OBJECTIVE To estimate whether breastfeeding is associated with the estimated risk of long-term atherosclerotic cardiovascular disease (ASCVD) and whether this association varies with prior gestational diabetes mellitus (GDM). METHODS We conducted a secondary analysis from the prospective HAPO (Hyperglycemia and Adverse Pregnancy Outcome) Follow-Up Study. The exposure was any breastfeeding (yes or no)

OBJECTIVE To compare prophylactic oral cephalexin and metronidazole with placebo for 48 hours after cesarean delivery following membrane rupture on the frequency of composite infection morbidity postpartum among pregnant individuals with obesity. METHODS This randomized, double-blind clinical trial was conducted at two medical centers from August 2017 to August 2023. We enrolled women with obesity

OBJECTIVE To evaluate the association between patient-reported social needs and birth outcomes in a large cohort of pregnant people after implementation of a universal screening program. METHODS We conducted a retrospective cohort evaluation of a quality-improvement initiative including 20,480 pregnant people who had social determinants of health screening during pregnancy between May 2021 and July

OBJECTIVE To evaluate the environmental effects and cost of four different uterine manipulators using life cycle assessment and life cycle costing. METHODS Life cycle assessment, which evaluates the environmental effects of a product or process throughout its life cycle, including production, use, and disposal, was performed on a reusable stainless-steel manipulator, two disposable manipulators, and

Cervical cancer remains a preventable yet significant public health concern, particularly among rural, racial and ethnic minority, and LGBTQ+ (lesbian, gay, bisexual, transgender, queer+) populations who are more likely to be unscreened or underscreened. The recent draft guidance by the U.S. Preventive Services Task Force of human papillomavirus (HPV) self-collection for cervical cancer screening offers

Complaints of brain fog, mood changes, and sleep disruption are common in the menopause transition. These symptoms can negatively affect overall health, quality of life, productivity, and relationships. This narrative review addresses the epidemiology, underlying mechanisms, and treatment options associated with changes in cognition, mood, and sleep during the menopause transition. The goal is to help

OBJECTIVE To describe the current and future use of vaginal hysterectomy in the United States for benign indications. METHODS In this retrospective cohort study using data from the PINC AI Healthcare Database, we analyzed patients who underwent hysterectomy for benign indications from 2006 to 2020. Hysterectomy was classified as abdominal, vaginal, or minimally invasive (laparoscopic or robotic-assisted)

OBJECTIVE To estimate the association between doula support and cesarean delivery compared with standard of care. DATA SOURCES We conducted a systematic review of randomized controlled trials (RCTs) and observational studies comparing in-person intrapartum doula support with standard care. We searched studies published in Ovid Medline, Embase.com, Scopus, Cochrane Central, and ClinicalTrials.gov before

In this serial cross-sectional study of more than 4,500 hospitals identified in the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project National Inpatient Sample, the annual number of obstetric care-providing hospitals decreased by 231, from 2,895 to 2,664, corresponding to an 8.0% decrease over the 7-year period from 2016 to 2022 (Ptrend<.001). The Midwest region (11

INTRODUCTION Adverse childhood experiences (ACEs) are associated with increased pain and opioid use after cesarean delivery (CD). Because prior trauma could affect pain perception related to labor, we examined the relationship between ACEs and postpartum opioid use stratified on presence of labor. METHODS This was a prospective cohort study of postpartum people aged 18 years or older who underwent

Recent studies have shown an increase in the rates of sterilization procedures among women of childbearing age after the Dobbs v. Jackson Women's Health Organization decision in June 2022. This trend may extend to the use of other forms of birth control, such as oral contraceptive pills and long-acting reversible contraception. Now, more than ever, broad access to contraception is imperative to reduce

OBJECTIVE To evaluate the effectiveness of various medications for the treatment of endometriosis-related pain through a network meta-analysis. DATA SOURCES A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Controlled Trials Register until July 22, 2024. We also searched ClinicalTrials.gov for additional data on recently completed trials or potentially eligible

OBJECTIVE To consolidate the best available evidence on the prevalence of genitourinary syndrome of lactation and its associated symptoms, including vaginal dryness, vaginal atrophy, urinary symptoms, dyspareunia, and sexual dysfunction, among postpartum lactating individuals. METHODS The systematic review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines

In-office gynecologic procedures, such as intrauterine device insertion, endometrial biopsy, hysteroscopy, intrauterine imaging, and cervical biopsy, among others, are common procedures experienced by many patients. There is an urgent need for health care professionals to have a better understanding of pain-management options and to not underestimate the pain experienced by patients and for patients

