Association Between First-Trimester Subchorionic Hematomas and Pregnancy Loss in Singleton Pregnancies.
Abstract OBJECTIVE: To assess the association of a first-trimester subchorionic hematoma with pregnancy loss in women with singleton pregnancies. METHODS: We conducted a retrospective cohort study of all women with singleton pregnancies presenting for prenatal care before 14 weeks of gestation over a 3-year period at a single obstetric practice. All patients had routine first-trimester ultrasound scans. We reviewed ultrasound data from the first ultrasound scan performed between 6 0/7 and 13 6/7 weeks of gestation and compared rates of pregnancy loss before 20 weeks in women with and without a subchorionic he...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Naert MN, Khadraoui H, Muniz Rodriguez A, Naqvi M, Fox NS Tags: Obstet Gynecol Source Type: research

Referral Patterns for the Evaluation of Asymptomatic Microscopic Hematuria in Women in a Single Health Care System: Room for Improvement.
CONCLUSION: Fewer than half of the referrals for asymptomatic microhematuria were appropriate, leading to wasted and entirely preventable health care expenditures. This study highlights the need for education of health care providers making these referrals. PMID: 31306311 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Handler SJ, Ackerman AL, Samimi PA, Bresee C, Anger JT, Eilber KS Tags: Obstet Gynecol Source Type: research

Neonatal and Maternal Adverse Outcomes Among Low-Risk Parous Women at 39-41 Weeks of Gestation.
CONCLUSION: Though only modestly, the rates of the composite neonatal and maternal adverse outcomes increase, from 39 through 41 weeks of gestation, among low-risk parous women. PMID: 31306312 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Chen HY, Grobman WA, Blackwell SC, Chauhan SP Tags: Obstet Gynecol Source Type: research

Effects of Educational Interventions on Human Papillomavirus Vaccine Acceptability: A Randomized Controlled Trial.
Abstract OBJECTIVE: To estimate whether targeted educational interventions can increase human papillomavirus (HPV) vaccine acceptability and knowledge among young women. METHODS: An exploratory phase of the study was conducted to determine baseline acceptance of the prophylactic HPV vaccine and barriers to acceptance. Based on the results of that phase of the study, a randomized controlled trial of women aged 12-26 at a single institution was completed. A sample size of at least 84 women in each of three study arms (control, educational handout, or educational video) was planned to detect a 20% difference in ...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Cory L, Cha B, Ellenberg S, Bogner HR, Hwang WT, Smith JS, Haggerty A, Morgan M, Burger R, Chu C, Ko EM Tags: Obstet Gynecol Source Type: research

Toward Achieving Risk Appropriate Maternity Care: Maternal Morbidity Prediction.
PMID: 31306314 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Menard MK Tags: Obstet Gynecol Source Type: research

Connect the Dots-August 2019.
PMID: 31306315 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Saiz AM, Thomas MC, Sax M, Chescheir NC Tags: Obstet Gynecol Source Type: research

Dermatomyositis Presenting as Vulvovaginitis.
CONCLUSION: Dermatomyositis is an inflammatory disease that can be associated with malignancy. This particular patient presented with vulvovaginitis. This case is important because the diagnosis was delayed. Early recognition is important to evaluate for malignancy. PMID: 31306316 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Dickison S, Grither W, Compton L, Chibnall R, Jones H Tags: Obstet Gynecol Source Type: research

Medication Abortion Provided Through Telemedicine in Four U.S. States.
CONCLUSION: Findings from this study conducted across geographically diverse settings support existing evidence that outcomes for medication abortion provided through telemedicine are comparable with standard provision of medication abortion. Differences in observed outcomes may be due to differential follow-up between groups. PMID: 31306317 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Kohn JE, Snow JL, Simons HR, Seymour JW, Thompson TA, Grossman D Tags: Obstet Gynecol Source Type: research

