Gynecology & Obstetrics (all articles)
M-A | Pretest probability assessment and D-Dimer are preferred for the initial evaluation of suspected PE in pregnant women
15 Mar, 2023 | 14:50h | UTC
RCT | Intrapartum azithromycin fails to reduce neonatal sepsis and death
14 Mar, 2023 | 14:00h | UTCSummary: This randomized controlled trial aimed to evaluate the effectiveness of administering azithromycin during labor to reduce neonatal sepsis and mortality. The randomized trial involved 11,983 birthing parents and their infants in West Africa.
The study found no significant difference in the incidence of neonatal sepsis or mortality between the azithromycin and placebo groups. On the other hand, the rate of non-invasive infections, including skin infections in newborns, and mastitis and puerperal fever in parents, was lower in the azithromycin group in the following four weeks.
The authors concluded that these results do not support the routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. However, it is important to notice that a recent large study published in the New England Journal of Medicine showed conflicting results.
Article: Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries:
Azithromycin during labor doesn’t reduce sepsis, mortality in newborns – CIDRAP
Effect of antibiotics during pregnancy on neonatal sepsis and mortality – MedicalResearch.com
Related study with conflicting results: Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Single-dose antibiotic prevents maternal sepsis and death – NIH News
Commentaries:
In large study, a single antibiotic dose slashed rate of sepsis in childbirth – STAT
Dose of azithromycin found to cut risk of maternal death, sepsis in childbirth – CIDRAP
Commentary on Twitter
Study results do not support routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. https://t.co/yDpg1CCGa2 pic.twitter.com/5Oc4HqZ4sX
— JAMA (@JAMA_current) March 7, 2023
Review | Pathogenesis, epidemiology and control of Group A Streptococcus infection
14 Mar, 2023 | 13:38h | UTC
Commentary on Twitter
NEW📢🎉Pathogenesis, epidemiology and control of Group A Streptococcus infectionhttps://t.co/XFSKQrTe1P
Brouwer & co. summarize the epidemiological and clinical features of Group A Streptococcus infection, and the molecular mechanisms of GAS virulence and drug resistance. pic.twitter.com/qm23YgnKlg
— Nature Reviews Microbiology (@NatureRevMicro) March 10, 2023
RCT | Sulfadoxine-pyrimethamine vs. dihydroartemisinin-piperaquine for preventive treatment of malaria in pregnant women in Africa
13 Mar, 2023 | 14:43h | UTC
RCT | Vaginal cleansing before unscheduled cesarean delivery did not reduce postoperative infections
10 Mar, 2023 | 14:23h | UTCVaginal cleansing before unscheduled cesarean delivery to reduce infection: a randomized clinical trial – American Journal of Gynecology & Obstetrics (link to abstract – $ for full-text)
Related studies with conflicting results:
Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis – Obstetrics & Gynecology (link to abstract – $ for full-text)
Commentary on Twitter
Vaginal Cleansing Before Unscheduled Cesarean Delivery to Reduce Infection: A Randomized Clinical Trial https://t.co/QuNWfCxl3D @acog pic.twitter.com/sauvsRq5C1
— AJOG (@AJOG_thegray) November 30, 2022
M-A | Supplemental breast cancer screening in women with dense breasts and negative mammography
10 Mar, 2023 | 14:12h | UTCSupplemental Breast Cancer Screening in Women with Dense Breasts and Negative Mammography: A Systematic Review and Meta-Analysis – Radiology (link to abstract – $ for full-text)
News Release: Breast MRI effective at detecting cancer in dense breasts – Radiological Society of North America
Commentary on Twitter
Compared with other supplemental modalities, MRI was superior in detecting breast cancer in a systematic review and meta-analysis. @JDMIRadiologist @UHN @UHN_Research https://t.co/NiZIFO5z9K pic.twitter.com/f9xzVXN9LJ
— Radiology (@radiology_rsna) February 1, 2023
Pregnancy complications linked to long-term mortality in a racially diverse cohort
10 Mar, 2023 | 14:01h | UTCPregnancy Complications and Long-Term Mortality in a Diverse Cohort – Circulation
Related:
