Contemporary OB/GYN week in review: IUD placement, UTI misinformation, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, November 18 - Friday, November 22, 2024), and click each link to read and watch anything you may have missed.

Reduced pain during IUD placement found when using mepivacaine

During intrauterine device (IUD) placement, nulliparous women experience a significant reduction in pain when utilizing intrauterine instillation of mepivacaine, according to a recent study published in the American Journal of Obstetrics & Gynecology.

There were 141 participants in the intention-to-treat (ITT) analysis and 124 in the per the protocol (PP) analysis. Demographic characteristics did not significantly differ between groups, and the mean visual analog scale (VAS) score during the most intense cramping during menstruation was 50.7 mm in the mepivacaine group vs 55.1 mm in the placebo group.

The mepivacaine group had a reduced mean VAS pain score during IUD placement compared to the placebo group in the ITT analysis, at 53.9 mm vs 67.2 mm, respectively. This indicated an absolute difference of 13.3 mm. A mean reduction in the VAS pain score of 12.2 mm was reported for the intervention.

Click here for the full article.

Online misinformation about UTIs and ASB reported

There is significant variation in the quality of information about urinary tract infections (UTIs) and asymptomatic bacteriuria on the internet, according to a recent study published in JAMA Network Open.

There were 331 websites included in the final analysis, 97% of which mentioned at least 1 accurate UTI symptom and 80% mentioned at least 1 inaccurate UTI symptom. A change in urine color was the most common inaccurate symptom, mentioned by 74% of websites. This was followed by strong-smelling urine by 69%.

The term asymptomatic bacteriuria was only mentioned by 9% of websites, and only 3% mentioned the requirement of symptoms being present to diagnose a true UTI. The possibility of antibiotic resistance on an individual level was mentioned by only 21%, with only 9% mentioning the possibility of global antibiotic resistance and 8% adverse reactions of antibiotics.

Click here for the full article.

Early preterm birth risk linked to low PlGF levels during pregnancy screening

The risk of early preterm birth may be identified based on low placental growth factor (PlGF) level during routine gestational diabetes screening.

To determine the efficacy of maternal circulating PlGF at a midpregnancy screening test as a predictor of early preterm birth, investigators conducted a single-center, prospective cohort study. Participants included women aged at least 18 years with singleton pregnancy receiving care from obstetricians, midwives, or family physicians at Mount Sinai Hospital.

The area under the curve of PlGF was 0.80 for early preterm birth, with an optimal PlGF threshold of 290 pg/mL identified by the Youden Index. This indicated a sensitivity of 64.7%, specificity of 87.9%, positive predictive value of 8.6%, and negative predictive value of 98.9%.

Click here for the full article.

Improved maternal cardiac arrest management reported from Obstetric Life Support training

Management of maternal cardiac arrest (MCA) among health care providers is significantly improved by Obstetric Life Support (OBLS) education, according to a recent study published in JAMA Network Open.

Participants were assigned 1:1 to receive either OHS education or no education, with randomization stratified by hospital status. Cognitive and confidence evaluations were performed at enrollment for individuals in the OHS arm, alongside additional evaluations after intervention time, 6 months after enrollment, and 12 months after enrollment.

The intervention group had a higher mean cognitive score compared to the control group, at 79.5% vs 63.4%, respectively. Similarly, megacode scores were 91% vs 61%, respectively, indicating a significant increase among patients receiving the intervention.

Click here for the full article.

Reproductive genetic carrier screening: A tool for reproductive decision-making

Couple-based reproductive genetic carrier screening is an accessible and effective method of reproductive decision making, according to a recent study published in the New England Journal of Medicine.

Low odds of having a child with a genetic condition were reported in 96.1% of couples who received reproductive genetic carrier screening, while new identification of an increased chance was reported in 1.9% and knowledge prior to screening in 2%. Of the 180 couples with knowledge prior to the screening, 4 learned about an increased risk of a different condition.

Of newly identified couples with current pregnancy when receiving the result, 64% had the fetus genetically tested, with 24 of these 29 couples receiving normal test results. In impacted pregnancy was found in 5, with 4 deciding to terminate the pregnancy.

Click here for the full article.