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2 Minute Medicine ® - Obstetrics & Gynecology

Collection of high-impact paper summaries that have been hand-picked, written and peer-reviewed by practicing clinicians. Provides 2 minute summarization and application to bedside care. Updated weekly.

https://read.qxmd.com/read/101001737/osteoporosis-and-fracture-risk-increased-following-benign-hysterectomy-among-female-patients-in-korea
#21
SUMMARY
Soroush Nedaie, Alex Chan
1. This large retrospective cohort study found that female patients who underwent a hysterectomy with or without an adnexal surgical procedure had an increased osteoporosis risk compared with those without a hysterectomy. 2. Beyond 7 years, osteoporosis risk in the hysterectomy group without adnexal surgery was similar to the nonhysterectomy group, while the hysterectomy group with an adnexal procedure maintained an increased osteoporosis risk. 3. Despite the increased osteoporosis risk, hysterectomy with or without an adnexal surgical procedure was not associated with an increased fracture risk...
February 7, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001732/multifaceted-intervention-reduces-perinatal-morbidity-without-increasing-cesarean-rates
#22
SUMMARY
Neel Mistry, Teddy Guo
1. Best practices centred around supportive decisions and ultrasound evaluation of risk significantly reduced perinatal and maternal morbidity. 2. No difference in perinatal or maternal morbidity was seen between groups among patients who underwent elective Caesarean delivery. Evidence Rating Level: 1 (Excellent) Study Rundown : Women with a prior cesarean section face the dilemma of choosing between a repeat elective cesarean or attempting vaginal delivery, each associated with potential complications. This randomized controlled trial aimed to evaluate whether a multifaceted intervention, promoting patient-centred decision-making and best practices, could reduce major perinatal morbidity in women with a previous cesarean...
February 6, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001723/maternal-autistic-traits-may-be-associated-with-greater-risk-of-adverse-birth-outcomes
#23
SUMMARY
Jayden Berdugo, Alex Chan
1. A cohort study found that increased maternal autistic traits were associated with a greater risk of adverse birth outcomes. 2. Women who scored in the clinical range for AQ-J10 were more likely to be young and have higher levels of psychological distress. Evidence Rating Level: 1 (Excellent) Autism spectrum disorder (ASD) is a neurological and developmental disorder affecting individuals throughout their life and is characterized by different communication mechanisms and repetitive actions. Recent study findings have indicated that women with ASD may experience health challenges while pregnant, including inadequate access to care, chronic health conditions, higher stress levels and a greater risk of pregnancy complications...
February 4, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001719/low-dose-calcium-noninferior-to-high-dose-calcium-in-reducing-rates-of-pre-eclampsia
#24
SUMMARY
Junghoon Ko, Kiera Liblik
1. In two randomized, noninferiority trials, low-dose calcium in pregnant women with low dietary calcium intake was noninferior to high-dose supplementation in reducing the risk of pre-eclampsia.  2. Low-dose calcium was noninferior to high-dose calcium in reducing the risk of live preterm birth in the trial in India but not in Tanzania.  Evidence Rating Level: 1 (Excellent) Study Rundown: Hypertensive disorders of pregnancy, including preeclampsia, are one of the most common complications of pregnancy and are associated with an increased risk of preterm birth and death...
February 2, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001714/small-long-term-increased-risks-of-neurodevelopmental-deficits-for-infants-born-preterm
#25
SUMMARY
Jayden Berdugo, Alex Chan
1. Moderately or late preterm infants were found to have an increased risk of neurological outcomes at a median follow-up of 13 years.  Evidence Rating Level: 2 (Good) Preterm babies have greater risks of developing behavioural or neurological disabilities throughout their childhood compared to babies born at term. However, babies born moderately preterm (32-33 weeks) or late preterm (34-36 weeks) often go unstudied, despite them accounting for the majority of preterm births, which pose a huge burden on the healthcare system...
February 1, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001711/worse-breast-cancer-death-rates-for-non-screen-detected-ductal-carcinoma-situ
#26
SUMMARY
Jayden Berdugo, Alex Chan
1. Women with non-screen detected ductal carcinoma in situ had worse outcomes for the 25 years following their diagnosis. 2. When compared with surgery, mastectomies had better results at lowering the risks of invasive breast cancer. Evidence Rating Level: 2 (Good) A breast screening program developed by the National Health Service has contributed to the increased incidence of ductal carcinoma in situ. However, not all women with this type of cancer have been diagnosed through the screening program. A study examining outcomes of a population of 27543 women in England who had been diagnosed with non-screen detected ductal carcinoma in situ as their first cancer diagnosis...