Severity of obstructive coronary artery stenosis after pre-eclampsia – Heart
Consensus bundle on cardiac conditions in obstetric care
9 Mar, 2023 | 14:14h | UTC
M-A | Tailoring the optimal duration of the extended adjuvant endocrine therapy in patients with early-stage breast cancer
9 Mar, 2023 | 14:06h | UTC
RCT | Home telemonitoring vs. hospital care in complicated pregnancies in the Netherlands
9 Mar, 2023 | 13:58h | UTC
Commentary on Twitter
NEW Research investigating home #telemonitoring versus hospital care in complicated #pregnancy. Read it here: https://t.co/Cu5DvAgJ58@BekkerMN @hotelstudie @umcutrecht pic.twitter.com/wcTthWPaxK
— The Lancet Digital Health (@LancetDigitalH) February 23, 2023
Position Statement | Telemedicine in obstetrics — quality and safety considerations
8 Mar, 2023 | 14:23h | UTC
Commentary on Twitter
Society for Maternal-Fetal Medicine Special Statement: Telemedicine in obstetrics—quality and safety considerations https://t.co/15knjAg4tc @MySMFM @acog #telemedicine pic.twitter.com/jUL7inHuu4
— AJOG (@AJOG_thegray) March 7, 2023
Update on current contraceptive options | A case-based discussion of efficacy, eligibility, and use
7 Mar, 2023 | 13:06h | UTC
Cohort Study | Early pregnancy exposure to NSAIDs is associated with slightly higher risks of neonatal and maternal adverse outcomes
7 Mar, 2023 | 12:56h | UTCSummary:
A nationwide cohort study in South Korea, including 1.8 million pregnancies, investigated the association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during early pregnancy and neonatal and maternal adverse outcomes.
The study revealed that pregnant women exposed to NSAIDs during early pregnancy were at increased risk of oligohydramnios and had a slightly higher likelihood of having an infant with major congenital malformations and low birth weight. These risks remained elevated when comparing NSAIDs against acetaminophen or past users.
The study suggests that clinicians should weigh the need to prescribe NSAIDs in early pregnancy against the modest but possible risk of neonatal and maternal outcomes and consider prescribing nonselective NSAIDs for <10 days, with continued careful monitoring for any safety signals.
Severity and impact of accidental bowel leakage two decades after no, one, or two obstetrical sphincter injuries
3 Mar, 2023 | 13:56h | UTCSummary: This study investigated the long-term severity and subjective impact of anal incontinence among women who had experienced 1 or 2 consecutive obstetrical anal sphincter injuries compared with those without injuries. The study used prospectively registered data and a questionnaire to analyze outcomes, including the frequency of fecal and gas incontinence, the impact on daily life, and the effect on other pelvic floor disorders. The results showed that the severity and impact of anal incontinence doubled and quadrupled in women with 1 or 2 consecutive sphincter injuries, respectively, compared with those without injury. The second sphincter injury had an equally large additive effect compared to the first injury. However, the study found that 1 or 2 sphincter injuries did not affect other pelvic floor disorders or lower urinary tract symptoms compared to women without injury.
News Release: Decades-long suffering from obstetric injuries – University of Gothenburg
RCT | Immediate vs. delayed urinary catheter removal following non-hysterectomy benign gynecological laparoscopy
3 Mar, 2023 | 13:55h | UTCSummary: This randomized clinical trial compared the rates of urinary retention and postoperative urinary tract infection between women with immediate vs. delayed removal of the indwelling catheter following benign gynecological laparoscopic surgery, excluding hysterectomy, pelvic floor, or surgeries with concomitant bowel procedures. A total of 693 women aged 18 years or older were randomized to immediate or delayed urinary catheter removal. The results showed an increased risk of urinary retention with immediate vs. delayed removal of the urinary catheter (8.2% vs. 4.2%), highlighting the need to ensure patients report normal voiding and emptying before discharge to reduce the need for readmission for management of urinary retention.
