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Adenomyosis is a clinical condition where endometrial glands are found in the myometrium of the uterus. One in three patients with adenomyosis is asymptomatic, but the rest may present with heavy menstrual bleeding, pelvic pain, or infertility. Heavy menstrual bleeding is the most common symptom. Ad...
Jun 1, 2021 Issue
Pessaries for Managing Pelvic Organ Prolapse in Women [Cochrane for Clinicians]
Pessaries combined with pelvic floor muscle training (PFMT) probably improve pelvic organ prolapse symptoms in women and prolapse-specific quality of life compared with PFMT alone.
Medication management of early pregnancy loss and medication abortion has become increasingly common. Medication abortion now accounts for 60% of all abortions completed before 10 weeks’ gestation. Mifepristone (Mifeprex) and misoprostol (Cytotec) are safe and effective for outpatient treatment of early pregnancy loss for up to 84 days’ gestation and for medication abortion up to 77 days’ gestation. The most effective regimens include 200 mg of oral mifepristone followed by 800 mcg of misoprostol administered buccally or vaginally.
Feb 1, 2021 Issue
Screening for Cervical Intraepithelial Neoplasia with Patient-Collected HPV Samples [FPIN's Clinical Inquiries]
How useful are patient-collected human papillomavirus vaginal swabs as a screening test for cervical intraepithelial neoplasia?
Bleeding decreased over time for most women after the insertion of a levonorgestrel-releasing intrauterine system.
Vaginal, oral, and sublingual misoprostol in single doses of 600 to 800 mcg are equally effective for promoting completed abortion in patients with an incomplete first-trimester spontaneous abortion.
Jul 15, 2020 Issue
Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends against screening for bacterial vaginosis in pregnant persons who are not at increased risk for preterm delivery.
Endometrial biopsy is a safe and efficient method to evaluate the endometrium. The biopsy is performed using a catheter that is inserted through the cervix into the uterine cavity. Cramping is a common adverse effect, and complications are rare. Patients should be referred for further evaluation if the procedure fails or an insufficient sample is obtained.
Topical lidocaine preparations including gels, creams, and sprays may modestly decrease pain with tenaculum placement but not during IUD insertion.
Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.