American Journal of Obstetrics and Gynecology

BACKGROUND: Myomectomy is associated with a significant risk of hemorrhage. Tranexamic acid is a synthetic lysine derivative with antifibrinolytic activity used in other surgical disciplines to reduce blood loss during surgery. However, its utility in gynecologic surgery is not well understood. OBJECTIVE: To determine the effect of the early administration of intravenous tranexamic acid on perioperative bleeding and blood transfusion requirements in women undergoing a myomectomy...

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OBJECTIVE: To evaluate the association between opioid prescribing during pregnancy and new persistent opioid use in the year following delivery. STUDY DESIGN: This nationwide retrospective cohort study included patients ages 12-55 in Optum's de-identified Clinformatics® Data Mart Database, undergoing vaginal birth (VB) or cesarean birth (CB) from 2008-2016, with continuous enrollment from 2-years before birth to 1-year post- discharge. Women were included if they were opioid-naïve in pregnancy (i...

The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome 2 (SARS-CoV-2) virus, is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2 - 2.5, indicating that 2 - 3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with over 7,000 related deaths...

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INTRODUCTION: Many cases of placenta accreta spectrum (PAS) are not diagnosed antenatally, despite identified risk factors and improved imaging methods. Identification of plasma protein biomarkers could further improve antenatal diagnosis of PAS. OBJECTIVE: The purpose of this study was to determine if women with PAS have a distinct plasma protein profile compared with controls. STUDY DESIGN: We obtained plasma samples prior to delivery from 16 participants with PAS and 10 controls with similar gestational ages (35...

BACKGROUND: Given the accelerating opioid crisis in the United States and evidence that patients use less opioid than prescribed, surgeons may choose to decrease prescribed quantities. The effect this may have on patient satisfaction with pain control after hospital discharge is unknown. OBJECTIVE: The primary objective of this study was to compare patient satisfaction with postoperative pain control between patients receiving a routine or reduced quantity opioid prescription after prolapse repair...

OBJECTIVE: Chronic hypertension is associated with adverse perinatal outcomes, although the optimal treatment is unclear. The aim of this network meta-analysis is to simultaneously compare the efficacy and safety of antihypertensive agents in pregnant women with chronic hypertension. DATA SOURCES: Medline, Scopus, CENTRAL, Web of Science, Clinicaltrials.gov and Google Scholar databases were systematically searched from inception to 15 December 2019. STUDY ELIGIBILITY CRITERIA: Both randomized controlled trials (RCTs) and cohort studies were held eligible if they reported the effects of antihypertensive agents on perinatal outcomes among women with chronic hypertension...

Uterine fibroids are the most common benign pelvic tumors in women, with complications including heavy menstrual bleeding, pelvic pain, reproductive complications, and bulk-related symptoms. While the majority of uterine fibroids are asymptomatic, those suffering from symptoms can experience substantial burdens on quality of life and daily functioning. Comparative effectiveness reviews into available medical, surgical, and radiological treatments have found that a lack of high-quality data to inform treatment decisions is due, in part, to the use of heterogeneous outcomes and instruments in clinical studies...

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BACKGROUND: Long-term safety and efficacy data on use of single incision slings in stress urinary incontinence are limited. OBJECTIVE: Determine if the single incision sling Solyx (Boston Scientific, Marlborough, MA) is non-inferior to the transobturator sling Obtryx II (Boston Scientific, Marlborough, MA) in efficacy and safety for treatment of stress urinary incontinence. This 522 post-market surveillance study has been designed in response to an FDA request to evaluate improvement in stress urinary incontinence at 36 months following single incision sling compared to baseline, as well as provide an assessment of mesh-related complications and subject-reported outcomes, relative to the transobturator sling control...

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Iron is essential for the function of all cells through its roles in oxygen delivery, electron transport, and enzymatic activity. Cells with high metabolic rates require more iron and are at greater risk for dysfunction during iron deficiency. Iron requirements during pregnancy increase dramatically as the mother's blood volume expands and the fetus grows and develops. Thus, pregnancy is a condition of impending or existing iron deficiency, which may be difficult to diagnose because of limitations to commonly utilized biomarkers such as hemoglobin and ferritin concentrations...

No abstract text is available yet for this article.

OBJECTIVE: We sought to determine the costs and reimbursement associated with running a vaccine program in five obstetrics/gynecology (Ob/Gyn) practices in Colorado that had participated in a 3-year randomized, controlled trial focused on increasing vaccination in this setting. METHODS: This was a secondary analysis on costs from five clinics participating in a cluster-randomized controlled trial that assessed the effectiveness of a multimodal intervention to improve vaccination rates in outpatient Ob/Gyn clinics in central Colorado...

OBJECTIVE: The aspirin use in twin pregnancies for prevention of preeclampsia is a controversial topic and the evidence on the required dose of aspirin is scarce. We aimed to assess the efficacy of 75mg/day versus 150mg/day aspirin for prevention of preeclampsia in twin pregnancies. STUDY DESIGN: This is a retrospective cohort study of twin pregnancies managed at St. George's University Hospital between 2012 and 2019. The National Institute for Health and Care Excellence (NICE) guideline published in 2010 has recommended low-dose aspirin to women at high risk of preeclampsia...