2 Minute Medicine ® - Obstetrics & Gynecology

1. In this randomized controlled trial, the fresh embryo transfer group had a higher rate of live births compared to the frozen embryo transfer group, in women with a low prognosis of a successful pregnancy using in vitro fertilization (IVF).  Evidence Rating Level: 1 (Excellent)  In vitro fertilization (IVF) has progressed bounds since first being introduced, however, many women are still struggling. Specifically, women with 9 or fewer oocytes retrieved, or those with poor ovarian reserve (defined as antral follicle count <5 or serum anti-Müllerian hormone level <8...

1. Among female patients with positive human papillomavirus (HPV) test results and negative intraepithelial lesion or malignancy (NILM) findings on cytology, less than half received the surveillance follow-up testing within the timeframe set forth by the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines. Evidence Rating Level: 2 (Good) The current ASCCP guidelines for patients who receive a positive HPV test result and a normal NILM result recommend 2 consecutive negative annual results to return to routine screening...

: https://www.2minutemedicine.com/wp-content/uploads/2025/01/2MM_01.12.25_Angel_Steroids.jpg 1. In this cohort study of offspring born to mothers at risk for preterm delivery or diagnosed with an autoimmune or inflammatory disorder, there was an association between systemic glucocorticoid exposure prenatally and future development of a mental disorder.  Evidence Rating Level:  2 (Good) Systemic glucocorticoids have been prescribed for use in preterm labour as a way to decrease fetal morbidity and mortality, and for individuals with autoimmune or inflammatory disorders...

1. In this cohort study of offspring born to mothers at risk for preterm delivery or diagnosed with an autoimmune or inflammatory disorder, there was an association between systemic glucocorticoid exposure prenatally and future development of a mental disorder.  Evidence Rating Level: 2 (Good) Systemic glucocorticoids have been prescribed for use in preterm labour as a way to decrease fetal morbidity and mortality, and for individuals with autoimmune or inflammatory disorders. Cortisol, a hormone, and endogenous glucocorticoid is involved in key development processes in utero, including development of the central nervous system (CNS)...

1. In this prospective cohort study, genetic screening among Australian reproductive couples was widely accepted and associated with low decisional regret. 2. Three out of four couples identified as having an increased risk of having a child with a genetic condition opted for reproductive interventions . Evidence Rating Level: 2 (Good) Study Rundown: Reproductive genetic screening offers individuals insight into their risk of having a child affected by genetic conditions, particularly X-linked or autosomal recessive ones...

1. Tranexamic acid significantly reduced life-threatening postpartum bleeding. 2. There were no differences in the risk of thromboembolic events. Evidence Rating Level: 1 (Excellent) Study Rundown : Postpartum hemorrhage is a significant cause of maternal mortality. While tranexamic acid is used to treat this condition, its potential to prevent bleeding remains unclear. This systematic review and meta-analysis aimed to examine tranexamic acid’s effects in reducing life-threatening bleeding and thromboembolic risk in women giving birth...

1. A history of endometriosis and uterine fibroids in women was associated with a greater risk of premature mortality and mortality due to gynecological cancers. 2. A history of endometriosis in women was associated with a greater risk of non-cancer mortality.  Evidence Rating Level: 2 (Good) Endometriosis and uterine fibroids are common disorders among women of reproductive age which have previously been shown to be associated with increased risks of cardiovascular disease, hypertension and cancer. However, the associations between endometriosis and uterine fibroids and subsequent mortality risk as well as the impact of co-occurrence of the two disorders have not been well characterized...

1. Suboptimal carbohydrate consumption is negatively associated with male fertility but not female fertility Evidence Rating Level: 3 (Average)  Subfertility is the inability to conceive after 12 months of unprotected intercourse and affects millions of couples globally. Many factors such as age and genetics are non-modifiable, however diet has become the focus of modifiable factors influencing fertility. High glucose levels affect insulin sensitivity, hormonal balance, and ovarian function. Hyperglycemia can also cause oxidative stress which can contribute to subfertility...

1. 5-year progression-free survival was increased in the induction chemotherapy group compared to standard chemoradiotherapy. 2. Patients in the induction chemotherapy group reported more frequent grade 3 or greater adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown: Locally advanced cervical cancer is typically treated with chemoradiotherapy. However, many patients continue to undergo relapse and death from metastatic disease. This randomized controlled trial aimed to assess whether induction chemotherapy, followed by standard chemoradiotherapy, improves both progression-free survival and overall survival in patients with locally advanced cervical cancer...

1. 71% of home group patients and 46% of hospital group patients completed abortion as a day-care procedure. 2. Majority of adverse events were mild-to-moderate with no fatalities reported. Evidence Rating Level: 1 (Excellent) Study Rundown: Medical abortion after three months has traditionally required hospital admission. Studies suggest that administering the first dose of misoprostol at home could increase the rate of day-care procedures, reduce hospital stays, and improve patient satisfaction. This randomized controlled trial aimed to compare home versus hospital misoprostol administration in pregnant women undergoing abortion...