Red blood cells (RBCs) have the potential to bind and harbor viral DNA, providing a novel approach to detecting human papillomavirus (HPV). Red blood cells incubated with fluorescently labeled HPV CpG acquired HPV DNA in a concentration-dependent manner. Red blood cells incubated with HPV-positive cervical cancer cells (CaSki cell line) acquired HPV 16 DNA detected by quantitative polymerase chain

This report summarizes key points from a session at the 2024 American Gynecological & Obstetrical Society Annual Meeting focused on developing a framework on how to build and sustain competency in gynecologic surgical skills, an issue of importance for both graduating residents and practicing obstetricians and gynecologists. Recommendations include increasing focus in surgical skill training and adopting

OBJECTIVE To estimate the association between historical maternal adverse childhood experiences (ACEs) and offspring internalizing (ie, depression, anxiety, social withdrawal) and externalizing (ie, aggression, conduct disorders, attention-deficit/hyperactivity disorder) behavior symptoms not explained by offspring ACEs. METHODS This was a retrospective cohort study using childhood adversity data collected

OBJECTIVE To evaluate demographic, pregnancy, and labor characteristics and perinatal outcomes related to intrapartum cesarean delivery in twin gestations. METHODS We conducted a population-based retrospective cohort study of twin pregnancies using natality data from the National Center for Health Statistics in the United States from 2018 to 2023. Women who attempted vaginal delivery for twin pregnancy

OBJECTIVE To examine long-term risk of cardiovascular disease (CVD) after undergoing hysterectomy with or without oophorectomy. METHODS Participants in the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHS II) (N=239,907) were grouped based on history of no surgery, hysterectomy alone, or hysterectomy with bilateral oophorectomy, and further categorized by use or nonuse of estrogen. The

BACKGROUND Placenta accreta spectrum (PAS) often results in significant maternal morbidity and mortality. Cesarean hysterectomy is the standard treatment in the United States but can be surgically complex and resource-intensive, with significant morbidity. In other countries, conservative management (ie, cesarean delivery with retention of the placenta) is offered as a potentially less morbid option

OBJECTIVE To examine the association between coronavirus disease 2019 (COVID-19) vaccination and spontaneous abortion. METHODS We conducted a case-control study of clinically adjudicated spontaneous abortions (case group) occurring between January 19, 2021, and October 27, 2021, and live births (control group). Patients aged 16-49 years at eight Vaccine Safety Datalink sites who had singleton pregnancies

OBJECTIVE To perform metabolomic and lipidomic profiling with plasma samples from patients with placenta accreta spectrum (PAS) to identify possible biomarkers for PAS and to predict PAS with machine learning methods that incorporated clinical characteristics with metabolomic and lipidomic profiles. METHODS This was a multicenter case-control study of patients with placenta previa with PAS (case group

Placenta accreta spectrum (PAS) disorder poses significant risks to maternal health, given the complexities of screening, diagnosis, and management. To address these challenges, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) hosted a workshop on June 10-11, 2024, bringing together expert health care professionals, researchers, stakeholders, and patient advocates

OBJECTIVE To evaluate the accuracy of International Classification of Diseases, Tenth Revision (ICD-10) codes for placenta accreta spectrum (PAS) by analyzing frequency and reasons for miscoding, with particular attention to differences between PAS referral centers and other nonreferral obstetric hospitals. METHODS We conducted a retrospective cohort study of all deliveries with ICD-10 codes for PAS

OBJECTIVE To assess variation in inpatient antepartum management strategies for placenta accreta spectrum (PAS) disorder and their association with hospitalization costs in a national sample. METHODS This retrospective cohort study used the 2016-2021 Nationwide Readmissions Database to identify individuals aged 15-54 years who underwent cesarean hysterectomy for PAS between 23 and 35 weeks of gestation

Placenta accreta spectrum (PAS) disorder, characterized by failure of the abnormally adherent placenta to detach from the uterus after delivery, is a leading cause of severe maternal morbidity. Despite its relatively low incidence, disproportional contributions to perinatal hemorrhage, massive transfusion, and emergency hysterectomy underscore the critical need for development of evidence-based surgical

OBJECTIVE To evaluate maternal outcomes when leaving the placenta in situ for placenta accreta spectrum (PAS) according to planned surgical management. METHODS We conducted a single-center retrospective cohort study of patients with PAS managed by leaving the placenta in situ from January 2015 to October 2024. At our center, patients are given options other than cesarean hysterectomy for the management

