neonatal hypoglycemia in neonates born to patients with diabetes as the result of maternal hyperglycemia in labor. However, strict intrapartum maternal glycemic control appeared to be associated with a reduced risk of neonatal hypoglycemia only in patients with gestational diabetes on medication, but not for other diabetes subtypes.
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Oral vs. IV Iron for the Treatment of Iron-Deficiency Anemia in Pregnant Women
Compared to oral iron, intravenous iron reduced maternal anemia at delivery (40% vs. 85%, P = 0.039), and rates of maternal hemoglobin < 10 g/dL were lower with intravenous iron compared to oral iron (10% vs. 54%, P = 0.029). Rates of mild to moderate adverse events were similar between the two groups, and no severe adverse reactions were noted with intravenous iron.
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The Pseudogestational Sac of Ectopic Pregnancy: Does it Really Matter?
In this retrospective cohort study of 1,236 women, the rate (2.2%) of ectopic pregnancy was rare among women with a fluid collection (or pseudosac) in the uterus. The size of the fluid collection was not predictive of ectopic pregnancy. The presence of an intrauterine fluid collection decreased the risk of ectopic pregnancy (adjusted relative risk, 0.09; 95% confidence interval, 0.05-0.19) after adjusting for age and the presence of bleeding.
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Is the Timing of Interval Postpartum Insertion of Intrauterine Device Associated with the Frequency of Complications?
Having an intrauterine device (IUD) inserted at four to eight weeks postpartum was associated with higher frequency of uterine perforation, but not higher frequency of expulsion, compared to IUD insertion at nine to 36 weeks postpartum. Overall, perforation and expulsion rates were low.
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The Effects of Maternal Cannabis Use During Pregnancy on the Neurobehavioral Development of Children at Ages 3-6 Years
This study examined associations between maternal cannabis use in pregnancy and neurobehavioral problems diagnosed in children between ages 3 and 6 years. Maternal cannabis use was associated with higher cortisol levels, as well as abnormal behaviors, including anxiety, aggression, and hyperactivity. Placental analyses for a subset of children indicate a potential mechanism for neurobehavioral disorders as the result of selective gene regulation.
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Midurethral Slings for the Management of Stress Urinary Incontinence
The controversy surrounding polypropylene mesh use has confused and discouraged women from seeking surgical treatment for stress urinary incontinence. Midurethral slings remain the standard of care for the surgical treatment of stress urinary incontinence.
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Pregnancy-Associated Mortality: The Contribution of Homicide
In this national study, there were 3.62 homicides per 100,000 live births among females who were pregnant or within one year postpartum from 2018 to 2019. This rate was slightly higher (16%) than the rate among nonpregnant and non-postpartum females of reproductive age. Homicide was found to be a leading cause of pregnancy-associated mortality.
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Contraceptive Visits Declined in the United States During the COVID-19 Pandemic
Using a nationwide sample of insurance claims, researchers found that large declines occurred in contraceptive visits in the first month of the COVID-19 pandemic (April 2020 compared to May 2019). Although visit numbers improved over time, they remained below pre-pandemic levels through the end of 2020.
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Gestational Diabetes Risk May Be Higher Earlier in Pregnancy for Women with Sleep-Disordered Breathing
Screening and treatment might need to begin much earlier for these patients.