Symptom Documentation Before Antibiotics for Recurrent Urinary Tract Infections.

Importance: Documentation of symptoms in the medical record before prescribing antibiotics for urinary tract infection (UTI) could promote antibiotic stewardship.

Objective: The aim of this study was to describe the number and type of symptoms documented across specialties during encounters where an antibiotic was prescribed to older women with recurrent UTI.

Study Design: We conducted a retrospective cohort study of women aged 65 years or older with a diagnosis of recurrent UTI.

Cost of care associated with utilization of telehealth in clinical trials.

Objective: Due to COVID-19 pandemic restrictions, telehealth was incorporated into standard oncologic care and clinical trial operations. We sought to analyze whether telehealth changed cost of care compared to traditional clinical trial operations.

Methods: We conducted a retrospective cohort study of gynecologic oncology patients enrolled in therapeutic clinical trials at a National Cancer Institute designated center, comparing the cost of cancer care on trial pre-TELEhealth (9/30/2019 to 3/15/2020) versus during TELEhealth (3/16/2020 to 8/20/2020).

Subsequent pregnancies in peripartum cardiomyopathy: Patient-level differences and decision-making.

Study Objective: To evaluate patient-level differences and decision making surrounding subsequent pregnancies (SSP) after peripartum cardiomyopathy (PPCM).

Design: Mixed methods approach to evaluate quantitative demographic and clinical differences between patients with and without a SSP and to qualitatively describe the decision-making regarding a SSP with a survey component.

Setting/participants: 220 PPCM cases within the University of Pennsylvania Health System.

Adaptations to COVID-19 by US abortion clinics: Analysis of Society of Family Planning survey data.

Objective: Analyze changes in abortion practices during the early coronavirus disease 2019 (COVID-19) pandemic.

Study Design: Sites recruited by Society of Family Planning participated in a longitudinal descriptive analysis comprising three surveys between February and October 2020. Average monthly total and medication abortion volume was analyzed by χ and linear regression.

Exploring Reasons for Loss to Follow-up in Pregnancy of Unknown Location: A Mixed-Methods Study.

To quantify proportions of loss to follow-up in patients presenting with a pregnancy of unknown location and explore patients' perspectives on follow-up for pregnancy of unknown location. A pregnancy of unknown location is a scenario in which a patient has a positive pregnancy test but the pregnancy is not visualized on transvaginal ultrasound. We conducted a retrospective cohort study of patients with pregnancy of unknown location who presented to an urban academic emergency department or complex family planning outpatient office.

Telemedicine Follow-up After Medication Management of Early Pregnancy Loss.

Our objective was to evaluate the feasibility of a new protocol for telemedicine follow-up after medication management of early pregnancy loss. The study was designed to assess the feasibility of planned telemedicine follow-up after medication management of early pregnancy loss. We compared these follow-up rates with those after planned in-person follow-up of medication management of early pregnancy loss and planned telemedicine follow-up after medication abortion.

Multiplexed serum biomarkers to discriminate nonviable and ectopic pregnancy.

Objective: To evaluate combinations of candidate biomarkers to develop a multiplexed prediction model for identifying the viability and location of an early pregnancy. In this study, we assessed 24 biomarkers with multiple machine learning-based methodologies to assess if multiplexed biomarkers may improve the diagnosis of normal and abnormal early pregnancies.

Design: A nested case-control design evaluated the predictive ability and discrimination of biomarkers in patients at risk of early pregnancy failure in the first trimester to classify viability and location.

Cost-effectiveness analysis of expectant vs active management for treatment of persistent pregnancies of unknown location.

Background: Persistent pregnancies of unknown location are defined by abnormally trending serum human chorionic gonadotropin with nondiagnostic ultrasound. There is no consensus on optimal management.

Objective: This study aimed to assess the cost-effectiveness of 3 primary management strategies for persistent pregnancies of unknown location: (1) expectant management, (2) empirical 2-dose methotrexate, and (3) uterine evacuation followed by methotrexate, if indicated.

Outcomes After Induction of Labor Compared With Dilation and Evacuation for the Management of Rupture of Membranes in the Second Trimester.

Previable and periviable rupture of membranes is associated with significant morbidity for the pregnant patient. For those who have a choice of options and undergo active management, it is not known how the risks of induction of labor compare with those for dilation and evacuation (D&E). We performed a retrospective cohort study of patients with rupture of membranes between 14 0/7 and 23 6/7 weeks of gestation who opted for active management.

