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Background Clerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past two decades in our specialty. Objective To investigate obstetrics and gynecology clerkship directors’ practices and perspectives in grading. Study Design A 12-item electronic

Background Participation in clinical trials may help mitigate disparate cancer outcomes. Ensuring equitable access to clinical trials is thus a major priority for national cancer organizations. Objective This study aimed to examine clinical trial eligibility criteria that may adversely impact the enrollment of underrepresented groups and assess the availability of demographic information in published

Background Spontaneous preterm birth significantly increases the risk for a recurrent preterm birth (rPTB). Few identifiable clinical risk factors exist in counseling of rPTB. Furthermore, treatment with progesterone supplementation has not consistently prevented preterm birth in high-risk patients, but may be effective in a subset of such patients. Placental pathology from a prior pregnancy may be

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Background In randomized trials, one primary outcome is typically chosen to evaluate the consequences of an intervention while other important outcomes are relegated to secondary outcomes. This issue is amplified for many obstetric trials in which an intervention may have consequences for both the pregnant person and the child. In contrast, desirability of outcome ranking (DOOR), a paradigm shift for

Background Prenatal diagnosis of cleft palate is challenging. Numerous 2D and 3D methods have been proposed to assess the integrity of the fetal palate, yet detection rate remains relatively low. We propose the "Hard Palate Sweep", a novel 2D method which enables a clear demonstration of the entire fetal palate throughout pregnancy, in a single sweep, avoiding acoustic shadows cast by surrounding bones

Background Vasa previa is an obstetrical condition in which fetal vessels traverse the fetal membranes unprotected by underlying placenta and located near the cervix. Type I vasa previa arises directly from a velamentous cord root, while types II and III arise from an accessory lobe or a distal lobe of the same placenta, respectively. Fetoscopic laser ablation for types II and III vasa previa is a

Antenatal steroid therapy is increasingly central to the obstetric management of women at imminent risk of preterm birth. For women likely to deliver between 24 and 34 weeks’ gestation, antenatal steroid therapy is standard of care, conveying sizable benefits and few risks in high-resource environments when appropriately targeted. Recent studies have focused on antenatal steroid use in periviable and

Background Over 150 million women worldwide use oral contraceptives. Women with inherited thrombophilia and carriers of certain thrombophilia gene variants, such as factor V Leiden and prothrombin mutation, are at increased risk of venous thromboembolism, especially in combination with oral contraceptive use. Venous thromboembolism is a complex disorder involving many genetic risk factors and recently

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Background 22q11.2 deletion syndrome (22qDS) is the most common microdeletion syndrome and is frequently associated with congenital heart disease (CHD). Prenatal diagnosis of 22qDS is increasingly offered. It is unknown whether there is a clinical benefit to prenatal detection as compared to postnatal diagnosis. Objective To determine differences in perinatal and infant outcomes between patients prenatally

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BACKGROUND Multiple pregnancy with a complete hydatidiform mole and a normal fetus is prone to severe obstetrical complications and malignant transformation after birth. Prognostic information is limited for this rare form of gestational trophoblastic disease. OBJECTIVE This study aimed to determine obstetrical outcomes and the risk of gestational trophoblastic neoplasia in women with multiple pregnancy

Objective To assess the effects on oncological outcomes of intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer. Data sources A systematic literature search was performed by an expert librarian in multiple electronic databases from inception to January 31, 2023. Study eligibility criteria We included all studies in the English language that compared oncologic outcomes

Background There is a growing literature base regarding menstrual changes following COVID-19 vaccination among premenopausal people. However, relatively little is known about uterine bleeding in postmenopausal people following COVID-19 vaccination. Objectives To examine trends in incident postmenopausal bleeding diagnoses over time before and after COVID-19 vaccine introduction and describe cases of

BACKGROUND Epigenetic clocks use CpG DNA methylation (DNAm) to estimate biologic age; acceleration is associated with cancer, heart disease, and shorter lifespan. Few studies evaluate DNAm age and pregnancy outcomes. AgeAccelGrim is a novel epigenetic clock that combines seven DNAm components. OBJECTIVES We sought to determine if maternal biologic aging (via AgeAccelGrim) is associated with early PTB