Short-Term Health-Related Quality of Life After Hysterectomy Compared With Myomectomy for Symptomatic Leiomyomas.
Abstract OBJECTIVE: To compare short-term health-related quality of life (HRQOL) 6-12 weeks after hysterectomy or myomectomy for the treatment of symptomatic leiomyomas. METHODS: We conducted a prospective comparative effectiveness analysis of data. In an existing multisite registry, we compared 6-12-week postsurgical HRQOL using the disease-specific Uterine Fibroid Symptom Quality of Life and the generic EuroQoL 5-Dimension Health Questionnaire, in women from the ages of 18-54 years with documented leiomyomas undergoing hysterectomy or myomectomy. Propensity score weighting was used to adjust for confounding...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Nicholson WK, Wegienka G, Zhang S, Wallace K, Stewart E, Laughlin-Tommaso S, Thomas L, Jacoby VL, Marsh EE, Wise L, Borah BJ, Spies J, Venable S, Anchan RM, Larry Maxwell G, Diamond M, Lytle B, Myers ER Tags: Obstet Gynecol Source Type: research

Tissue Adhesive Compared With Sterile Strips After Cesarean Delivery: A Randomized Controlled Trial.
CONCLUSION: Compared with sterile strips, tissue adhesive after closure of Pfannenstiel incision for cesarean delivery is unlikely to lower the risk of wound complications. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02838017. PMID: 31306319 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Braginsky L, Javellana M, Cleveland E, Elue R, Wang C, Boyle D, Plunkett BA Tags: Obstet Gynecol Source Type: research

What Truly Matters.
PMID: 31306320 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Scott JR Tags: Obstet Gynecol Source Type: research

To Live and Let Dye.
PMID: 31306321 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Schorge JO Tags: Obstet Gynecol Source Type: research

Overcoming Barriers to Accessing Obstetric Care in Underserved Communities.
This article describes an alternative model for remote obstetric care and quality review in Santa Fe, New Mexico, that is applicable to any community facing limited access to full-spectrum obstetric care. PMID: 31306322 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Burlone S, Moore L, Johnson W Tags: Obstet Gynecol Source Type: research

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Care for Women With Opioid Use Disorder.
Abstract The opioid epidemic is a public health crisis, and pregnancy-associated morbidity and mortality due to substance use highlights the need to prioritize substance use as a major patient safety issue. To assist health care providers with this process and mitigate the effect of substance use on maternal and fetal safety, the National Partnership for Maternal Safety within the Council on Patient Safety in Women's Health Care has created a patient safety bundle to reduce adverse maternal and neonatal health outcomes associated with substance use. The Consensus Bundle on Obstetric Care for Women with Opioid Use ...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Krans EE, Campopiano M, Cleveland LM, Goodman D, Kilday D, Kendig S, Leffert LR, Main EK, Mitchell KT, OʼGurek DT, DʼOria R, McDaniel D, Terplan M Tags: Obstet Gynecol Source Type: research

What Is New in Chronic Pelvic Pain Research?: Best Articles From the Past Year.
Abstract This month we focus on current research in chronic pelvic pain. Dr. El-Nashar discusses four recent publications, which are concluded with a "bottom-line" that is the take-home message. A complete reference for each can be found on Box 1 on this page along with direct links to abstracts. PMID: 31306324 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: El-Nashar SA Tags: Obstet Gynecol Source Type: research

Predictive Model of Factors Associated With Maternal Intensive Care Unit Admission.
CONCLUSION: This model provides insight as to the cumulative effect of multiple risk factors on maternal ICU admission risk. The predictive model achieves an AUC of 0.81, discriminating women with significantly increased risk (30-fold) for ICU admission. Nonetheless, because of the low frequency of maternal ICU admission, the PPV of the model was low and therefore whether models such as ours may be beneficial in future efforts to reduce the prevalence and burden of maternal morbidity is uncertain. PMID: 31306325 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Rossi RM, Hall E, Dufendach K, DeFranco EA Tags: Obstet Gynecol Source Type: research

Urologic Injury and Fistula After Hysterectomy for Benign Indications.
CONCLUSION: Genitourinary injury occurs in 1.8% of hysterectomies for benign indications; immediate identification and repair is associated with a reduced risk of subsequent genitourinary fistula formation. PMID: 31306326 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Dallas KB, Rogo-Gupta L, Elliott CS Tags: Obstet Gynecol Source Type: research