Impact of coronavirus disease 2019 vaccination on live birth rates after in vitro fertilization.

Objective: To investigate coronavirus disease 2019 (COVID-19) vaccination on the live birth rates in patients who underwent in vitro fertilization.

Design: Retrospective cohort study.

Setting: Academic fertility practice.

Evaluation of novel biomarkers for early pregnancy outcome prediction†.

Objective: To assess performance and discriminatory capacity of commercially available enzyme-linked immunosorbent assays of biomarkers for predicting first trimester pregnancy outcome in a multi-center cohort.

Design: In a case-control study at three academic centers of women with pain and bleeding in early pregnancy, enzyme-linked immunosorbent assays of biomarkers were screened for assay performance. Performance was assessed via functional sensitivity, assay reportable range, recovery/linearity, and intra-assay precision (%Coefficient of Variation).

Telehealth utilization in gynecologic oncology clinical trials.

Objective: Prior to the COVID-19 pandemic, telehealth visits and remote clinical trial operations (such as local collection of laboratory tests or imaging studies) were underutilized in gynecologic oncology clinical trials. Current literature on these operational changes provides anecdotal experience and expert opinion with few studies describing patient-level safety data. We aimed to evaluate the safety and feasibility of telehealth and remote clinical trial operations during the COVID-19 Pandemic.

Telephone-Based Intervention to Improve Family Planning Care in Pregnancies of Unknown Location: Retrospective Pre-Post Study.

Background: Patients followed for a pregnancy of unknown location are generally followed by a team of clinicians through telephone calls, and their contraceptive needs at the time of pregnancy resolution may not be addressed.

Objective: This study aimed to assess contraceptive counseling and contraceptive uptake before and after a telephone-based intervention.

Methods: This was a retrospective pre-post study assessing pregnancy intendedness in patients with a pregnancy of unknown location and the proportion of patients who received contraceptive counseling and a contraceptive prescription before and after the initiation of a telephone-based intervention.

Application of a Multiplex Platform to Identify Novel Biomarkers for Pregnancy Location and Viability.

Determining early pregnancy location and viability can be cumbersome, often requiring serial evaluations. This study aimed to identify novel biomarker candidates for pregnancy location and viability using a pseudodiscovery high-throughput technique. This was a case-control study among patients presenting for early pregnancy assessment, including ectopic pregnancies, early pregnancy losses, and viable intrauterine pregnancies.

Race, ovarian responsiveness, and live birth after in vitro fertilization.

Objective: To determine if ovarian responsiveness to gonadotropin stimulation differs by race/ethnicity and whether this predicts live birth rates (LBRs) in non-White patients undergoing in vitro fertilization (IVF).

Design: Retrospective cohort study.

Setting: Academic infertility center.

Elevated antimüllerian hormone levels are not associated with preterm delivery after in vitro fertilization or ovulation induction.

Objective: To investigate the association between antimüllerian hormone (AMH) and preterm birth risk in a larger cohort of patients who underwent either in vitro fertilization or ovulation induction with intrauterine insemination at a US academic fertility center.

Design: Retrospective cohort study.

Setting: Single academic fertility center.

Outcomes of assisted reproductive technology procedures performed on weekdays versus weekends: a retrospective cohort study.

Purpose: To evaluate if assisted reproductive technology (ART) outcomes are different based on whether procedures - oocyte retrieval, insemination, embryo biopsy, or embryo transfer - are performed on a weekday versus weekend/holiday.

Methods: Retrospective cohort study of all patients ≥ 18 years old who underwent oocyte retrieval for in vitro fertilization or oocyte banking (n = 3,197 cycles), fresh or natural-cycle frozen embryo transfers (n = 1,739 transfers), or had embryos biopsied for pre-implantation genetic testing (n = 4,568 embryos) in a large academic practice from 2015-2020. The primary outcomes were as follows: oocyte maturity for oocyte retrievals; fertilization rate for insemination; rate of no result on pre-implantation genetic testing for embryo biopsy; and live birth rate for embryo transfers.

Application of a Multiplex Platform to Identify Novel Biomarkers for Pregnancy Location and Viability.

Determining early pregnancy location and viability can be cumbersome, often requiring serial evaluations. This study aimed to identify novel biomarker candidates for pregnancy location and viability using a pseudodiscovery high through-put technique. This was a case-control study among patients presenting for early pregnancy assessment, including ectopic pregnancies, early pregnancy losses, and viable intrauterine pregnancies.