Gynecology & Obstetrics (all articles)
WHO Report | Global progress in tackling maternal and newborn deaths stalls since 2015
25 May, 2023 | 11:36h | UTCNews Release: Global progress in tackling maternal and newborn deaths stalls since 2015: UN – World Health Organization
A pragmatic approach to the management of menopause
25 May, 2023 | 11:30h | UTCA pragmatic approach to the management of menopause – Canadian Medical Association Journal
News Release: Managing menopause: Hormone therapy is back – Canadian Medical Association Journal
RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics
24 May, 2023 | 13:27h | UTCSummary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.
The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.
The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.
Editorial: What do we know about prescribing spironolactone for acne? – The BMJ
News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton
WHO Report | 152 million babies born preterm in the last decade
23 May, 2023 | 13:15h | UTCNews Release: 152 million babies born preterm in the last decade – World Health Organization
Report: Born too soon: decade of action on preterm birth – World Health Organization
Consensus Statement | Management of arrhythmias during pregnancy
23 May, 2023 | 13:00h | UTC2023 HRS Expert Consensus Statement on the Management of Arrhythmias During Pregnancy – Heart Rhythm
News Release: Management of Arrhythmias During Pregnancy Consensus Statement Emphasizes Shared Decision-Making – European Heart Rhythm
USPSTF Draft Statement recommends biennial screening mammography for women ages 40 to 74 years
22 May, 2023 | 13:56h | UTCBreast Cancer: Screening – U.S. Preventive Services Task Force
Critical perspectives on the statement:
Earlier screening for breast cancer: Benefits and harms – Lown Institute
Why more mammograms aren’t the solution to breast cancer – Vox
Special Supplement | Labor and delivery at term – partograms, labor disorders, analgesia/anesthesia, and fever
22 May, 2023 | 13:51h | UTC
Cluster RCT | Early detection and treatment bundle reduces postpartum hemorrhage complications
16 May, 2023 | 15:02h | UTCSummary: An international, cluster-randomized trial assessed the effectiveness of a multicomponent clinical intervention for postpartum hemorrhage in patients having vaginal delivery. The study involved 80 secondary-level hospitals across Kenya, Nigeria, South Africa, and Tanzania, with 210,132 patients. The intervention group utilized a calibrated blood-collection drape for early detection of postpartum hemorrhage and a first-response treatment bundle, while the control group received usual care.
The primary outcome measured was a composite of severe postpartum hemorrhage (blood loss ≥1000 ml), laparotomy for bleeding, or maternal death from bleeding. The results showed a significant reduction in primary-outcome events in the intervention group (1.6%) compared to the usual-care group (4.3%) with a risk ratio of 0.40 (95% CI, 0.32 to 0.50; P<0.001). Postpartum hemorrhage detection rates were 93.1% and 51.1% in the intervention and usual-care groups, respectively, and treatment bundle adherence was 91.2% and 19.4%, respectively.
These findings demonstrate that early detection of postpartum hemorrhage and the use of a bundled treatment approach can significantly reduce the risk of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding among patients having vaginal delivery. The results have important implications for improving clinical practice and reducing postpartum hemorrhage complications globally.
Article: Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Lifesaving solution dramatically reduces severe bleeding after childbirth – World Health Organization
Commentary on Twitter
In a large, cluster-randomized trial involving patients with PPH after vaginal delivery, a multicomponent intervention lowered the risk of severe PPH, laparotomy for bleeding, or maternal death from bleeding. Full results of the E-MOTIVE trial: https://t.co/NjcE4Q1rxM#IMNHC2023
— NEJM (@NEJM) May 9, 2023
RCT | Optimizing the timing of whooping cough immunization in mums through investigating pertussis vaccination in pregnancy
16 May, 2023 | 14:49h | UTC
RCT | Neck–shoulder region training for chronic headache in women
15 May, 2023 | 12:59h | UTC
Commentary on Twitter
Neck-Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial
👀👀👇👇
"The progressive exercise program almost halved headache frequency"https://t.co/HQN2yppF27 pic.twitter.com/3ZFltwJTWl
— Physio Meets Science (@PhysioMeScience) April 26, 2023
RCT | Transvenous occlusion of incompetent pelvic veins to treat chronic pelvic pain in women