OBJECTIVE To evaluate whether using a 4-French balloon aortic occlusion device was associated with lower blood loss and subsequent blood transfusions in placenta accreta spectrum (PAS) cesarean hysterectomy. METHODS This was a retrospective cohort study of patients with ultrasound findings consistent with complex PAS (placenta increta or percreta) who were delivered at a single tertiary care center

The nulliparous, term, singleton, vertex (NTSV) cesarean birth rate is a metric that may be used to evaluate obstetric care and compare performance across similar hospitals and regions. Safe reduction of primary cesarean birth prevents the need for future cesarean births and associated maternal morbidity risk. Quality-improvement methodologies such as optimizing culture of care; practice environment;

Prenatal care is one of the most common preventive services in the United States; it is designed to improve the health and well-being of pregnant and birthing individuals and their children through evidence-based services. Despite the prevalence of prenatal care, formalized models of prenatal care delivery have changed little since they were first published in 1930. The purpose of this Clinical Consensus

Although the Americans with Disabilities Act has been the law for more than 30 years, individuals with disabilities still face substantial barriers to health care and are at higher risk of receiving inadequate care than those without disabilities. It is important that obstetrician-gynecologists are aware of best practices for caring for their patients with disabilities, as well as how to adjust their

OBJECTIVE To establish contemporary rates of maternal morbidity and placenta accreta spectrum (PAS) based on history of cesarean delivery and placental location at a single institution. METHODS This is a retrospective cohort study conducted between January 2011 and May 2024. All patients who delivered by cesarean were included. Maternal demographics and morbidities, including rates of PAS, placenta

Although diffuse, ongoing bleeding due to refractory coagulopathy is not frequently encountered in obstetric surgery, patients with placenta accreta spectrum undergoing cesarean hysterectomy are at uniquely high risk for this occurrence. Therefore, obstetrician-gynecologists (ob-gyns) should be familiar with strategies to manage these rare but critical surgical situations. Abdmoinopelvic packing, a

OBJECTIVE To compare maternal and surgical outcomes between local resection and immediate hysterectomy after cesarean delivery in patients with placenta accreta spectrum (PAS). DATA SOURCES Four public databases (PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials) were systematically searched for relevant publications up to July 31, 2024. Because the Cochrane Library

Placenta accreta spectrum (PAS) is associated with significant maternal morbidity, but inconsistent outcome reporting across studies hampers meaningful comparisons of management approaches. This statement proposes standardized criteria for measuring severe maternal morbidity and mortality (SMM) for PAS, distinguishing true complications from expected interventions in care. Traditional SMM definitions

Placenta accreta spectrum (PAS) is a disorder secondary to abnormal development of placental trophoblasts, resulting in invasion of the maternal uterine tissue beneath the placenta. The incidence of PAS continues to rise as a result of several factors, with the most common being the increasing number of cesarean deliveries. The diagnosis of PAS carries significant increased risk of maternal morbidity

Placenta accreta spectrum (PAS) disorders present a significant clinical challenge, characterized by abnormal placental adherence to the uterine wall secondary to uterine scarring. With the rising global cesarean delivery rates, the incidence of this iatrogenic disorder has increased, underscoring the critical need for an understanding of its pathophysiology to inform management and prevention strategies

The management of multiple pregnancies complicated by monochorionicity continues to evolve as new investigations support a change in clinical practice to optimize outcomes. Monochorionic twins are at risk of unique conditions such as monoamnionicity, conjoined twinning, twin reversed arterial perfusion sequence, twin-twin transfusion syndrome, twin anemia-polycythemia sequence, unequal placental sharing

OBJECTIVE To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities. METHODS This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to

OBJECTIVES To provide clinicians with a standardized educational tool to effectively counsel transgender and gender-diverse (TGD) patients on fertility preservation and to support informed consent before interventions that may affect future fertility. PROJECT SUMMARY After performing a literature search, we wrote a detailed script outlining fertility-preservation options and considerations for TGD

OBJECTIVE To educate health care professionals and nurses on buprenorphine initiations in pregnancy, establish a mutual care agreement to promote therapeutic partnership, and standardize buprenorphine initiation using the Epic electronic health record (EHR) order set. PROJECT SUMMARY This project provides resources that can be adapted and implemented at other institutions to perform inpatient buprenorphine

OBJECTIVE To compare characteristics of patients ordering abortion medications from a telehealth service for potential future use (advance provision) with characteristics of patients ordering medications to terminate a current pregnancy. METHODS This cross-sectional study used electronic medical records from a U.S. clinician-supported asynchronous telehealth service to compare patient characteristics

