Expectant management of second-trimester rupture of membranes offers better perinatal and long-term survival than previously thought.
Short cervix and dilatation of internal cervical os at 18 to 22 weeks' gestation by transvaginal ultrasonography identified 29% of patients who delivered before 35 weeks.
Screening for fetal growth restriction by ultrasound scans performed at 2-week intervals leads to false-positive diagnoses in more than 10% of cases.
A cross-sectional analysis of a nationally representative sample of women shows an association between regular douching and low birth weight after controlling for potential confounders.
During labor with fetal distress, lactate levels in scalp blood obtained shortly before delivery are correlated with those in cord blood.
Immediate bedside inoculation of lower genital tract swabs into selective media does not improve the detection rate of group B streptococci over transporting swabs to the clinical laboratory for inoculation within 2 hours.
Vaginal colonization of group B streptococcus during pregnancy is not associated with preterm labor or premature rupture of membranes even after correction for risk factors.
Penicillin G or ampicillin is adequate for preventing early onset neonatal group B streptococcal disease.
Maternal age of 44 or more years is associated with medical complications and more interventions during labor, but neonatal outcome is good.
Nulliparity and the early placement of epidural analgesia are associated with an increased risk for cesarean delivery in twin gestations over 36 weeks.
Among term breech births, elective cesarean reduces risks of neonatal mortality and morbidity while not increasing rates of maternal morbidity.
Nulliparous women, although less likely to present with urinary incontinence and pelvic organ prolapse, overall differ little from parous women with these conditions.
Instrumental delivery and prolonged second stage of labor are the main factors that determine anal sphincter injury during primigravid vaginal delivery.
In 73 women diagnosed with vulvar intraepithelial neoplasia III and treated surgically, surgical margin status correlated with recurrent disease, and 22% of patients harbored an underlying cancer.
A delay between initial laparoscopy and staging laparotomy in ovarian cancer may affect the distribution of disease stage adversely.
The use of preemptive analgesia reduces postoperative pain in patients undergoing laparoscopy.
During endometrial ablation, connecting outflow of the uterine irrigation fluid system to wall suction reduces the absorption of fluid from that with passive outflow.
Ovulation induction and in vitro fertilization–embryo transfer can be performed successfully in the presence of ovarian cystic teratoma.
Postmenopausal hormones treat hot flashes equally well, breast tenderness occurs only with progestin-containing regimens, and there is no effect of postmenopausal hormones on cognition or anxiety.
Serum progesterone may be a better marker than serum hCG for predicting ectopic resolution.
Women having surgery for an ectopic pregnancy have significantly more perihepatic and pelvic adhesions than women having elective laparoscopic tubal ligation.
Synthetic mesh erosion, a recognized complication of abdominal sacrocolpopexy, is treated effectively with transvaginal excision of the mesh and vaginal advancement.
Uterine artery Doppler examination and ambulatory 24-hour blood pressure monitoring at 20–24 weeks' gestation identifies gravidas at risk of developing pregnancy-induced hypertension or preeclampsia.
Low total glutathione/hemoglobin ratios in maternal whole blood might indicate decreased detoxificating or free radical scavenging capacity in pregnancies complicated by preeclampsia or the hemolysis, elevated liver enzymes, low platelets syndrome.
Changes in cerebral blood flow are maintained up to 1 week after delivery.
A decline in placental leptin messenger RNA abundance, which is commensurate with advancing gestation, suggests evolving roles for leptin in the maternal-fetoplacental unit.
Before attributing chronic pelvic pain to endometriosis, there should be a surgical diagnosis, and the pain should be cyclic and relieved by specific treatment.
Leaders in academic obstetrics and gynecology recommend changes in education, practice, and research, emphasizing primary care and greater participation in federal research activities.
Scores from an objective structured clinical examination provide a reliable and valid indication of medical student competency in an obstetrics-gynecology clerkship.
Current concepts involving pathogenesis and pathophysiology of fetal growth restriction are a useful expansion of older basic concepts.
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