Gynecology & Obstetrics (all articles)
Perspective | Gender dysphoria in young people is rising — and so is professional disagreement
28 Feb, 2023 | 13:55h | UTCGender dysphoria in young people is rising—and so is professional disagreement – The BMJ
News Release: Gender dysphoria is rising—and so is professional disagreement – BMJ Newsroom
Commentary on Twitter
More children and adolescents are identifying as transgender and are being offered medical treatment, especially in the US—but some providers and European authorities are urging caution because of a lack of strong evidence. @writingblock reports https://t.co/24aDMo7rb0
— The BMJ (@bmj_latest) February 26, 2023
M-A | Adverse perinatal outcomes associated with antiretroviral therapy in women living with HIV
27 Feb, 2023 | 12:48h | UTC
Review | Pre-eclampsia
27 Feb, 2023 | 12:47h | UTCPre-eclampsia – Nature Reviews Disease Primers (if the link is paywalled, try this one)
RCT | Aspirin discontinuation at 24 to 28 weeks’ gestation in pregnancies at high risk of preterm preeclampsia
24 Feb, 2023 | 13:56h | UTCArticle: Aspirin Discontinuation at 24 to 28 Weeks’ Gestation in Pregnancies at High Risk of Preterm Preeclampsia: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Biomarkers and the Risk of Preeclampsia – JAMA (free for a limited period)
Commentary on Twitter
Aspirin discontinuation at 24 to 28 weeks of gestation was noninferior to aspirin continuation for preventing preterm preeclampsia in pregnant individuals at high risk of preeclampsia and a normal sFlt-1:PlGF ratio. https://t.co/6yIBsfxwU5 pic.twitter.com/RGqQLvb20l
— JAMA (@JAMA_current) February 21, 2023
SR | Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes
24 Feb, 2023 | 13:45h | UTCSummary: The article discusses the effectiveness of myo-inositol, a naturally occurring sugar, as a dietary supplement for preventing gestational diabetes in pregnant women. The review included seven randomized controlled trials, with a total of 1319 women who were 10 to 24 weeks pregnant at the start of the studies. The results showed that myo-inositol may reduce the incidence of gestational diabetes, hypertensive disorders of pregnancy, and preterm birth, but there was limited data on other outcomes, such as perinatal mortality and serious infant morbidity. The certainty of the evidence was low to very low due to small sample sizes, inconsistency in doses and timing of administration, and lack of data from diverse populations. The authors suggest that further well-designed studies are needed to assess the effectiveness of myo-inositol in preventing gestational diabetes and improving other health outcomes for mothers and their babies.
Cohort Study | Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum
24 Feb, 2023 | 13:43h | UTCSummary: Several studies show that women who develop diabetes during pregnancy are at increased risk of developing diabetes later in life. This study investigated whether giving birth to a larger-than-normal baby is associated with an increased risk of prediabetes or diabetes 10-14 years after pregnancy in individuals without gestational diabetes. The study used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study, including pregnant individuals without gestational diabetes. After adjusting for various baseline maternal characteristics, the researchers found that individuals who gave birth to a large-for-gestational age (LGA) infant had a 21% higher risk of being diagnosed with prediabetes or diabetes 10-14 years after delivery compared to those who had an appropriate-for-gestational age (AGA) infant. The study concluded that having a previous LGA infant is a marker of increased risk of developing prediabetes or diabetes in individuals without gestational diabetes.
Abstract: Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum in the HAPO follow-up study – American Journal of Obstetrics & Gynecology (link to abstract, presented at the Society for Maternal-Fetal Medicine’s annual meeting)
Commentaries:
Delivering a Plus-Sized Baby Could Be Sign of Diabetes Risk – HealthDay
Large for Gestational Age Births Could Increase Diabetes Risk in Women – HCP Live
M-A | Pregnancy outcomes in Takayasu arteritis patients
24 Feb, 2023 | 13:40h | UTCSummary: The systematic review and meta-analysis examined the data from 27 studies with 825 pregnancies and found that pregnant women with Takayasu arteritis (TA) are at higher risk for adverse pregnancy outcomes; 37% developed hypertension, 14% developed pre-eclampsia, and the occurrence of miscarriage was 16%. High disease activity during pregnancy, renal artery involvement, and history of hypertension were identified as risk factors, while maternal age or prolonged disease duration did not pose a risk. The most common treatments were corticosteroids, anti-hypertensive agents, low-dose aspirin, and azathioprine. The study was limited by the heterogeneity of the included studies and the lack of large-scale prospective case-control studies, indicating the need for further research.