Background Testosterone use among transgender people likely impacts their experience of sexual function and vulvovaginal pain via several complex pathways. Testosterone use is associated with decreased estrogen in the vagina and atrophic vaginal tissue, which may be associated with decreased vaginal lubrication and/or discomfort during sexual activity. At the same time, increased gender affirmation

Background After the publication of the LACC trial, the standard surgical approach for early-stage cervical cancer is open radical hysterectomy. Only limited data were available regarding whether the change to open abdominal hysterectomy observed after the LACC trial led to an increase in post-operative complication rates as a consequence of the decrease in use of the minimally invasive approach. Objective

Placenta accreta spectrum is a dangerous complication of pregnancy that is underdiagnosed and can result in massive hemorrhage, disseminated intravascular coagulation, massive transfusion, surgical injury, multisystem organ failure, and even death. Given the rarity and complexity, most obstetric hospitals and providers do not have comprehensive expertise in diagnosis and management of placenta accreta

Objective To quantify the association between mode of operative delivery in the second stage of labour (cesarean delivery versus operative vaginal delivery) and spontaneous preterm birth (sPTB) in a subsequent pregnancy. Data Sources MEDLINE, EMBASE, Emcare, CINAHL, the Cochrane Library, Web of Science: Core Collection, and Scopus from database inception to April 1st 2023 Study eligibility criteria

Background In the pivotal LIBERTY 1 and 2 trials and long-term extension (LTE) study, once-daily relugolix combination therapy (relugolix CT: relugolix 40 mg, estradiol 1 mg, norethindrone acetate 0.5 mg) reduced menstrual blood loss (MBL) volume and pain in women with uterine fibroids (UF). Relugolix CT was well tolerated, with preservation of bone mineral density (BMD) through 52 weeks. Objective

Background With increased success, ovarian tissue cryopreservation has recently become a standard technique for fertility preservation. However, malignant cell introduction through ovarian tissue transplantation remains a major concern for patients with acute leukemias. Objective To investigate the safety of performing autologous ovarian tissue transplantation in acute leukemia survivors. Study Design

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Background Severe maternal morbidity (SMM) has been increasing in the past few decades. Few studies have examined the risk of SMM among individuals experiencing a stillbirth versus a live birth. Objective To examine the prevalence and risk of SMM among individuals with stillbirth versus individuals with live birth deliveries during delivery hospitalization as a primary outcome and during postpartum

Obstetrical hemorrhage is a relatively frequent obstetric complication, and a common cause of maternal morbidity and mortality worldwide. The majority of maternal deaths attributable to hemorrhage are preventable, thus developing rapid and effective means of treating postpartum hemorrhage is of critical public health importance. Uterine balloon tamponade is one option for management of refractory postpartum

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The “A Randomized Trial of Induction Versus Expectant Management” trial (ARRIVE trial) published in 2018 suggested that induction of labor can be considered a “reasonable option” for low-risk nulliparous women at ≥39 weeks of gestation. The study results led some professional societies to endorse the option for elective induction of labor at 39 weeks of gestation in low-risk nulliparas, and this has

Background Patients with myofascial pelvic floor dysfunction often present with lower urinary tract symptoms (LUTS) such as urinary frequency, urgency, and bladder pressure. Often confused with other lower urinary tract disorders, this constellation of symptoms, recently termed myofascial urinary frequency syndrome (MUFS), is distinct from other LUTS and optimally responds to pelvic floor physical

Background The effect on obstetrical outcomes of closed- or open-glottis pushing is uncertain among both nulliparous and parous women. Objective This study aimed to assess the association between open- or closed-glottis pushing and mode of delivery after an attempted singleton vaginal birth at or near term. Study Design This was an ancillary planned cohort study of the TRAAP (TRAnexamic Acid for Preventing

Background Extramammary Paget’s disease recurs often after traditional surgical excision. Margin-controlled surgery improves recurrence rate for male genital disease but is less studied for female anatomy. Objective To compare surgical and oncologic outcomes of margin-controlled vs traditional surgical excision for female genital Paget’s disease. Study Design We conducted a prospective observational