OBJECTIVE To evaluate the short-term effectiveness of fractional CO 2 laser for the treatment of genitourinary syndrome of menopause. DATA SOURCES Systematic review was performed of PubMed, Scopus, Web of Science, Cinhal, MEDLINE, and ClinicalTrials.gov . METHODS OF STUDY SELECTION The included studies had to meet the following criteria: 1) The sample consisted exclusively of women diagnosed with genitourinary

Separation of patients by insurance status in ambulatory care settings is a long-standing practice in academic medicine. This payer-based segregation of patients between resident and faculty outpatient practices may lead to inequitable quality of care. Informed by replies to a free-response text question for residents and program directors within the 2023 U.S. obstetrics and gynecology in-service examination

National rates of trial of labor after cesarean (TOLAC) have increased, but the risk of uterine rupture remains. Clinical practice- and patient-level changes also have occurred in the past decade, and an evaluation of contemporary uterine rupture rates is needed. Using natality files available in the National Vital Statistics System from 2010 to 2022, we conducted a repeated cross-sectional analysis

We conducted a population-based retrospective cohort study and performed interrupted time series analyses to examine whether the removal of race and ethnicity from the vaginal birth after cesarean (VBAC) calculator was associated with changes in rates of trial of labor after cesarean (TOLAC) and VBAC in the United States. After the calculator revision, rates of TOLAC and VBAC in the overall eligible

This cross-sectional study analyzed associations between preconception and prenatal cannabis use and first-trimester nausea and vomiting in pregnancy (NVP) using data from 356,343 pregnancies in a large health care system (2011-2022). Prevalence of preconception and prenatal cannabis use was 11.3% (2.7% daily, 2.4% weekly, 6.3% monthly or less) and 6.5% (0.7% daily, 0.7% weekly, 1.4% monthly or less

OBJECTIVE To investigate the association between the duration of levonorgestrel-releasing intrauterine system (LNG-IUS) use and breast cancer risk in Korean women. METHODS A retrospective cohort study was conducted using the Korean National Health Insurance Claims database from 2013 to 2022. A total of 2,094,029 women aged 30-49 years with initial diagnoses of endometriosis, uterine leiomyomas, or

BACKGROUND Patients with inflammatory bowel disease, particularly Crohn disease (CD), are at increased risk of fat malabsorption and fat-soluble vitamin deficiencies. Vitamin K is a fat-soluble vitamin that plays a critical role in blood coagulation. Vitamin K deficiency during pregnancy can lead to severe maternal and neonatal hemorrhagic complications. CASE We report the case of a patient with severe

OBJECTIVE To quantify how many patients treated for high-grade cervical dysplasia completed guideline-concordant surveillance. METHODS We retrospectively analyzed patients aged 30-65 treated for high-grade cervical dysplasia (cervical intraepithelial neoplasia 2 or worse) at two PROSPR II METRICS (Population-based Research to Optimize the Screening Process Multi-level Optimization of the Cervical Cancer

OBJECTIVE To explore the associations between hypertensive disorders of pregnancy and the subsequent development of autoimmune diseases. METHODS This retrospective cohort study used TriNetX, a federated network of real-world data. Using the Global Collaborative Network data, we collected electronic medical records from 102 health care organizations with 131 million patient records from 2006 to 2020

OBJECTIVE To assess the long-term changes in cardiovascular biomarkers during the WHI (Women's Health Initiative) hormone therapy (HT) clinical trials of conjugated equine estrogens (CEE) alone and CEE plus medroxyprogesterone acetate (MPA). METHODS HT trial participants from the CEE alone (n=1,188, 0.625 mg/d CEE or placebo) and the CEE+MPA (n=1,508, 0.625 mg/d CEE plus continuous 2.5 mg/d MPA or

OBJECTIVE To characterize and estimate rates of fragmented care, to investigate its association with the receipt of guideline-concordant treatment, and to evaluate treatment components at risk with fragmented care. METHODS This is a single-institution retrospective study of patients with locally advanced cervical cancer (stage IB3-IVA) from January 2003 to September 2023. We stratified patients into

OBJECTIVE To compare the performance of four commonly used algorithms to differentiate benign from malignant adnexal masses when used by a novice operator. METHODS Women with adnexal masses treated at Mayo Clinic, Rochester, Minnesota, in 2019 were identified retrospectively. Patients were included if they underwent surgery within 3 months of diagnosis or had at least 10 months of follow-up. A nonexpert