Registry of the international society of uterus transplantation: first report
24 Feb, 2023 | 13:29h | UTCRegistry of the International Society of Uterus Transplantation: First Report – Transplantation
ISUOG Practice Guidelines | Performance of 11–14-week ultrasound scan
23 Feb, 2023 | 13:35h | UTC
Cohort Study | Pre-pregnancy migraine linked to a higher risk of adverse pregnancy outcomes
23 Feb, 2023 | 13:31h | UTCSummary: This study investigated the relationship between migraine and adverse pregnancy outcomes. Researchers examined data from the Nurses’ Health Study II, which included 30,555 pregnancies from 19,694 women. Pre-pregnancy migraine was associated with a higher risk of preterm delivery, gestational hypertension, and preeclampsia. Migraine with aura was associated with a higher preeclampsia risk than migraine without aura. However, migraine was not associated with low birth weight or gestational diabetes mellitus. The study suggests that migraine history, and to a lesser extent, migraine phenotype, could be useful in identifying women at risk of pregnancy complications. Regular aspirin use prior to pregnancy was associated with a lower risk of preterm delivery for women with migraine, but randomized trials are needed to evaluate this hypothesis.
Article: Prepregnancy Migraine, Migraine Phenotype, and Risk of Adverse Pregnancy Outcomes – Neurology (link to abstract – $ for full-text)
News Release: Migraine associated with increased risk for pregnancy complications – Brigham and Women’s Hospital
Commentary: Prepregnancy Migraine Tied to Adverse Pregnancy Outcomes – HealthDay
SR | Psychological interventions for women with non‐metastatic breast cancer
23 Feb, 2023 | 13:19h | UTCPsychological interventions for women with non‐metastatic breast cancer – Cochrane Library
Podcast | Abnormal uterine bleeding pearls
22 Feb, 2023 | 12:19h | UTC#382 Abnormal Uterine Bleeding – The Curbsiders
AHA Scientific Statement | Anesthetic care of the pregnant patient with cardiovascular disease
20 Feb, 2023 | 12:29h | UTCSummary: The AHA emphasizes the need for specialized cardio-obstetric anesthesiology care for pregnant patients with cardiovascular disease, involving a multidisciplinary team of obstetricians, cardiologists, anesthesiologists, and other specialists as needed. The approach includes preoperative evaluation, intraoperative management, and postoperative care to maintain maternal hemodynamic stability, optimize oxygen delivery to the fetus, and avoid factors that exacerbate cardiovascular disease. Vaginal delivery with effective neuraxial analgesia is the preferred mode of delivery, with cesarean delivery used for obstetrical indications or high-risk patients. Specific recommendations are also provided for the management of patients with different types of cardiovascular disease, including congenital heart disease, valvular heart disease, pulmonary hypertension, and hypertrophic cardiomyopathy.
Top Things to Know: Statement on the anesthetic care of the pregnant patient with cardiovascular disease – American Heart Association
RCT | Breast-conserving surgery without irradiation may be an option for older patients with early breast cancer
17 Feb, 2023 | 13:25h | UTCSummary: The article reports a phase 3 randomized trial that investigated the efficacy of omitting irradiation after breast-conserving surgery in women aged 65 years or older with hormone receptor-positive, node-negative, T1 or T2 primary breast cancer, and tumors ≤3 cm in the largest dimension, who received adjuvant endocrine therapy. A total of 1326 women were enrolled, with 658 receiving whole-breast irradiation and 668 receiving no irradiation. The results showed that the omission of radiotherapy led to an increased incidence of local breast cancer recurrence but had no negative effect on distant recurrence as the first event or overall survival. The study suggests that omission of radiotherapy could be a viable treatment option for older women with low-risk, hormone receptor–positive early breast cancer who receive adjuvant endocrine therapy.*
Article: Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
For many older breast cancer patients, study finds radiation doesn’t affect survival – STAT
Do Older Patients Need Radiation Rx After Breast Cancer Surgery? – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
SR | Antipsychotic exposure is an independent risk factor for breast cancer
17 Feb, 2023 | 12:41h | UTC
RCT | Laser treatment does not improve sexual dysfunction in survivors of breast cancer
16 Feb, 2023 | 15:19h | UTCInvited commentary: Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy – JAMA Network Open
Related:
RCT | Laser no better than sham treatment for genitourinary syndrome of menopause
M-A | Carbon dioxide laser vs. vaginal estrogen for genitourinary syndrome of menopause.