1. In a cohort of infants born to mothers during the COVID-19 pandemic, neither vaccination nor infection with COVID-19 led to increased risk of any congenital anomaly.  Evidence Rating Level: 1 (Excellent)  There is an increased risk of pregnancy complications in women who contract COVID-19 while pregnant. As a result, it is highly recommended that pregnant women get vaccinated against COVID-19 to prevent transmission. Since there are not many past studies on the effects of vaccinations during pregnancy, these researchers attempted to understand the risk of the fetus developing congenital anomalies from exposure to COVID-19 (whether through the vaccination or infection) during the first trimester...

1. The data from two cohort studies show that the chances of receiving an autism diagnosis was decreased in mothers who had a higher adherence to a healthy prenatal dietary pattern (HPDP) compared to mothers who had low adherence to a HPDP.  Evidence Rating Level: 1 (Excellent) Autism spectrum disorder includes a spectrum of characteristics related to neurodevelopmental conditions such as lack of eye contact and differences responding in social situations. Previous studies have mainly focused on specific nutrient intake (such as folic acid) and their relationship to autism diagnosis, therefore leaving a gap in the literature regarding the relationship between an overall healthy prenatal diet and autism diagnosis...

1. Cardiovascular health and infertility are negatively correlated with physical activity, BMI, and blood glucose being major indicators of cardiovascular health that impact fertility Evidence Rating Level: 2 (Good)  Female infertility affects around 10% of couples globally. There is emerging evidence that links female infertility with cardiovascular diseases (CVD) which suggests infertility could be a sign of CVD later in life. Elevated triglyceride levels and lower levels of high-density lipoproteins have been observed in females with idiopathic infertility...

1. In this randomized controlled trial, the body-fat percentage among preterm infants was similar between those who received parenteral nutrition and those who received dextrose solution. 2. The time to full enteral feeding was similar between preterm infants who received smell and taste exposure before gastric-tube feeding versus those who did not. Evidence Rating Level: 1 (Excellent) Study Rundown: Moderate-to-late-preterm infants, defined as infants born between 32 weeks zero days and 36 weeks six days gestation, are at increased risk for adverse health outcomes, including developmental delay, cardiometabolic disease, and death...

1. Women in the surgical group reported 2.5 times more spontaneous ovulations than in medical therapy. 2. Those assigned to surgery had a higher rate of adverse events, although none led to long-term issues. Evidence Rating Level: 1 (Excellent) Study Rundown: Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and obesity exacerbates its reproductive complications. Despite this, effective obesity management in women with PCOS remains a challenge. This randomized controlled trial aimed to compare the safety and efficacy of bariatric surgery versus medical care on ovulation rates in women with PCOS, obesity, and oligomenorrhoea or amenorrhea...

1. In this retrospective cohort study, exposure to antiseizure medications was associated with a higher incidence of autism spectrum disorder (ASD) compared to general population data. 2. Restricted to children born to mothers with epilepsy, valproate, but not topiramate and lamotrigine, was associated with an increased risk of ASD compared to no medication exposure. Evidence Rating Level: 2 (Good) Study Rundown: Most female adults with epilepsy receive antiseizure medications throughout pregnancy. Prenatal exposure to valproate is associated with neurodevelopmental disorders such as ASD and attention deficit hyperactivity disorder...

The Latest A first-in-human, double-blind phase 1 clinical trial funded by Reunion Neuroscience Inc. investigated the safety, tolerability, and pharmacological profile of RE104, a proprietary psychedelic prodrug the company hopes to investigate in the treatment of postpartum depression (PPD). In this study, 48 healthy participants were enrolled across 6 dose levels ranging from 5.5 mg to 44 mg. In general, RE104 was safe and well tolerated by all study participants. Nausea, asymptomatic sinus tachycardia, headache, and restlessness were the most commonly reported adverse effects (AE)...

1. Restricted growth of a fetus during early pregnancy was examined as a risk factor for impaired neurodevelopment. 2. Decreased crown-to-rump length was shown to impact neurodevelopment at 2 years of age. Restricted fetal growth in the uterus is an important risk factor to consider for impaired development in the child. Early pregnancy is a crucial time for growth of a fetus, as it allows for the development of the neural tube, along with an increasing number of fetal brain cells. There is a lack of research studying the association between first-trimester fetal size and childhood neurodevelopment...

1. In a cohort study in South Korea, prenatal opioid use did not significantly increase the risk of neuropsychiatric disorders in infants.  2. The risk of a neuropsychiatric disorder was increased by long-term opioid use, greater doses, and use during the first trimester.  Evidence Rating Level: 2 (Good)  Prenatal opioid exposure is generally contraindicated in pregnancy, though chronic pain and addiction can still lead to exposure.  Currently, the association between opioid exposure and subsequent neuropsychiatric disorders in infants is poorly characterized...

1. Progression-free survival at 24 months was higher in the pembrolizumab versus placebo-controlled group. 2. The pembrolizumab-chemoradiotherapy group reported slightly higher rates of grade 3 or higher adverse events compared to the placebo-chemoradiotherapy group. Evidence Rating Level: 1 (Excellent) Study Rundown: Pembrolizumab has demonstrated efficacy in advanced cervical cancer, prompting an investigation into its potential synergy with chemoradiotherapy. This randomized controlled trial aimed to assess the safety and efficacy of adding pembrolizumab to chemoradiotherapy for the treatment of locally advanced cervical cancer...