Obstetrics/Gynecology Topics
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Preterm Birth Predicts Lower Rate of Desired Permanent Contraception
A new study finds that patients who had preterm delivery were less likely to receive their desired permanent contraception when compared with patients who had at-term delivery.
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Who Is Most Likely to Seek Contraception from Publicly Supported Providers?
People with private health insurance typically obtain their contraceptive methods from private doctors’ offices, in-store clinics, or pharmacies, while just about everyone else relies on publicly funded health centers and family practice clinics for contraceptive care, a new study says.
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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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Parvovirus and Increasing Danger in Pregnancy and Sickle Cell Disease
The incidence of human parvovirus B19 infection is increasing in the United States, putting vulnerable groups at risk of serious complications.
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Intrauterine Instillation of Mepivacaine at the Time of IUD Placement
In a randomized clinical trial of 151 women, intrauterine instillation of mepivacaine significantly reduced pain with intrauterine device insertion on visual analog scales both before (53.9 mm vs. 67.2 mm, respectively; P < 0.001) and after adjustment for individual provider variability (55.2 mm vs. 77.4 mm, respectively; P < 0.001), compared to placebo.
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Do Warm Compresses Combined with Perineal Massage Reduce Perineal Trauma During Labor?
In this randomized trial, the addition of warm compresses to perineal massage during the second stage of labor showed no significant difference in reducing perineal tears, obstetric anal sphincter injuries, or episiotomies compared to perineal massage alone.
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Interventions for Pain During Office Endometrial Biopsy
In this randomized controlled trial, the use of transcutaneous electric nerve stimulation during endometrial biopsy did not clinically significantly reduce pain compared to placebo (median [interquartile range], 50 mm [20 mm to 80 mm] vs. 60 mm [40 mm to 100 mm]; P = 0.039), but was associated with increased satisfaction with the procedure.