Perspective: From vaginal laser treatment to spa breaks – it’s the great menopause gold rush.
Commentary on Twitter
The LIGHT Trial RCT: Vaginal laser therapy does not improve sexual dysfunction/genitourinary syndrome of menopause in breast cancer survivors receiving aromatase inhibitors when added to first line therapy based on moisturizers and vibrator stimulation. https://t.co/jdVDgHe9HC
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
10-year follow-up on preterm prelabor rupture of membranes: induced labor vs. expectant management childhood outcomes
16 Feb, 2023 | 15:05h | UTCSummary: This study aimed to compare the long-term outcomes of children born after singleton pregnancies complicated by preterm prelabor rupture of membranes and managed by induction of labor vs. expectant management in RCTs undergone between 2007 and 2011. The study assessed the children’s cognition, motor function, and behavior as the primary outcomes. It found that expectant management did not improve long-term outcomes compared to induction of labor for children born after pregnancies with preterm prelabor (between 34 0/7 and 36 6/7 weeks of pregnancy) rupture of membranes. The confidence in the results of this follow-up study is diminished because only 35% of the children who participated in the original trials participated in the follow-up study.
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Reconstructive burnout after mastectomy: implications for patient selection
16 Feb, 2023 | 15:02h | UTCCommentary: One in Four Patients Experience Breast Reconstruction Burnout – HealthDay
Review | Female genital tuberculosis
16 Feb, 2023 | 14:42h | UTCFemale Genital Tuberculosis – Open Forum Infectious Diseases
Development and validation of a genomic profile for the omission of local adjuvant radiation in breast cancer
16 Feb, 2023 | 14:39h | UTC
Recent advances in the classification of gynecological tract tumors: updates from the 5th edition of the WHO “Blue Book”
16 Feb, 2023 | 14:35h | UTC
USPSTF reaffirms recommendation against serologic screening for genital herpes infection
15 Feb, 2023 | 16:17h | UTCSummary: The US Preventive Services Task Force (USPSTF) recommends against routine screening for genital herpes infection in asymptomatic adolescents, adults, and pregnant women, as the potential harms of such screening outweigh the benefits. This recommendation is based on a systematic evaluation of the available evidence, and the USPSTF has moderate certainty in its conclusion.*
Evidence Report: Serologic Screening for Genital Herpes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Editorials:
Reducing HSV-2 Morbidity and MortalityRoutine Serologic Screening Still Not the Best Answer – JAMA
Reaffirmed USPSTF Recommendation Against Serologic Screening for Genital Herpes: Empowering Clinicians and Reducing Potential Harm – JAMA Dermatology (free for a limited period)
Author Interview: Serologic Screening for Genital Herpes Infection – JAMA
JAMA Patient Page: Screening for Genital Herpes
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
AHA Statement | Optimizing prepregnancy cardiovascular health improves outcomes for pregnant women, offspring
15 Feb, 2023 | 16:14h | UTCSummary: This statement highlights the need to optimize cardiovascular health before pregnancy to reduce the risk for adverse pregnancy outcomes and cardiovascular disease in mothers and children. It emphasizes the role of clinicians in promoting early cardiovascular health, clinical trials to investigate interventions, and the use of a life course framework to monitor health. By targeting cardiovascular health before pregnancy, interventions can improve health outcomes across generations.*
News Release: Does risk for heart disease start before birth? – American Heart Association
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Preoperative MRI in breast cancer did not influence local relapse-free survival, overall survival, or reoperation rates
15 Feb, 2023 | 15:57h | UTCSummary: This study investigated the impact of preoperative magnetic resonance imaging (MRI) on survival and surgical outcomes in conservative surgery for breast cancer. The randomized controlled trial included female participants with stage 0-III breast cancer, eligible for breast-conserving surgery. The study found that preoperative MRI increased the rate of mastectomies by 8% compared to routine radiologic exams using mammography and ultrasound. However, preoperative MRI did not impact the rates of local relapse-free survival, overall survival, or reoperation.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
SR | The effect of parental leave on parents’ mental health
15 Feb, 2023 | 15:44h | UTCInvited Commentary: Paid parental leave and mental health: the importance of equitable policy design – The Lancet Public Health
News Release: Generous parental leave schemes protect against poorer mental health – Stockholm University / News Medical