Background Placenta accreta spectrum disorders are associated with substantial maternal morbidity and mortality. Despite a preoperative diagnosis, the rate of complications remains high and the condition is generally associated with the need for a hysterectomy. Objective To evaluate the outcomes of a new uterine-preserving technique (called the combined approach, including surgical hemostasis, bilateral

Postpartum hemorrhage remains a major cause of maternal mortality and morbidity worldwide with higher rates found in resource-challenged countries. Conventional use of uterotonics such as oxytocin, prostaglandins, and medications to support coagulation, such as fibrinogen and tranexamic acid, are helpful but may not be sufficient to arrest life-threatening postpartum hemorrhage. Severe postpartum hemorrhage

Postpartum hemorrhage remains one of the principal causes of maternal mortality in the United States and throughout the world. Its management, which must be multidisciplinary (obstetrics, midwifery, anesthesiology, interventional radiology, and nursing), depends on the speed of both diagnosis and implementation of medical and surgical treatment to control the hemorrhage. The aim of this work is to

Viscoelastic hemostatic assays are point-of-care devices that assess coagulation and fibrinolysis in whole blood samples. These technologies provide numeric and visual information of clot initiation, clot strength, and clot lysis under low-shear conditions, and have been used in a variety of clinical settings and subpopulations, including trauma, cardiac surgery, and obstetrics. Emerging data indicate

The third stage of labor is defined as the time period between delivery of the fetus through delivery of the placenta. During a normal third stage, uterine contractions lead to separation and expulsion of the placenta from the uterus. Postpartum hemorrhage is a relatively common complication of the third stage of labor. Strategies have been studied to mitigate the risk of postpartum hemorrhage, leading

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Background Plant-based diets (PBD) have been associated to a lower risk of cardiovascular disease in non-pregnant adults, but specific evidence for their effects on risk of hypertensive disorders of pregnancy (HDP) is scarce. Objective(s) To evaluate the prospective association between adherence to PBD before pregnancy and risk of HDP. We hypothesized that women with higher adherence to PBD would have

BACKGROUND Zika virus (ZIKV) congenital infection evades double-stranded RNA detection and may persist in the placenta for the duration of pregnancy, without accompanying overt histopathologic inflammation. Understanding how viruses can persist and replicate in the placenta, without causing overt cellular or tissue damage, is fundamental to deciphering mechanisms of maternal-fetal vertical transmission

BACKGROUND Genital talc and douching are practices that can involve exposure to chemical compounds linked to certain gynecologic cancers. However, it is unclear if they are associated with fibroid risk or age at fibroid diagnosis among women. OBJECTIVE We evaluated the impact of early adolescence genital talc use and douching on prevalent fibroids diagnosed before age 35 and age 50 years among Black/African

Background Having a Caesarean section at full dilatation (CSfd) has been associated with an increased subsequent risk of spontaneous preterm birth (sPTB). The Aberdeen Maternity and Neonatal Databank (AMND) provides a rare opportunity to study subsequent pregnancy outcomes after a previous CSfd over 40 years with an ability to include a detailed evaluation of potential confounding factors. Objective(s)

Objective To assess the risk of adverse maternal and perinatal complications in twin and singleton pregnancies affected by gestational diabetes mellitus (GDM), compared to the respective group without GDM. Data sources Medline, Embase and Cochrane (January 1980 to May 2023). Study eligibility criteria Observational studies reporting maternal and perinatal outcomes in singletons and/or twin pregnancies

In the management of shoulder dystocia, it is often recommended to start with external maneuvers, such as the McRoberts maneuver and suprapubic pressure, followed by internal maneuvers including rotation and posterior arm delivery. However, this sequence is not based on scientific evidence of its success rates, the technical simplicity, or the related complication rates. Hence, this review critically

Background Cervical intraepithelial neoplasia grade 2 has historically been the threshold for surgical excision, but due to high regression rates, many countries are transitioning to active surveillance. Yet, estimates for regression rates are based on small studies with heterogenous definitions of regression and progression. Objectives The aim of this study was to describe regression and progression