Article: Immediate versus delayed urinary catheter removal following non-hysterectomy benign gynecological laparoscopy: a randomised trial – BJOG (link to abstract – $ for full-text)
Related: Feasibility of immediate removal of urinary catheter after laparoscopic gynecological surgery for benign diseases: A meta-analysis of randomized controlled trials – Obstetrics & Gynecology (link to abstract – $ for full-text)
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland
3 Mar, 2023 | 13:51h | UTCSummary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.
Commentary from the author on Twitter
Proudly presenting our preprint (thread):
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland https://t.co/rFnlNYPrgn 1/7
— Emmi Helle (@EmmiHelle) February 27, 2023
RCT | Efficacy of Fezolinetant in moderate-to-severe vasomotor symptoms associated with menopause
3 Mar, 2023 | 13:28h | UTC
Cohort Study | Female hormone therapy and risk of intracranial hemorrhage from cerebral cavernous malformations
2 Mar, 2023 | 13:03h | UTCSummary: The study aimed to investigate the association between female hormone therapy (oral contraception or menopausal hormone therapy) and intracranial hemorrhage in female patients with cerebral cavernous malformations (CCM) using data from 2 large prospective cohort studies. The researchers analyzed data from 722 female patients with CCM and found that female hormone therapy use was associated with an increased risk of subsequent intracranial hemorrhage. The risk was more significant among female patients aged 10-44 years using oral contraceptives (adjusted hazard ratio 2·00, 95% CI 1·26-3·17; p=0·003). These findings raise questions about the safety of female hormone therapy in patients with cerebral cavernous malformation.
Article: Female Hormone Therapy and Risk of Intracranial Hemorrhage From Cerebral Cavernous Malformations: A Multicenter Observational Cohort Study – Neurology (link to abstract – $ for full-text – you can try this link for full-text)
Cohort Study | Risk of endometrial polyps, hyperplasia, carcinoma, and uterine cancer after tamoxifen treatment in premenopausal women with breast cancer
2 Mar, 2023 | 12:56h | UTCCommentary: Risk of Uterine Diseases, Cancers Up With Tamoxifen Treatment – HealthDay
Commentary on Twitter
Use of tamoxifen as an adjuvant hormone therapy for breast cancer was associated with an increased risk of endometrial polyps, hyperplasia, carcinoma, and other uterine cancers in Korean premenopausal women. https://t.co/JqnKjemjoW
— JAMA Network Open (@JAMANetworkOpen) November 29, 2022
M-A | Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide
2 Mar, 2023 | 12:54h | UTC
Cohort Study | IVF-conceived children have similar school-age educational outcomes as spontaneously conceived children
2 Mar, 2023 | 12:53h | UTCSchool-age outcomes among IVF-conceived children: A population-wide cohort study – PLOS Medicine
News Release: No link between IVF-assisted conception and school-age childhood development outcomes, study says – University of Melborn
Commentary: IVF Not Tied to Worse Developmental, Educational Outcomes – HealthDay
RCT | Addition of preoperative transversus abdominis plane block to multimodal analgesia in open gynecological surgery
2 Mar, 2023 | 12:43h | UTC
Cohort Study | Association between marked fetal heart rate variability and neonatal acidosis
2 Mar, 2023 | 12:44h | UTCCommentary: Marked variability associated with twofold increased risk of neonatal acidosis: BJOG
RCT | US-assisted carbon nanoparticle suspension mapping vs. dual tracer-guided sentinel lymph node biopsy in patients with early breast cancer
1 Mar, 2023 | 13:42h | UTC
WHO Report | A woman dies every two minutes due to pregnancy or childbirth
28 Feb, 2023 | 14:04h | UTCSummary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.
News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization
Commentaries:
Ambitious goal to slash maternal deaths in jeopardy – Nature
U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT
Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch