Obstetrical & Gynecological Survey

Interventions to Prevent Perinatal Depression: Evidence Report and Systematic Review for the US Preventive Services Task Force (Abstracted from JAMA 2019;321(6):588–601) Perinatal depression is a common condition that was estimated in 2012 to affect more than 180,000 new mothers (11.5%) annually in the United States and that can have serious impact on mother and infant well-being. Numerous interventions have been proposed to prevent perinatal depression, but there is no commonly agreed-on prevention method, creating a scenario with substantial variation in clinical practice.

Pregnancy Outcome After First Trimester Exposure to Ionizing Radiations (Abstracted from Eur J Obstet Gynecol Repr Biol 2019;232:18–21) Exposure to ionizing radiation during pregnancy induces anxiety for both pregnant patients and their practicing physicians. The effects of radiation exposures can be classified as deterministic and stochastic.

Prepregnancy and Early Pregnancy Calcium Supplementation Among Women at High Risk of Pre-eclampsia: A Multicentre, Double-blind, Randomised, Placebo-Controlled Trial (Abstracted from Lancet 2019;393:330–339) Hypertension complicates 5% of all pregnancies and 11% of first pregnancies, and half of these cases are associated with preeclampsia (gestational hypertension plus proteinuria). Hypertensive disorders of pregnancy are the direct cause of death of approximately 30,000 women annually, or approximately 14% of maternal deaths, most of which occur in low-income countries.

The Frequency of Intrapartum Caesarean Section Use With the WHO Partograph Versus Zhang's Guideline in the Labour Progression Study (LaPS): A Multicentre, Cluster-Randomised Controlled Trial (Abstracted from Lancet 2019;393:340–348) The rate of cesarean sections is increasing worldwide and is a great concern because of its association with adverse outcomes for mothers and babies, the more than 50% risk for a subsequent cesarean section, and the increase in costs of labor care. Assessment and identification of labor progression and prolonged labor, denoted as true labor dystocia and often caused by inadequate contractions or obstructed labor, have profound effects on labor management and intrapartum cesarean section (ICS) use, because labor dystocia is the main indication for an ICS.

Hospital Variation in Utilization and Success of Trial of Labor After a Prior Cesarean (Abstracted from Am J Obstet Gynecol 2019;220:98.e1–98.e14) The rate of cesarean delivery in the United States has increased from 20.7% in 1996 to 31.9% in 2016. Cesarean delivery places the mother and fetus at increased risk of morbidities such as surgical injuries, maternal thromboembolic and anesthesia complications, and neonatal respiratory distress.

Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome (Abstracted from JAMA 2019;321(4):385–393) Neonatal abstinence syndrome (NAS) has increased over the last 2 decades, likely related to the increase in opioid use in the United States from 1999 to 2014. The increased use of opioid analgesics, heroin, and fentanyl, associated with increased opioid overdose death rates, has severely impacted poor, rural counties, where residents are at risk because they have poor access to health care and other economic and social opportunities.

Non-invasive Prenatal Sequencing for Multiple Mendelian Monogenic Disorders Using Circulating Cell-free Fetal DNA (Abstracted from Nat Med 2019;25:439–447) Noninvasive prenatal screening has focused on the detection of chromosomal abnormalities in the fetus. At present, screening for many dominant monogenic disorders associated with de novo mutations is not available, despite their relatively high incidence.

Advanced Paternal Age, Infertility, and Reproductive Risks: A Review of the Literature (Abstracted from Prenat Diagn 2019;39:81–87) Advanced paternal age (APA) is associated with infertility and other reproductive risks. Studies looking at APA and outcomes have used different paternal age cutoffs, which has complicated systematic evaluations of reproductive risk associated with paternal aging.

Vaginoscopy Against Standard Treatment (VAST): A Randomised Controlled Trial (Abstracted from BJOG 2019;126:891–899) Hysteroscopy is one of the most commonly used tests in gynecology. It is used in the diagnosis of abnormal bleeding, reproductive problems, and endometrial cancer.

Gaining the Patient Perspective on Pelvic Floor Disorders' Surgical Adverse Events (Abstracted from Am J Obstet Gynecol 2019;220:185.e1–185.e10) Surgical adverse events (AEs) following urogynecological surgery are common. The incidence of any AEs in surgical studies ranges from 30% to 76%, and serious AEs range from 3% to 17%.

Alexandros Sfakianakis
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alsfakia@gmail.com