To evaluate the association between maximum oxytocin dose and uterine rupture among individuals undertaking a trial of labor after cesarean (TOLAC). Secondarily, to evaluate the association between total time on oxytocin and time at maximum oxytocin dose and uterine rupture.

Clinical guidelines recommend avoiding cannabinoids, including cannabidiol (CBD), during pregnancy and lactation. Use of CBD is widespread, but prevalence in pregnancy and among women of reproductive age is not well documented. We conducted a cross-sectional analysis using data from the 2022 and 2023 National Survey on Drug Use and Health, with incorporation of survey sampling weights to estimate the prevalence of CBD use. Similar proportions of pregnant women and reproductive-aged women reported ever using CBD in 2022 (353.4 vs 365.1, respectively) and in 2023 (323.4 [95% CI, 259.2-387.6] vs 361.3 [95% CI, 353.6-367.0], respectively) per 1,000 population. More reproductive-aged women had used CBD within the past 30 days compared with pregnant women in 2022 (121.3 vs 43.9, respectively) and in 2023 (113.2 [95% CI, 107.4-118.9] vs 39.3 [95% CI, 16.2-62.4], respectively) per 1,000 population. Due to unknown effects of CBD during pregnancy and prevalent use, clinicians should screen for CBD use to facilitate counseling patients against use in pregnancy and while breastfeeding.

Effective communication between physicians and patients is the cornerstone of the patient -physician relationship. Effective communication practices can build positive relationships, enable sharing power, and lead to mutual trust. Moreover, effective patient -physician communication improves patient experiences and health outcomes. The building blocks of relationship-centered communication include acknowledgment of a patient's identity and experiences, clarity of information, patient activation and participation, knowledge-related power and authority, emotional proximity and shared experiences, and managing health care and relational goals. In practical terms, this translates to communication behaviors that demonstrate humility to close the patient -physician relationship distance and achieve effective communication, particularly for marginalized patient populations.

Fertility preservation is a critical consideration in the care of reproductive-aged patients with gynecologic cancers, yet referral to reproductive specialists remains low, indicating a gap between guidance and practice. We compared 28 clinical guidelines that addressed fertility-sparing management of endometrial, cervical, and ovarian cancers, and reviewed diagnostic workup, eligibility thresholds, surgical approaches, and surveillance protocols. Recommendations were synthesized into stage-specific pathways to delineate areas of consensus, highlight discrepancies, and map evidence gaps. There is broad agreement across multiple independent guidelines to support fertility-sparing treatment for carefully selected patients with: grade 1, stage IA endometrioid endometrial carcinoma; stage IA1-IB1 cervical tumors measuring less than 2 cm without high-risk features; and borderline ovarian tumors and most malignant germ cell tumors. Recommendations for higher stage disease and uncommon histologies, however, diverge and remain inconsistent. Overall guideline quality was moderate to high but frequently relied on limited evidence or expert opinion outside early-stage, low-risk conditions. Synthesizing current guidance clarifies areas where practice can be standardized and prospective data are needed. Embedding routine fertility counseling and referral into standardized pathways is an important step to improve uptake while maintaining oncologic safety and preserving fertility potential.

To characterize the presenting comorbidity profile of patients with uterine cancer by race and ethnicity and use real-world data to quantify expected effects of common comorbidity eligibility criteria on uterine cancer trial accrual.

To assess the safety of the respiratory syncytial virus prefusion F protein (RSVpreF) vaccine in pregnant women during the 2024-2025 French immunization campaign, with a particular focus on the risk of preterm birth.

Vector-borne diseases, including dengue, Zika virus, chikungunya, and Oropouche, pose significant health risks during pregnancy, with potential adverse outcomes for both mother and fetus. As a result of expanding vector habitats, there is increasing likelihood that obstetricians will encounter these illnesses in their clinical practice. This clinical guidance aims to provide evidence-based recommendations for the diagnosis and management of tropical vector-borne diseases in pregnant individuals, emphasizing clinical risk stratification based on epidemiologic risk factors. The clinical overlap with other obstetric syndromes such as intrauterine inflammation and infection underscores the importance of early detection to mitigate adverse pregnancy outcomes. Discussion of preventive measures, including vector control, the use of repellents, and vaccination, is included.

Chronic pelvic pain (CPP) is a complex and often debilitating condition that affects 15-26% of women worldwide. It is defined as pain perceived to originate from pelvic organs or structures that typically lasts longer than 6 months and is often associated with negative cognitive, behavioral, sexual, and emotional consequences. Chronic pelvic pain is not a single disease but rather a symptom with many potential causes, with most patients having multiple contributing conditions. This article provides an overview of the evaluation and management of CPP for obstetrician-gynecologists. We recommend an organ system-based approach to diagnosis, recognizing that any combination of gynecologic, gastrointestinal, musculoskeletal, urologic, neurologic, and vascular sources is a possible cause. Effective management integrates behavioral, pharmacologic, and surgical strategies tailored to the suspected pain mechanisms in each patient. Educating patients about pain physiology, including the interaction between peripheral pathology and central pain amplification, is essential. Although CPP is not always curable, patients can experience significant and meaningful improvement in pain, function, and quality of life through long-term interdisciplinary support. Establishing a strong therapeutic relationship, validating patients' experiences, and empowering patients to take an active role in their care are central to effective management. Shared decision making, collaborative goal setting, and establishing clear expectations support sustained engagement and functional improvement.

To assess the association between opioid exposure in the childbirth period and persistent postpartum opioid use and to evaluate whether there are differential associations based on specific medication exposure.

To evaluate whether there is an association between the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI) score and postpartum care attendance.

To evaluate referral patterns and care delay for the growing population of patients with limited English proficiency (LEP) who seek treatment with gynecologic oncologists.

To examine the receipt of screening, services, and counseling during prepregnancy reproductive health, prenatal care, and postpartum care visits by disability status among people with recent live births in the United States.

We conducted a statewide, retrospective cohort study to evaluate the association between maternal receipt of the respiratory syncytial virus (RSV) vaccine and preterm birth. All individuals who delivered a singleton neonate in Utah and were between 32 0/7 and 36 6/7 weeks of gestation from September 2023 to February 2024 were included and followed up until delivery. Overall, 2,733 of 24,213 individuals (11.3%) received the vaccine. Vaccine receipt was associated with lower odds of preterm birth (5.5% vaccinated group vs 6.8% unvaccinated group, adjusted odds ratio 0.80, 95% CI, 0.67-0.95). Receipt of the RSV vaccine was not associated with any adverse birth outcomes, including hypertensive disorders of pregnancy, low birth weight, or fetal or infant death. These findings support the safety of this vaccine in pregnancy, which is known to prevent neonatal severe lower respiratory tract disease.

To compare the efficacy of 162 mg vs 81 mg aspirin daily for the prevention of preterm preeclampsia (less than 37 weeks of gestation) or preeclampsia with severe features among pregnant people at high risk.