OB/GYN Clinical Alert
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The Studied and Unstudied Dangers of ‘Abortion Reversal’
Colorado’s Senate Bill 190, signed in May 2023, declared the practice of “abortion reversal” to be unprofessional conduct, meaning that healthcare providers providing this treatment could face sanctions to their licensure. However, Colorado’s Medical Board subsequently issued a draft rule declaring “abortion reversal” as “generally accepted standard of practice” and, therefore, potentially acceptable. Clearly, confusion exists among state medical boards and legislatures, and, potentially, among healthcare providers. This commentary will review both the medical evidence regarding “abortion reversal” and the legal context so that providers can be better informed and communicate the best evidence to their patients.
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The Degree of Pyuria Can Help Determine Urinary Tract Infection in Elderly Women
Elderly women with a urinary tract infection had a higher median number of urinary leukocytes compared to uninfected controls, including those with asymptomatic bacteriuria. For 264 leukocytes/µL, the sensitivity and specificity of microscopy were 88%. Using the standard pyuria threshold of 10 leukocytes/µL gave a specificity of 36% and a sensitivity of 100%.
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Use of Dexamethasone for Fetal Lung Maturity: A Secondary Analysis of the WHO ACTION-I Trial
The neonatal advantages of prenatal dexamethasone administration seem to increase with longer administration-to-birth intervals than previously believed in women at risk of preterm birth before 34 weeks of gestation.
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The Progestin-Only Pill: How Effective Is It?
In this systematic literature review of 54 studies, the median typical use Pearl Index failure rate was 1.63 (range 0.00 to 14.20) and the median perfect use Pearl Index failure rate was 0.97 (range 0.40 to 6.50).
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Postpartum Depression Medication Headed to Market
FDA approves first oral solution.
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Pregnancy with IUDs in Place: What Is the Risk of Complications?
In this retrospective cohort study, 233 individuals who conceived with a copper intrauterine device (IUD) in place were followed. There were 44 ectopic pregnancies, 31 non-viable intrauterine pregnancies, and 158 viable intrauterine pregnancies. Of the viable pregnancies, 137 patients continued the pregnancy and, of these, 54 had the IUD removed. Those who underwent IUD removal had a lower rate of pregnancy loss (33%) compared to those who retained the IUD (61.4%).
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Does Treatment of Gestational Diabetes Before 20 Weeks of Gestation Improve Pregnancy Outcomes?
Therapy for gestational diabetes diagnosed before 20 weeks of pregnancy was associated with a slightly decreased frequency of a composite of unfavorable neonatal outcomes compared to deferred treatment or no therapy. No significant changes were demonstrated for pregnancy-related hypertension or neonatal lean body mass between the two groups.
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Risk-Reducing Surgery and Quality of Life for Patients with Breast and Ovarian Cancer
Risk-reducing mastectomy (RRM) and risk-reducing salpingo-oophorectomy (RRSO) for patients at high risk of breast and ovarian cancer led to decreased cancer-related distress, unaffected health-related quality of life, poorer body image after RRM, and decreased sexual function and increased menopause symptoms after RRSO.
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Nonhormonal Treatment for Menopausal Vasomotor Symptoms: A Phase III Study of Fezolinetant
In this multinational, randomized, double blind, placebo-controlled trial, 522 women with moderate to severe menopausal vasomotor symptoms received either 45 mg of fezolinetant, 30 mg fezolinetant, or placebo. Both fezolinetant doses significantly reduced the frequency and severity of menopausal symptoms at four and 12 weeks of treatment as compared with placebo.
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Mothers, Babies, and HPV: Thanks for Not Sharing!
Nearly half of pregnant women in a Canadian study had vaginal swabs positive for human papillomavirus (HPV) deoxyribonucleic acid (DNA). Only about one-fourth of placentas and newborns produced by those HPV-positive women carried detectable HPV DNA, and all HPV-positive babies had cleared their positivity by 6 months of age.