January 31, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001695/perinatal-depression-associated-with-threefold-risk-of-suicidal-behaviour
#27
SUMMARY
Donika Yakoub, Alex Chan
1. Perinatal depression (PND) was found to be associated with a 3-fold increased risk for suicidal behaviours compared to a non-PND cohort at 18-year follow-up. 2. PND most significantly increased risk for suicidal behaviours for 1 year after diagnosis, with certain suicide methods being much more common than in the general population.  Evidence Rating Level: 2 (Good) Among several important public health issues is that of maternal mental health. Up to one-third of postnatal mortality has been attributed to maternal suicide, and thus, identifying at-risk groups for maternal suicide is thought to be a priority in prevention...
January 20, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001697/liquefied-petroleum-gas-stove-use-during-pregnancy-does-not-reduce-stunting-in-infants
#28
SUMMARY
Junghoon Ko, Kiera Liblik
1. In this randomized controlled trial, replacing biomass stoves with those using liquefied petroleum gas (LPG) during pregnancy did not reduce stunting in infants at one year despite reductions in household air pollution.  2. There was no appreciable difference in stunting in infants at six months between the biomass cookstove and liquefied petroleum gas cookstove groups.  Evidence Rating Level: 1 (Excellent) Study Rundown: Household air pollution is a significant environmental risk factor in low- and middle-income countries and arises from incomplete combustion of biomass fuels...
January 22, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001684/low-dose-prenatal-tobacco-and-alcohol-result-in-long-lasting-changes-on-electroencephalogram
#29
SUMMARY
Alex Chan
1. In this cohort study, children with low dose prenatal alcohol and tobacco exposure were found to have differences in electroencephalogram activity even at 11 years of age. 2. Males were particularly vulnerable to the effects of prenatal alcohol exposure compared to females.  Evidence Level Rating: 2 (Good) Tobacco and alcohol consumed during pregnancy have teratogenic effects on the fetus, even when consumed in low amounts. In this cohort study, researchers sought to further characterize the effects of PAE and PTE on neurodevelopment in childhood...
January 13, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001677/delayed-cord-clamping-reduces-mortality-in-infants-born-pre-term
#30
SUMMARY
Neel Mistry, Teddy Guo
1. Deferred (delayed) cord clamping significantly reduced mortality before discharge compared to immediate cord clamping. 2. Umbilical cord milking was not statistically different from immediate or deferred cord clamping. Evidence Rating Level: 1 (Excellent) Study Rundown: Umbilical cord clamping methods in preterm births can impact postnatal health outcomes. This systematic review and meta-analysis aimed to compare deferred cord clamping, umbilical cord milking, and immediate cord clamping for neonatal mortality and morbidity among infants with preterm births...
January 9, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001662/discontinuing-oxytocin-during-active-labour-has-no-significant-impact-on-neonatal-morbidity
#31
SUMMARY
Neel Mistry, Teddy Guo
1. Neonatal morbidity rate was comparable between the continuous oxytocin and discontinuous oxytocin groups. 2. There was no significant difference in adverse events between both groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Oxytocin is known for reducing labour duration but may pose risks for neonatal morbidity. In the multicenter STOPOXY trial, participants receiving oxytocin in early labour were randomly assigned to discontinuous or continuous administration. This randomized controlled trial aimed to assess the impact of discontinuing oxytocin during active labour on neonatal morbidity rate...
January 4, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001657/education-level-is-associated-with-prenatal-antidepressant-continuation-in-pregnant-women
#32
SUMMARY
Ashley Jackson
1. In this systematic review and meta-analysis, maternal education was significantly and positively associated with prenatal antidepressant continuation. 2. However, other social determinants of health, including race, relationship status, and income, were not significantly associated with prenatal antidepressant use and continuation. Evidence Rating Level: 1 (Excellent) Prenatal depression is very common in pregnancy and can be linked to post-partum depression and adverse outcomes in both the mother and child...
January 1, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001648/spirituality-has-contradictory-effects-on-coping-during-pregnancy
#33
SUMMARY
Ashley Jackson
1. In this systematic review, there were four main themes identified related to women’s experiences of social support during pregnancy: “a variety of emotional support,” “tangible and intangible instrumental support,” “traditional rituals and spiritual support,” and the “all-encompassing natal home.” 2. Although traditional rituals and spiritual support were associated with improved coping in some pregnant women, others found that spirituality was associated with increased stress. Evidence Rating Level: 1 (Excellent) Pregnancy can present several challenges for the expecting mother, including psychological distress, financial instability, and physical health issues...