15 May, 2023 | 12:54h | UTC
Cohort Study | Following lifestyle recommendations linked to lower recurrence in high-risk breast cancer
15 May, 2023 | 12:48h | UTCCommentary: Adherence to healthy lifestyle found to cut breast cancer recurrence, mortality – HealthDay
Commentary on Twitter
Adherence to the @AmericanCancer and the @aicrtweets lifestyle recommendations before and after high-risk breast cancer treatment was associated with a 37% reduced risk of disease recurrence and a 58% reduction in mortality. https://t.co/sy6b8CGgr1
— JAMA Network Open (@JAMANetworkOpen) May 4, 2023
Uncertainties and controversies in axillary management of patients with breast cancer
11 May, 2023 | 11:53h | UTC
Care plan for individuals at risk for preeclampsia: shared approach to education, strategies for prevention, surveillance and follow up
10 May, 2023 | 16:04h | UTCCommentary: Care Plan Developed for Individuals at Risk for Preeclampsia – HealthDay
Single-arm study | Halting endocrine therapy for pregnancy not linked to increased breast cancer events vs. a control cohort
10 May, 2023 | 16:01h | UTCInterrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In women with previous breast cancer who temporarily discontinued adjuvant endocrine therapy to attempt pregnancy, the frequency of breast cancer events was below the prespecified safety threshold and similar to that in controls (POSITIVE trial). https://t.co/zM3f4SbgjE
— NEJM (@NEJM) May 3, 2023
RCT | Early treatment of gestational diabetes slightly lowers risk of adverse neonatal outcomes
9 May, 2023 | 14:55h | UTCTreatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Early treatment of gestational diabetes for those at higher risk beneficial, study finds – Western Sidney University
Cohort Study | Limited evidence linking COVID-19 vaccines to menstrual disturbance or postmenopausal bleeding
9 May, 2023 | 14:52h | UTCNews Release: New study finds no increased risk of menstrual changes after covid-19 vaccination – BMJ Newsroom
Commentary: Large study shows no changes to menstrual cycles after COVID vaccination – CIDRAP
Related:
Editorial: Menstruation and Covid-19 vaccination.
Commentary on Twitter
The findings of this new study do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disordershttps://t.co/Tsw2hjIiIz
— The BMJ (@bmj_latest) May 4, 2023
New ACR breast cancer screening guidelines call for earlier and more-intensive screening for high-risk women
9 May, 2023 | 14:50h | UTCGuideline: Breast Cancer Screening for Women at Higher-than-Average Risk: Updated Recommendations from the ACR
Effects of intraoperative fluorescence guidance for breast cancer lumpectomy surgery
9 May, 2023 | 14:48h | UTCIntraoperative Fluorescence Guidance for Breast Cancer Lumpectomy Surgery – NEJM Evidence
News Release: Study finds fluorescent guide can help detect tumor left behind after breast cancer surgery – Mass General Brigham
M-A | Quality of life after risk-reducing surgery for breast and ovarian cancer prevention
9 May, 2023 | 14:21h | UTC
RCT | Single-dose intravenous iron not superior to oral iron for pregnancy anemia
8 May, 2023 | 12:52h | UTCNews Release: Landmark Malawi trial boosts iron levels in pregnant women – Walter and Eliza Hall Institute of Medical Research
Commentary from the author on Twitter
Very excited to announce the publication of our clinical trial – REVAMP – in @TheLancet: https://t.co/Zpd9500u6b. We evaluated intravenous iron vs oral iron's efficacy and safety in recovering anaemia in Malawian pregnant women. Check out this thread to learn what we found👇 pic.twitter.com/que9hefUhM
— Ricardo Ataide (@ricardoataide) April 24, 2023
RCT | Prednisone fails to enhance live birth outcomes in women with recurrent implantation failure
5 May, 2023 | 15:31h | UTCPrednisone vs Placebo and Live Birth in Patients With Recurrent Implantation Failure Undergoing In Vitro Fertilization: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
Enhanced recovery after surgery (ERAS) society guidelines for gynecologic oncology: addressing implementation challenges
5 May, 2023 | 14:53h | UTC
Cohort Study | There is no association between labor epidural analgesia and risk of offspring autism and ADHD
4 May, 2023 | 13:30h | UTC
Commentary with video on Twitter
AJOG Presents: Labor epidural analgesia and subsequent risk of offspring autism spectrum disorder and attention-deficit/hyperactivity disorder: a cross-national cohort study of 4.5 million individuals and their siblings https://t.co/XFbedq7SAz pic.twitter.com/J4Mu5xSwT6
— AJOG (@AJOG_thegray) February 4, 2023
RCT | Levonorgestrel IUS vs. hysteroscopic niche resection for postmenstrual spotting in cesarean scar
3 May, 2023 | 15:15h | UTC