American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 2018
Observational StudyEffect of baseline menstrual bleeding pattern on copper intrauterine device continuation.
Heavy menstrual bleeding is a leading cause of copper intrauterine device discontinuation. Thus, girls and women with heavy baseline menstrual bleeding may be at increased risk for early copper intrauterine device discontinuation. ⋯ We did not find that girls and women who reported baseline moderately heavy or heavy menstrual bleeding were at increased risk for early discontinuation. Thus, we do not believe that girls and women with heavy menstrual bleeding should be discouraged from using this safe and highly effective form of contraception.
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Am. J. Obstet. Gynecol. · Oct 2018
Meta AnalysisProgestogens in singleton gestations with preterm prelabor rupture of membranes: a systematic review and metaanalysis of randomized controlled trials.
Preterm prelabor rupture of membranes occurs in 3% of all pregnancies. Neonatal benefit is seen in uninfected women who do not deliver immediately after preterm prelabor rupture of membranes. The purpose of this study was to evaluate whether the administration of progestogens in singleton pregnancies prolongs pregnancy after preterm prelabor rupture of membranes. ⋯ Progestogen administration does not prolong pregnancy in singleton gestations with preterm prelabor rupture of membranes.
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Women in medicine have made strides towards equality and yet the gender gap continues to exist. Despite being the specialty dedicated to the promotion of women's health, obstetrics and gynecology is also marred by gender disparity. ⋯ Both men and women have a vested interest in promoting greater gender parity in obstetrics and gynecology, and participation of men is critical for realization of this goal. For the obstetrician-gynecologist, sexism is not just a "women's issue".
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Am. J. Obstet. Gynecol. · Oct 2018
Postpartum venous thromboembolism readmissions in the United States.
There are limited data on when postpartum readmissions for thromboembolism occur after delivery hospitalizations on a population basis in the United States. ⋯ While the majority of events occurred within 20 days of discharge, risk factors other than thrombophilia and prior venous thromboembolism were generally associated with modestly increased odds of events, and only a small proportion of readmissions occurred among women with thrombophilia and prior events. Our data demonstrate both the challenging nature and urgent need for further research to determine which clinical practices and interventions may reduce risk for venous thromboembolism readmissions on a population basis.
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Am. J. Obstet. Gynecol. · Oct 2018
Observational StudyCervical cerclage for singleton pregnant patients on vaginal progesterone with progressive cervical shortening.
Premature cervical ripening plays a significant role in spontaneous preterm birth. Vaginal progesterone is the recommended treatment in singleton pregnancy with incidental short cervix. There is lack of evidence on whether it is beneficial to reinforce the cervix with cerclage when the cervical length becomes progressively shortened <10 mm while on vaginal progesterone. ⋯ Our study showed that cerclage plus vaginal progesterone in women with extremely shortened cervix significantly decreased overall spontaneous preterm birth rates, prolonged pregnancy latency by 2-fold, and decreased the overall neonatal morbidity and mortality.