Open access

Gynecology & Obstetrics

Caesarean section is better for extremely premature breech babies but not necessarily for their mothers – NIHR Signal (free)

“Delivering extremely preterm breech babies (23 to 27 weeks) by caesarean reduced the risk of infant death or brain bleeds by around 40%, compared with vaginal delivery”. (RT @NIHR_DC see Tweet)


Aerobic exercise moderately reduces depressive symptoms in new mothers – NIHR Signal (free)

Original article: Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis – British Journal of General Practice (free)

“Involving new mothers in group exercise programmes, or advising them on an exercise of their choice, reduced depressive symptoms compared with usual care” (RT @NIHR_DC see Tweet)


Debate: the case for and against screening for breast cancer with mammography

The case for mammography: Routine mammograms do save lives: The Science – The Conversation (free)

The case against mammography: Routine mammograms do not save lives: The research is clear – The Conversation (free)

Related: Make Screening Mammography Personal, Say the French – Medscape (free registration required)

“The debate over breast cancer screening continues, with disagreements about the start age, frequency, mortality effect, overdiagnosis, and overtreatment” (from Medscape)


Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis – The BMJ (free)

“Women with antithrombin, protein C, or protein S deficiency or with homozygous factor V Leiden should be considered for antepartum or postpartum thrombosis prophylaxis, or both”.


Comparison of recommendations for screening mammography using CISNET models – Cancer (link to abstract – $ for full-text)

Commentaries: Three questions to ask about calls to widen breast cancer screening – The Conversation (free) AND Comparison of Screening Recommendations for Mammography – ASCO Post (free)

Canadian Task Force on Preventive Health Care: Risks & Benefits, Age 40–49 (free) AND Risks & Benefits, Age 50–69 (free) AND Risks & Benefits, Age 70–74 (free) AND Full Guideline and Resources (free)

This article had a lot of attention from the media and suggests an annual screening starting at age 40 would prevent more breast cancer deaths. But screening has potential harms. For a clearer picture of the benefits and harms of screening in this context have a look at The Conversation commentary above and the infographics from the Canadian Task Force.


China’s embrace of embryo selection raises thorny questions – Nature News (free)

“Fertility centres are making a massive push to increase preimplantation genetic diagnosis in a bid to eradicate certain diseases”.


Accuracy of combinations of visual inspection using acetic acid or lugol iodine to detect cervical precancer: a meta-analysis – BJOG (link to abstract – $ for full-text)

Source: ACP Journal Wise ($)

“Although imperfect, VILI (Lugol’s iodine) alone appeared to be the most useful visual screening strategy”.


The Risk of Adverse Pregnancy Outcomes Following Nonobstetric Surgery During Pregnancy: Estimates From a Retrospective Cohort Study of 6.5 Million Pregnancies – Annals of Surgery (free)

Source: Journal Watch ($)

“we found that the risk associated with nonobstetric surgery was relatively low, confirming that surgical procedures during pregnancy are generally safe”


Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis – PLOS One (free)

This systematic review and meta-analysis mostly of observational studies suggests early breastfeeding initiation is associated with increased survival. The authors acknowledge that there are many reasons for delayed breastfeeding initiation that may confound the relationship between breastfeeding initiation and mortality, but remember that randomized trials would not be considered ethical, so we must rely on high quality observational data. Based on their analysis, the authors suggest the implementation of programs that emphasize the importance of early initiation of breastfeeding, in addition to promoting exclusive breastfeeding.


Risk of Stroke With Various Types of Menopausal Hormone Therapies: A National Cohort Study – Stroke (link to abstract – $ for full-text)

Source: EvidenceAlerts

This large cohort confirms an increased stroke risk with oral hormone therapies, but suggests no increased risk of stroke with transdermal or vaginal estrogen application.


Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth – Obstetrics & Gynecology (free)

Commentaries: Sleep Disorders in Pregnancy Linked to Preterm Birth – Medscape (free registration required) AND Insomnia linked to premature birth in study of 3 million mothers – Nature News (free)

“Women with sleep disorders were about twice as likely to deliver babies more than six weeks early” (from Nature News)


Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial – The Lancet (link to abstract – $ for full-text)

“Benefit of adding bevacizumab to CT for cervical cancer is sustained: OS curves remain separated with ext. follow-up” and “Unfortunately though bevacizumab is out of reach of many patients living in #LMICs” (RT @oncology_bg see Tweets)


Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel (free)

“For most people, treatment was not beneficial and may be harmful. Antibiotic treatment did appear to benefit women in pregnancy and those about to undergo urological surgery”.


Sexual Health

3 Aug,2017

A Dangerous, “Silent Reservoir” For Gonorrhea: The Throat – The New York Times (10 articles per month are free)

See related WHO report on the rising of “Untreatable Gonorrhea” in our July 10th issue (see #1)

“Drug-resistant gonorrhea is increasing. Now scientists say the epidemic is being driven by oral sex”. (RT @NYTHealth see Tweet)


Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease – Obstetrics & Gynaecology (free PDF)

Commentaries: Emergency Visits Common After Hysterectomy, Study Finds – Medscape (free registration required) AND ~10 Percent Present to ER After Hysterectomy for Benign Disease – Physician’s Briefing (free)
“Risk factors include younger age, higher parity, Medicare or self-pay insurance, postoperative pain” (from Physician’s Briefing)


Keeping Our Promise to 120 Million Women and Girls – Bill & Melinda Gates Foundation (free)

“Our goal: access to contraceptives for every woman, everywhere.” (RT @melindagates see Tweet)


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