December 25, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001641/statin-use-may-reduce-risk-of-venous-thromboembolism-in-women-taking-hormone-therapy
#34
SUMMARY
Rhianna Davis, Alex Chan
1. In this case-control study, the use of statins in menopausal women concurrently with hormone therapy (HT) significantly reduced the risk of VTE.  2. The response was dose-dependent, with high-intensity statins providing a higher reduction in VTE risk compared with low- to -medium intensity statins.  Evidence Rating Level: 3 (Average) Menopausal symptoms can have debilitating impacts on women’s quality of life, and although hormone therapy (HT) can be effective, concerns surrounding increased risk for complications (such as the doubled risk for VTE) are a barrier to the initiation of HT...
December 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001624/excess-gestational-weight-gain-may-result-in-increased-mortality-in-the-long-term
#35
SUMMARY
Neel Mistry, Teddy Guo
1. Among underweight mothers, weight gain in pregnancy above the recommendations was associated with increased cardiovascular mortality. 2. Gestational weight gain in mothers with normal weight was associated with increased all-cause and cardiovascular mortality but not diabetes-related mortality.  Evidence Rating Level: 2 (Good) Study Rundown: High pregnancy weight gain is linked to increased postpartum weight retention; however, the long-term effects on overall health are not well understood. The Collaborative Perinatal Project (CPP) investigated the association between gestational weight changes with mortality over 50 years since, until now, limited research has been conducted in this domain...
December 12, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001616/specific-viruses-may-be-associated-with-increased-risk-and-worse-outcomes-of-ovarian-cancer
#36
SUMMARY
Donika Yakoub, Alex Chan
1. This retrospective cohort study tested ovarian tumors for 113 viruses and found six viruses of interest (VOIs) that were present in one-quarter of tumors. 2. The presence of one of these VOIs was associated with a four-fold decrease in overall survival (OS) compared to those with any other viral strain or no viral strains. This finding did not apply to women above the age of 70, however. Evidence Rating Level: 2 (Good) Infectious agents are thought to cause just shy of one-fifth of cancer cases globally, and thus far, ovarian cancer is not known to have an infectious etiology...
December 8, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001601/high-dose-docosahexaenoic-acid-does-not-improve-behavioral-functioning-in-preterm-infants-at-5-years-of-age
#37
SUMMARY
Ellen Song, Christopher Prendergast
1. Docosahexaenoic acid supplementation at the in utero dose for infants born at less than 29 weeks gestation did not improve behavioral and emotional functioning at 5 years of age. 2. No differences in executive functioning or health were found between the children who had received high-dose docosahexaenoic acid and the children who had not. Evidence Rating Level:   2 (Good)        Study Rundown:   Following preterm birth, children are at increased risk of developing behavioral problems, neurobehavioral disability, impaired executive functioning, chronic disease, and poor quality of life...
November 29, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001579/mrna-sars-cov-2-vaccination-during-pregnancy-confers-greatest-protection-for-newborns
#38
SUMMARY
Alex Chan
1. In a retrospective cohort of Singaporean, maternal mRNA SARS-CoV-2 vaccination during pregnancy was associated with a 41.5% reduction in SaR-CoV-2 infection for infants aged 6 months or less. 2. Vaccination during pregnancy demonstrated a larger risk reduction for infants than vaccinations administered prior to pregnancy. Evidence Rating Level: 2 (Good) Analysis of population data suggests that infants aged 6 months or younger face an increased risk of severe SARS-CoV-2 infection compared to other age groups, representing a significant portion of COVID-19 hospitalizations during the Omicron-dominant waves...
November 19, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001560/extrauterine-placental-perfusion-and-oxygenation-in-infants-with-very-low-birth-weight
#39
SUMMARY
Soroush Nedaie, Alex Chan
1. This randomized clinical trial showed that  very low birth weight (VLBW) infants who received extrauterine placental perfusion (EPP) had similar postnatal hematocrit levels compared to those who received delayed cord clamping (DCC) 2. The EPP group demonstrated significantly higher postnatal peripheral and cerebral oxygenation.  Evidence Rating Level : 1 (Excellent) DCC for at least 30 seconds in preterm infants improves survival and reduces complications. These benefits may be attributed to adequate lung aeration before cord clamping, also known as physiological-based cord clamping...
November 11, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001532/global-preterm-birth-rates-unchanged-amid-rising-need-for-improved-data-in-high-burden-regions
#40
SUMMARY
Neel Mistry, Teddy Guo
1. Global preterm births have remained stable from 2010 to 2020 (13.4 million vs. 13.8 million). 2. A large proportion of preterm births occur at less than 32 weeks of gestation. Evidence Rating Level: 1 (Excellent) Study Rundown : Preterm birth is a leading cause of neonatal mortality, accounting for one-tenth of all live births in 2014. Addressing the global burden of preterm births is key to improving neonatal outcomes and preventing early childhood mortality. This systematic analysis aimed to update global preterm birth rates and trends, including estimated gestational age subgroups, to inform global health goals...
October 24, 2023: 2 Minute Medicine
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