Reoperation for Urinary Incontinence After Retropubic and Transobturator Sling Procedures.
CONCLUSION: Women with primary SUI treated with a retropubic sling procedure have significantly lower cumulative incidence of reoperation for recurrent SUI compared with women who were treated with a transobturator sling procedure. Retropubic slings were associated with a higher risk of sling revision for urinary retention. PMID: 31306327 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Trabuco EC, Carranza D, El Nashar SA, Weaver AL, McGree ME, Elliott DS, Linder BJ, Occhino J, Gebhart JB, Klingele CJ Tags: Obstet Gynecol Source Type: research

Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women.
Abstract OBJECTIVE: To compare perinatal and maternal outcomes in low-risk multiparous women who underwent elective induction of labor in the 39th week of gestation with those who were expectantly managed. METHODS: We performed a single center retrospective cohort study of low-risk multiparous women delivering nonanomalous singletons between 39 and 42 completed weeks of gestation from 2014 to 2018. The primary outcome was a perinatal composite of death, neonatal respiratory support, a 5-minute Apgar score of 3 or less, and shoulder dystocia. Groups were compared using χ, Fisher exact, two sample t-test, a...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Sinkey RG, Blanchard CT, Szychowski JM, Ausbeck E, Subramaniam A, Neely CL, Casey BM, Tita AT Tags: Obstet Gynecol Source Type: research

Screening and Treatment After Implementation of a Universal Perinatal Depression Screening Program.
Abstract OBJECTIVE: To evaluate whether initiation of an institutional policy of universal perinatal depression screening was associated with sustained increases in frequency in screening and of depression treatment subsequent to a positive screen. METHODS: This retrospective cohort study included women receiving prenatal care in outpatient offices at a single academic medical center from 2008 to 2015. In 2009, an institutional policy of universal perinatal depression screening was disseminated in which screening twice antenatally and again postpartum were recommended. The frequency of screen completion at ea...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Miller ES, Wisner KL, Gollan J, Hamade S, Gossett DR, Grobman WA Tags: Obstet Gynecol Source Type: research

A Series of Firsts.
PMID: 31306330 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Chor J Tags: Obstet Gynecol Source Type: research

Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers.
CONCLUSION: Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school-aged adolescents, involving education, resources, and harm-reduction counseling...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Hill AL, Jones KA, McCauley HL, Tancredi DJ, Silverman JG, Miller E Tags: Obstet Gynecol Source Type: research

Lower Genital Tract Dysplasia in Female Solid Organ Transplant Recipients.
CONCLUSIONS: One in eight transplant recipients developed lower genital tract dysplasia and approximately half were high-grade dysplasia or cancer. Black race and hydroxychloroquine use were associated with an increased risk of dysplasia. Yearly cervical screening and comprehensive lower genital examination beyond the cervix is indicated in this population. PMID: 31306332 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Thimm MA, Rositch AF, VandenBussche C, McDonald L, Garonzik Wang JM, Levinson K Tags: Obstet Gynecol Source Type: research

Use and Misuse of Opioids After Gynecologic Surgical Procedures.
Abstract OBJECTIVE: To examine the rate of opioid use for gynecologic surgical procedures and to investigate persistent opioid use among those women who received an initial opioid prescription. METHODS: A retrospective cohort study using the MarketScan database was performed. MarketScan is a claims-based data source that captures claims from more than 50 million privately insured patients and 6 million Medicaid enrollees from 12 states. We identified women who underwent major and minor gynecologic surgery from 2009 to 2016. Among women who received an opioid prescription, new persistent opioid use was defined...
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Wright JD, Huang Y, Melamed A, Tergas AI, St Clair CM, Hou JY, Khoury-Collado F, Ananth CV, Neugut AI, Hershman DL Tags: Obstet Gynecol Source Type: research

Long-Term Assessment of a Prospective Cohort of Patients Undergoing Laparoscopic Sacrocolpopexy.
CONCLUSION: More than four out of five patients (82.5%) felt improved 86 months after laparoscopic sacrocolpopexy. Of those not improved, two thirds had recurrent prolapse; however, typically mid-vaginal. The other third reported urinary or bowel problems or dyspareunia. Reintervention for prolapse was 3.3%. The most common reasons for reoperation were graft-related complications (7.0%) and urinary incontinence (6.7%). PMID: 31306334 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Pacquée S, Nawapun K, Claerhout F, Werbrouck E, Veldman J, Dʼhoore A, Wyndaele J, Verguts J, De Ridder D, Deprest J Tags: Obstet Gynecol Source Type: research

Severe Maternal Morbidity Among Stillbirth and Live Birth Deliveries in California.
CONCLUSION: Women who have stillbirths are at substantially higher risk for severe maternal morbidity than women who have live births, regardless of cause of fetal death. The prevalence of severe maternal morbidity varies by cause of fetal death. PMID: 31306335 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - July 9, 2019 Category: OBGYN Authors: Wall-Wieler E, Carmichael SL, Gibbs RS, Lyell DJ, Girsen AI, El-Sayed YY, Butwick AJ Tags: Obstet Gynecol Source Type: research

The Backstory Behind Burnout in Obstetrics and Gynecology.
PMID: 31241581 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Young RC Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 31241582 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Winkel AF Tags: Obstet Gynecol Source Type: research

Elective Induction at 39 Weeks of Gestation and the Implications of a Large, Multicenter, Randomized Controlled Trial.
PMID: 31241583 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Scialli AR Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 31241584 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Marrs C, La Rosa M, Caughey A, Saade G Tags: Obstet Gynecol Source Type: research

Elective Induction at 39 Weeks of Gestation and the Implications of a Large, Multicenter, Randomized Controlled Trial.
PMID: 31241585 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Glantz JC Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 31241586 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Marrs C, La Rosa M, Caughey A, Saade G Tags: Obstet Gynecol Source Type: research

Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates.
PMID: 31241587 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Sloan M Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 31241588 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Fitzmaurice LE Tags: Obstet Gynecol Source Type: research

In Pursuit of Value-Based Maternity Care.
PMID: 31241589 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Saade G Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 31241590 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Shah NT, Sudhoff L Tags: Obstet Gynecol Source Type: research

Prediction of Success in External Cephalic Version for Breech Presentation at Term: Correction.
Authors: PMID: 31241591 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Association of Pharmacist Prescription of Hormonal Contraception With Unintended Pregnancies and Medicaid Costs: Correction.
Authors: PMID: 31241592 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

ACOG Publications: July 2019.
Authors: PMID: 31241594 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Female Sexual Dysfunction: ACOG Practice Bulletin Summary, NUMBER 213.
Authors: Abstract Female sexual dysfunction encompasses various conditions that are characterized by reported personal distress in one or more of the following areas: desire, arousal, orgasm, or pain (). Although female sexual dysfunction is relatively prevalent, women are unlikely to discuss it with their health care providers unless asked (), and many health care providers are uncomfortable asking for a variety of reasons, including a lack of adequate knowledge and training in diagnosis and management, inadequate clinical time to address the issue, and an underestimation of the prevalence (). The purpose of thi...
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion Summary, Number 782.
Authors: Abstract Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes. In the absence of intrapartum antibiotic prophylaxis, 1- 2% of those newborns will develop GBS EOD. Other risk factors include gestational age of less than 37 weeks, very low birth weight, prolonged rupture o...
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Migraine and Other Headache Disorders: ACOG Clinical Updates In Women's Health Care Primary and Preventive Care Review Summary Volume XVIII, Number 4.
Abstract Migraine is a common headache disorder for which women are likely to seek care. This primary headache disorder, which often may be debilitating, has a higher prevalence in women than in men that is likely related to times of hormonal changes throughout the reproductive life cycle, such as menarche, pregnancy, postpartum period, lactation, perimenopause, and menopause, as well as to external hormonal changes associated with the use of oral contraceptives and hormone therapy. The obstetrician-gynecologist is well positioned to recognize and treat migraine and to recognize a potential relationship between es...
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Authors: Lucas S Tags: Obstet Gynecol Source Type: research

Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213.
Authors: Abstract Female sexual dysfunction encompasses various conditions that are characterized by reported personal distress in one or more of the following areas: desire, arousal, orgasm, or pain (). Although female sexual dysfunction is relatively prevalent, women are unlikely to discuss it with their health care providers unless asked (), and many health care providers are uncomfortable asking for a variety of reasons, including a lack of adequate knowledge and training in diagnosis and management, inadequate clinical time to address the issue, and an underestimation of the prevalence (). The purpose of thi...
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 782.
Authors: Abstract Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes. In the absence of intrapartum antibiotic prophylaxis, 1-2% of those newborns will develop GBS EOD. Other risk factors include gestational age of less than 37 weeks, very low birth weight, prolonged rupture of...
Source: Obstetrics and Gynecology - June 27, 2019 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Implementation of the Safe Reduction of Primary Cesarean Births Safety Bundle During the First Year of a Statewide Collaborative in Maryland.
CONCLUSION: Our assessment has promising results, with a majority of hospitals having implemented new cesarean birth bundle practices during the collaborative's first year. However, there are lessons from the wide variability in the number and type of practices adopted. Clinicians should be aware of this variability and become more involved in the implementation of cesarean birth bundle practices. We identified six strategies associated with full implementation of more bundle practices for which clinicians' support and commitment to practice changes are critical. Clinicians' understanding of available and effective impleme...
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Callaghan-Koru JA, Creanga AA, DiPietro B, Mark K, Sowe A, Aboumatar N, Burke AB, Curran G Tags: Obstet Gynecol Source Type: research

Chemotherapy, Radiation, or Combination Therapy for Stage III Uterine Cancer.
CONCLUSION: Among women with stage III uterine cancer, combination chemotherapy and external beam radiation is associated with decreased mortality compared with chemotherapy or radiation alone. PMID: 31188310 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Syeda S, Chen L, Hou JY, Tergas AI, Khoury-Collado F, Melamed A, St Clair CM, Ananth CV, Neugut AI, Hershman DL, Wright JD Tags: Obstet Gynecol Source Type: research

Sexual Assault in the Military and Increased Odds of Sexual Pain Among Female Veterans.
Abstract OBJECTIVE: To examine whether the relationship between childhood sexual abuse and sexual function in civilian women is also found among female veterans, and to consider the additional effects of sexual assault in the military. METHODS: Using a retrospective cohort design, participants (N=1,004) from two midwestern Department of Veterans Affairs medical centers and associated clinics completed a telephone-assisted interview on sexual assault, sexual pain, and mental health. Binary logistic regression was used to compare the rates of sexual pain between women with no sexual assault history, histories o...
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Pulverman CS, Creech SK, Mengeling MA, Torner JC, Syrop CH, Sadler AG Tags: Obstet Gynecol Source Type: research

Genetically Modified Babies and a First Application of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR-Cas9).
Abstract The world's first babies with CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats)-edited genes were born on November 25, 2018. Dr. Jiankui He of Southern University of Science and Technology in Shenzhen performed this gene editing. Dr. He's objectives and an assessment of how well they were achieved are discussed in the context of existing research in this area.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properl...
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Rose BI, Brown S Tags: Obstet Gynecol Source Type: research

Race, Gender, and Generation: Reflections by Three Physicians in Three Parts.
PMID: 31188313 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Woods KD, Lindsay M, Robertson K Tags: Obstet Gynecol Source Type: research

Evaluation of Opioid Use With Split Doses of Oral Opioids in a Postcesarean Delivery Analgesia Order Set.
Abstract OBJECTIVE: To evaluate whether an order set change that halved the initial dose of oxycodone and allowed the remainder to be given 1 hour later, if requested, was associated with reduced opioid use and side effects after cesarean delivery. METHODS: This retrospective, clinical practice study reviewed electronic medical records after implementation of a new order set for cesarean delivery. Oxycodone orders changed from 5 mg (for verbal pain score of 4/10 or lower) and 10 mg (for 5-10/10) to 2.5 mg (for verbal pain score 1-4/10) or 5 mg (for 5-10/10), and the patient requesting pain relief, with a nurs...
Source: Obstetrics and Gynecology - June 11, 2019 Category: OBGYN Authors: Nanji JA, Guo N, Riley ET, Faulkner B, Do C, Carvalho B Tags: Obstet Gynecol Source Type: research